Chronobiology – How Circadian Rhythms Can Control Your Health & Weight

Chronobiology – How Circadian Rhythms Can Control Your Health & Weight
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Given the power of chronotherapy—how the same dose of the same drugs taken at a different time of day can have such different effects—it’s no surprise that chronoprevention approaches, like meal timing, can also make a difference.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The 2017 Nobel Prize in Medicine was awarded for elucidating the molecular mechanisms of our internal circadian clock. For billions of years, life on Earth evolved to a 24-hour cycle of light and dark, and so, it’s no surprise our bodies are finely tuned to that pattern. But put people in total darkness without any external time cues, and our body still continues to cycle in about a 24-hour “circadian” rhythm. In fact, you can even take tissue biopsies from people and show the cells continue to cycle outside the body in a petri dish. Nearly every tissue and organ in our body has its own internal clock.

An intricate system of intrinsic clocks drives not only some of our behavioral patterns, such as eating, fasting, sleeping, and wakefulness, but our internal physiology—our body temperature, blood pressure, hormone production, digestion, and immune activity. Most of the genes in our body exhibit daily fluctuations in expression, making the circadian rhythm the largest known regulatory system in our body. This cycling is thought to allow for a level of predictability and functional division of labor so each of our body processes can run at the best time. At night while we’re sleeping, a whole array of internal housekeeping activities can be switched on, for example, and as dawn approaches, our body can shift back into activity mode.

Anyone who’s ever had jet lag knows what throwing our cycle even just a few hours off can do, but now we know our circadian rhythms can literally be the difference between life and death. A study of more than 14,000 self-poisonings found that those who tried committing suicide in the morning were more than twice as likely to die than those who ingested the same dose in the evening. In the same vein, properly timed chemotherapy can not only end up being five times less toxic, but also twice as effective against cancer. The same drugs, at the same dose, but different effects depending on the time that they’re given. Our body absorbs, distributes, metabolizes, and eliminates what we ingest differently depending on when it is during the 24-hour cycle.

We’re just beginning to figure out the optimal timing for different medications. Randomize people suffering from hypertension into taking their blood pressure pills at bedtime instead of in the morning, and not only does the bedtime group achieve better blood pressure control and suffer fewer heart attacks and strokes, but cuts their risk of death in half (yet most physicians and pharmacists tell patients to take them in the morning, potentially doubling their risk of death). If chronotherapy—the optimal timing of drugs—can have such an impact, maybe it should come as no surprise that chronoprevention—the scheduling of lifestyle interventions like mealtimes—can also make a difference.

In the official Academy of Nutrition and Dietetics position paper on effective treatments for obesity, importance is placed not only on the quantity, but timing of calorie intake, suggesting that consuming more calories “earlier in the day, rather than later in the day can assist with weight management.” Some have gone further and even characterized obesity as a “chronobiological” disease. What evidence do we have to back up these kinds of claims?

Well, the timing of calorie intake may have shifted slightly over the last few decades towards a greater proportion of food later in the day, which raised the question about a possible role in the rise of obesity. Middle-aged men and women who eat a greater share of daily calories in the morning do seem to gain less weight over time, and a study entitled “Timing of food intake predicts weight loss effectiveness” found that dieters eating their main meal earlier in the day seemed to steadily lose more weight than those eating their main meal later.

The obvious explanation for these findings would just be that those who eat later also tend to eat more. And there does seem to be a relationship between when people eat most of their calorie intake and how many calories they end up eating over the entire day, with those eating a greater proportion in the morning eating less overall. Maybe later eaters are overeating junk on the couch watching primetime TV? A tendency has been found for night owls to eat more fast food, soda, and fewer fruits and vegetables. In the field of social psychology, there’s a controversial concept called “ego depletion,” where self-control is viewed as a limited resource like a muscle that can become fatigued from overuse. As the day wears on, the ability to resist unhealthy food choices may decline, leaving one vulnerable to temptation. So, is it just a matter of later eating leading to greater eating?

Remember this study where earlier eaters steadily lost more weight? To their surprise, the early eaters were eating as much as the late eaters despite the difference in weight loss magnitude. The early eaters ended up about five pounds lighter than the late eaters by the end of the 20-week study, even though they were apparently eating the same amount of food. There didn’t seem to be any difference in physical activity between the two groups either. Could it be that just the timing itself of calorie intake matters? Scientists decided to put it to the test, which we’ll cover next.

Please consider volunteering to help out on the site.

Image credit: Jan Vašek via pixabay. Image has been modified.

Video production by Glass Entertainment.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The 2017 Nobel Prize in Medicine was awarded for elucidating the molecular mechanisms of our internal circadian clock. For billions of years, life on Earth evolved to a 24-hour cycle of light and dark, and so, it’s no surprise our bodies are finely tuned to that pattern. But put people in total darkness without any external time cues, and our body still continues to cycle in about a 24-hour “circadian” rhythm. In fact, you can even take tissue biopsies from people and show the cells continue to cycle outside the body in a petri dish. Nearly every tissue and organ in our body has its own internal clock.

An intricate system of intrinsic clocks drives not only some of our behavioral patterns, such as eating, fasting, sleeping, and wakefulness, but our internal physiology—our body temperature, blood pressure, hormone production, digestion, and immune activity. Most of the genes in our body exhibit daily fluctuations in expression, making the circadian rhythm the largest known regulatory system in our body. This cycling is thought to allow for a level of predictability and functional division of labor so each of our body processes can run at the best time. At night while we’re sleeping, a whole array of internal housekeeping activities can be switched on, for example, and as dawn approaches, our body can shift back into activity mode.

Anyone who’s ever had jet lag knows what throwing our cycle even just a few hours off can do, but now we know our circadian rhythms can literally be the difference between life and death. A study of more than 14,000 self-poisonings found that those who tried committing suicide in the morning were more than twice as likely to die than those who ingested the same dose in the evening. In the same vein, properly timed chemotherapy can not only end up being five times less toxic, but also twice as effective against cancer. The same drugs, at the same dose, but different effects depending on the time that they’re given. Our body absorbs, distributes, metabolizes, and eliminates what we ingest differently depending on when it is during the 24-hour cycle.

We’re just beginning to figure out the optimal timing for different medications. Randomize people suffering from hypertension into taking their blood pressure pills at bedtime instead of in the morning, and not only does the bedtime group achieve better blood pressure control and suffer fewer heart attacks and strokes, but cuts their risk of death in half (yet most physicians and pharmacists tell patients to take them in the morning, potentially doubling their risk of death). If chronotherapy—the optimal timing of drugs—can have such an impact, maybe it should come as no surprise that chronoprevention—the scheduling of lifestyle interventions like mealtimes—can also make a difference.

In the official Academy of Nutrition and Dietetics position paper on effective treatments for obesity, importance is placed not only on the quantity, but timing of calorie intake, suggesting that consuming more calories “earlier in the day, rather than later in the day can assist with weight management.” Some have gone further and even characterized obesity as a “chronobiological” disease. What evidence do we have to back up these kinds of claims?

Well, the timing of calorie intake may have shifted slightly over the last few decades towards a greater proportion of food later in the day, which raised the question about a possible role in the rise of obesity. Middle-aged men and women who eat a greater share of daily calories in the morning do seem to gain less weight over time, and a study entitled “Timing of food intake predicts weight loss effectiveness” found that dieters eating their main meal earlier in the day seemed to steadily lose more weight than those eating their main meal later.

The obvious explanation for these findings would just be that those who eat later also tend to eat more. And there does seem to be a relationship between when people eat most of their calorie intake and how many calories they end up eating over the entire day, with those eating a greater proportion in the morning eating less overall. Maybe later eaters are overeating junk on the couch watching primetime TV? A tendency has been found for night owls to eat more fast food, soda, and fewer fruits and vegetables. In the field of social psychology, there’s a controversial concept called “ego depletion,” where self-control is viewed as a limited resource like a muscle that can become fatigued from overuse. As the day wears on, the ability to resist unhealthy food choices may decline, leaving one vulnerable to temptation. So, is it just a matter of later eating leading to greater eating?

Remember this study where earlier eaters steadily lost more weight? To their surprise, the early eaters were eating as much as the late eaters despite the difference in weight loss magnitude. The early eaters ended up about five pounds lighter than the late eaters by the end of the 20-week study, even though they were apparently eating the same amount of food. There didn’t seem to be any difference in physical activity between the two groups either. Could it be that just the timing itself of calorie intake matters? Scientists decided to put it to the test, which we’ll cover next.

Please consider volunteering to help out on the site.

Image credit: Jan Vašek via pixabay. Image has been modified.

Video production by Glass Entertainment.

Motion graphics by Avocado Video.

Doctor's Note

Wasn’t that chemo data wild? Amazing! And if you are on blood pressure medications, please share this video with your physician to ask to see if your timing is optimized.

We kicked off this chronobiology series by looking into the importance of breakfast when it comes to weight loss: Is Breakfast the Most Important Meal for Weight Loss? and Is Skipping Breakfast Better for Weight Loss?

I didn’t want it to be all chrono all the time in case there are some people uninterested in the topic, explaining, for example, why the previous video was an unrelated topic (The Effects of Hormones in Milk on Infertility in Women). I’ll keep doing that interspersing back and forth, but here’s the list of the rest of this punctuated series still to come:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

113 responses to “Chronobiology – How Circadian Rhythms Can Control Your Health & Weight

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  1. Hello Dr Greger,

    I would like to ask about your opinion regards a hernia operation. I’ve got a small hernia above my belly button and I’m booked for an op at the end of the month. But it hasn’t been really bothering me recently and I started thinking do I really need this intervention? Is there another way of recovering and dealing with this ?

    Recently BBC published an article about people became disabled after hernia operation and the fact that some kind of mesh has been tested to rabbits only for ten days and it just doesn’t sound very tempting to put my body through weeks pain if I don’t have any at the moment.

    My GP says small hernias are more dangerous.

    I am really confused and not sure what to do. Although would prefer to cancel the op….

    But I really value your opinion.

    Thank you for your time. Much appreciated.

    1. Hello Nina,
      I am a family doctor and also a volunteer for Dr. Greger on this website. Not knowing your exact situation makes it very difficult to give good advice on the internet. To name just a few factors that might influence my advice: your age, whether you’re overweight, whether you have any chronic medical conditions, what medications you take.

      A hernia is a place in your body where one of your organs (usually intestines) pushes through a weak place in your body wall (i.e. muscle and connective tissue). This is more common with aging, and with physical de-conditioning. The danger your doctor was talking about is that it’s possible for a hernia to become “strangulated”: in your case this would be where your intestines get squeezed by the tissue they’ve pushed through, to the point where the blood supply to that piece of intestines gets compromised, which can result in the need for emergency surgery.

      However, the chance that an umbilical or abdominal hernia gets strangulated is very small, even if it’s a small hernia. If your hernia is not causing any symptoms, there is no big rush. If you are feeling unsure about doing this, I recommend that you get a second opinion.

      I hope this helps.
      Dr.Jon
      PhysicianAssistedWellness.com
      Health Support Volunteer for NutritionFacts.org

    2. Nina, I got a hernia back in 2013, between my groin and belly button, to the left. I searched on the Internet for alternative therapies. I only found one account, of a German man who self-treated his hernia. He lightly rubbed the area surrounding the protrusion and visualized it healing. He may have also worn a pad that applied light pressure on it. I was a perfectly fit 51 year old back in 2013. My hernia resulted from me trying to protect my lower back, which was inflamed from eating carrots the day before (I am allergic to carrots), and lifting a bank of heavy solar power batteries in an odd way. The following morning, my hernia appeared. I replicated the German fellow’s treatment of wearing a light pressure pad, lightly rubbing the area surrounding the hernia, and visualizing it retracting. Over a period of 18 months or so, my hernia completely healed. I never had strangulation or any other complication. I think my excellent health — including normal weight and good exercise routine — played a major role in my recovery. I have never had a problem with the healed area since my recovery. I had no interest in surgery, and stay away from doctors and dentists (I have not seen either in 11 years, which I ascribe to eating whole foods, exercising, and largely staying away from my allergens, e.g., wheat, dairy, carrots, and eggplant). If it is appropriate for your case, I hope you are able to find a self-treatment regimen that works for you.

        1. Sobhendu, I did the following to treat my inguinal hernia: 1. Wore a pad, 24 hours a day, that lightly pushed in my hernia. I bought it via Amazon: https://www.amazon.com/gp/product/B004J6SIHS/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1 2. Laid down flat on the floor and lightly rubbed the area surrounding the hernia. I did this several times per day. As I did that, I pictured in my mind the hernia retracting and the area returning to normal appearance.
          3. I refrained from lifting heavy things.
          4. I continued to eat well — plant based, and avoiding my specific allergens: wheat, eggplant, carrots.
          5. I continued to exercise — walking, biking, push-ups. I do not remember when I returned to doing sit ups, whether it was while my hernia was reducing or until it was completely retracted.

          I think the ideas in this link are sound: http://www.groin-hernia.com/herniabible/

          Excellent, that they have a forum in which you can get questions answered and share progress reports.

          May you have success with your self-treatment, Sobhendu, and a speedy and complete recovery!

      1. Thank you so much for your replay John G. I feel relieved I can avoid doctors and will definitely follow your advice. I started doubting the surgery after I watched a film explaining how powerful our mind is and how we should use it to cure ourselves. And you just prove it’s all true. Thank you. I’ve already changed my diet and started doing yoga and meditation. Will have a look at the belt too. Thank you for your help.

  2. Hi ,
    I was just wondering, what is the “best” time of day for chemotherapy? It seemed strange that Dr. Gregor said that a study showed Chemo was more effective at certain times of the day but never mentioned the actual times? Thanks for your help!

    1. My layman’s impression is that it’s complicated and seems to vary by individual and perhaps even varies in a single individual over a period of time. The ‘sources cited’ provide the details.

      In short, there appears to be no one size that fits everybody so to speak … timing may need to be personalised.

    2. Anthony, Chemotherapy involves many complex issues so while there may be a “best time” for a specific drug, it may not be the same for all chemotherapy. In addition there may be other factors that must be considered. To give a better view of the complexity of your good question, this is an article that reviews the issues involved: Molecular Aspects of Circadian Pharmacology and Relevance for Cancer Chronotherapy
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666849/

  3. I already hit pause.

    The chemotherapy can be less toxic and twice as effective just by what time they give it.

    So explain why they aren’t giving it based on those times?

    My mind paused and put circadian rhythms and autophagy and mimicking fasting together. I don’t know what my mind will do after that, but they are in a group now.

  4. Okay, the lazy version of me just mentally said, “Having chemo at the right time of day is easier than mimicking fasting” and doctors are less likely to pull the cachexia card.

  5. Still paused.

    I found this by looking up circadian rhythm and autophagy

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600856/

    They said that people with Alzheimer’s disease and Parkinson’s disease may suffer disease onset or progression as a result of alterations in the DNA methylation of clock genes. Methylation of clock genes. That sounds like a topic for me.

    With regard to cancer, what interests me is the particular cancers that get an increased risk of tumorigenesis that correlates with the loss of a maintained circadian rhythm – nasopharyngeal carcinoma, breast cancer, and metastatic colorectal cancer.

    The circadian clock system relies upon the regulation of the critical pathways of autophagy, the mechanistic target of mTOR, AMPK, and something called silent mating type information regulation 2 homolog 1 whatever the heck that means. Ha, I recognize all of the rest of the mechanistic targets. Getting there.

    Silent mating type information regulation sounds like those old silent girly peep shows that people put a coin in.

      1. I found this sentence

        Circadian disruption causes changes in DNA methylation of circadian genes.

        So that sounds like a loop?

        Circadian disruption causes changes in DNA methylation of circadian genes causing circadian disruption?

        The methylation of the clocks are also correlated with insulin resistance, so I am mentally pairing Keto up with the clock methylation. Not sure if that will pan out, but saturated fat gets added to the list.

            1. I am so far beyond my understanding already, but I found a link between turmeric and FOXO’s and I am going to post it here for me to come back to and figure out if it can fix my cognitive problems.

              Novel Treatment Strategies for the Nervous System: Circadian Clock Genes, Non-coding RNAs, and Forkhead Transcription Factors.

              https://www.ncbi.nlm.nih.gov/pubmed/29557749

              Forkhead Transcription Factors: Formulating a FOXO Target for Cognitive Loss.

              https://www.ncbi.nlm.nih.gov/pubmed/29149835

              Tetrahydrocurcumin extends life span and inhibits the oxidative stress response by regulating the FOXO forkhead transcription factor

  6. I really wish he would go back to making videos with just his voice over rather than half the frame being him. It’s very distracting as he is constantly waving his arms around and bobbing his head. It makes it very hard to focus on the articles and graphs he is presenting.

    1. Amanda,

      Dr. Greger asked for feedback a few weeks ago and has already heard feedback about it. The videos are made a few months ahead, so it will be like this until Spring.

    2. Amanda, I just read the transcript so I don’t see Dr. G at all. I love him but I find him and his delivery more distracting than helpful.

  7. I just unpaused and saw the blood pressure pills given in the morning even though it causes twice as many deaths.

    I do not understand “doctor culture” at all.

    1. >>>I just unpaused and saw the blood pressure pills given in the morning even though it causes twice as many deaths.

      I do not understand “doctor culture” at all.<<<

      Hey Deb, it's not "doctor culture" so much as IGNORANCE, same as with food interventions and with the chemotherapy. Also PRACTICALITY of administering those things to the unnatural abundance of cancer patients. Patients take chemo when they can get the appointment. I'll guess that we simply do not have the capacity to give everyone their chemo at the proper time of day.

      As to the hypertension thing–simply ignorance because most doctors are too busy shuffling patients and other duties, plus their personal lives to actually keep up with every new pertinent development in their field. It is a DUTY of Professionals to keep up and required by professional licensing boards in many cases (continuing education), BUT that doesn't keep new information from taking a few years to filter down through the courses/seminars that offer the credits they need per their professional board requirements.

      WE have just learned of these things. While I am a bit upset, as you are, that no mention was made of the best chemo times; I SHALL be informing my dear mother when to take her hypertension medication from now on–and will never relent helping her find better health through food selection (to her credit she's changed a lot, but I can't get her off diet soda or sugar).

      Michael Greger is driven to stay current because he sees a crisis. Many doctors only see busy schedule and more folks to treat and no end in sight-they are doing good work but they could do better. It's the doctors like Michael and many others of his ilk who REALLY believe their patients can be healed (not just comforted, cut on, and managed) that make the NEW MEDICINE so exciting and worthwhile and give hope to the future of humanity. Evidence-Based preventive medicine is our BEST hope.

      Just that everyone doesn't see it yet.

    2. I do not understand “doctor culture” either! They take an oath to “do no harm” while they depend on big pharma. My doctor says diet doesn’t matter! But I am in a poor state, rural area, guess lucky? To have a doctor at all. I too am so thankful I found this website and Dr Greger. I wish I had found it before my dad died…he probably could have survived. :(

  8. The year 2017: Yeah, hippi a yeah, the western medicine is coming to the same conclution as the traditional chinese medicine over 2000 years before. Congratulations! What kind of modern science! (sarcasm off)
    The traditional chinese medicine knows and use the so called organ-clock since hundred of years to detemine some inbalance in health by the patients also for treatment (like when you have to take your medicine best). But also the occidentel medicin (the so called herbs medicine or alternative medicine) knows a lot about the circadian rhythms – but we use the phases of the moon. ;-)
    Anyway, it is good to read a little bit here by master Greger, because he is open to all what will be good for health. Thank you so much my friend.

  9. As an overweight 82 year-old retiree with early Parkinson’s Disease, Type 2 Diabetes and arteriosclerotic disease (status-post bypass many years ago) who has tried to lose excess weight without success for most of my life, I am quite interested in this theory. My wife, a vegetarian, is prolonging my life by giving me celery juice and a blueberry shake ever morning, I will have my near-vegetarian dinner a bit earlier than 7:00 PM.

    1. If you’re eating a lot of dairy and eggs, then a vegetarian diet isn’t healthy at all. All of the science shows that the diet that Dr. Greger recommends, a whole food plant based diet is the optimal diet. And can reverse type 2, cardio, and many other diseases. Why aren’t you eating a WFPB diet?

    2. Alan Lasnover,

      I bought the book “How Not to Diet,” and I highly recommend it! I’ve learned so much from reading it — though I’m not done. It’s 570 pages long, with about 5000 references (the references are listed online, since there are so many and the book is already so thick).

      The biggest conclusion is that eating whole plant foods is the best way to lose weight. Whole meaning not processed, and plant foods meaning veggies and fruit, legumes (beans, chickpeas, lentils, split peas) and WHOLE grains, and in moderation nuts and seeds. That worked for my brother, and for my husband and me — although we thought we already were at healthy weights, we each lost more weight when we transitioned from vegetarian to whole plant foods (we stopped eating dairy products and eggs) without meaning to or trying. The book contains lots more information, especially explaining why, and exploring tweaks for losing weight a bit faster.

      Actually, after a heart attack, my brother started eating whole plant foods about 4 years ago (he also switched from being vegetarian; he told me that he liked cheese too much before his heart attack; afterwards, not so much, I guess), and eventually went off his meds for T2 diabetes and high cholesterol. (Plus some other ones, though he still takes BP meds, but now at the lowest dose). He also exercises. And he’s almost 71.

      Your wife is steering you in the right direction. But, I would go skip vegetarian and go straight to whole plant food eating. I wish both my husband and I had done that years ago, instead of starting only about 3-4 years ago. Good luck, and good health!

  10. As an overweight 82 year-old retiree with early Parkinson’s Disease, Type 2 Diabetes and arteriosclerotic disease (status-post bypass many years ago) who has tried to lose excess weight without success for most of my life, I am quite interested in this theory. My wife, a vegetarian, is prolonging my life by giving me celery juice and a blueberry shake ever morning, I will have my near-vegetarian dinner a bit earlier than 7:00 PM.

    1. As an overweight 82 year-old retiree with early Parkinson’s Disease, Type 2 Diabetes and arteriosclerotic disease (status-post bypass many years ago) who has tried to lose excess weight without success for most of my life, I am quite interested in this theory. My wife, a vegetarian, is prolonging my life by giving me celery juice and a blueberry shake ever morning, I will have my near-vegetarian dinner a bit earlier than 7:00 PM.

      Have you tried Dr. Esselstyn’s diet to reverse heart disease? Have you read Dr. Greger’s “How not to Die” or “How not to Diet” books? Are you aware of the folks who have reversed their heart disease and T2DM with diet? If all of this is new to you I understand. If not, I a baffled by your lack of progress. It’s never too late to cut out sugar and oils and animal products (but you do not have to be 100% vegan) (Blue Zones). Greens are the absolute most important thing to put into our bodies for endothelial health. Humming also causes our body to produce it’s own nitric oxide, for better arterial health. See Irminne Van Dyken, MD on youtube (Out of the Doldrums channel). Best of health to you. Mine has vastly improved over the last 5 years-thanks to these doctors and many more of their cloth. I’m 53.

  11. Another home run by Dr. Greger! He should have a comprehensive education course required for all physicians. The world would be better and everyone would be healthier.

    1. Absolutely!

      With microbiome research, now is such a great time to be a doctor.

      Very depressing that some people just don’t care and will not change. This makes the entire discussion about Healthcare in the US a bit hard to listen to. We need to make it like the availability of food stamps…maybe something like eat right and get some exercise if you want healthcare.

  12. Okay, now I would like this theory reconciled with Dr. Lisle’s theory that most morbidly obese people did it by eating a hundred or two extra calories – a snacks-worth which over the years starts to become a weight problem.

  13. The link to “How Circadian Rhythms Affect Blood Sugar Levels” is incorrect. Searched the site for this video but no luck. Where can I find it? Thanks

  14. By the way, the Uncle Freud and Betty Crocker story turned out to be sweet. Pun intended.

    Bernays’ research revealed that women felt guilty for not contributing more to the cake, so Bernays advised Betty Crocker to alter the recipe to require adding an egg. From a Freudian perspective, the woman felt she was giving her egg to her family. From a practical one, it felt a little more like “real” baking. Sales skyrocketed.

    1. Freud’s nephew’s advertising smarts may have destroyed the health of a country, but he also knew how to use it for helping the cause of the black community and the fact that he could easily get a change and

      He promoted the positive contributions of African Americans to the South and during a deeply racist time period, he had enough power using his methods to gain media coverage and to have a conference with zero violent incidents.

      Media abusing power and manipulating people’s minds in ways that cause violence and cause racism and cause obesity epidemics is deeply disturbing.

      1. Oh, I forgot to tie it back to the topic of breakfast for Reality Bites.

        Freud’s nephew was behind the advertising that doctors say that heartier breakfasts are healthier as a way to market bacon and eggs.

        Yes, Dr. Greger is NOT recommending THAT type of heartier breakfast.

  15. Ron,

    Sorry if you didn’t like any of my topics.

    It should fill in over time if anybody has anything to say.

    Maybe you could bring up a topic you like.

  16. In my 70 odd years of life I have never had a weight problem.
    I am much more interested in the sleep issue. For example is sleep as restorative if assisted by non-prescriptive legal chemicals which if I were to take them regularly would cease to be effective, the pharmacist said. The circadian pattern gets me to sleep early though only to 2, 3, or 4 am.

      1. I also had issues falling to sleep. My mind was everywhere, troubleshooting, finding answers to problems or reviewing the day. Until the day a friend doctor thought me to meditate when laying in bed, with a “blank mind” . Now I fall to sleep very quickly.
        And to improve it, I am now sleeping much better on a comfortable office chair that reclines pretty far, with my legs laid straight over the bed. Bonus: The pain on both of my shoulders is GONE. Search for “sleeping chairs for adults”

      2. Deb, for menopausal sleep problems, have you tried the herb Vitex? Works for me. One in the morning on an empty stomach for about 3 weeks at a time, then I take a break. Any longer the insomnia comes back. Give it a week or so, then it starts to work. Its cheap thankfully, you can get it on Vitacost for maybe $5 a bottle. Hope it helps…I hate insomnia but as a vegan that has been my only menopause issue, so I feel lucky for that.

        if that doesn’t work, have you tried chinese medicine? I take chinese herbs occasionally –provided by a chinese med doctor—for other things and it usually gets me back to that wonderful deep sleep. Chinese medicine is great about bringing your body back in balance and often sleep issues are a result of things being out of balance. But hopefully the vitex will work for you as that is easy and simple.

    1. Christine Dooley “In my 70 odd years of life I have never had a weight problem.
      I am much more interested in the sleep issue”

      I found that I am a slow metabolizer of caffeine. That means that 6-7 hours is the HALF-LIFE of caffeine in my system. So I quit drinking a pot of coffee each day. I dropped back to zero. And MY SLEEP IMPROVED TREMENDOUSLY!!!(falling asleep, staying asleep, and restfulness of sleep). I learned of this from one of the great plant-oriented doctors discussing how sleep-deprivation is linked to dementia and Alzheimers.

      Now, sometimes I’ll have one single cup–if I make my own I only grind about 12 beans to make it very weak (it’s Ethiopian, home roasted, so it’s still quite delicious) but it will still give me a little trouble nodding off at night.

      I never really had a weight problem if you consider 25BMI to be normal. I no longer do. AND when I changed to WFPB, my BMI dropped back to 23 which is where greatest longevity has been found. So, I’m good with that.

      Additionally, when one doesn’t consume caffeine regularly (I realize that you may not drink it at all, or be a fast metabolizer), it works as a very powerful vasoconstricter and is FANTASTIC for knocking out a migraine. But then I’ve not had any migraines in 5 years since going WFPB–I still get aura (visual disturbances, which used to be the beginning stage of a migraine for me) but that I can knock that out with a single SIP of a caffeinated beverage. It happened to me when driving some months ago and I stopped at a market and got some tea (far past fresh coffee hour). After I swigged the tea, I saw my vision clear immediately. Another time I knocked out the pounding misery of a migraine with a single sip of caffeinated soda (long before WFPB-but had been “off caffeine” for 2 weeks when a migraine hit while driving, far from home).

      Anyway. Maybe someone can dig some helpful information from this anecdotal report. I’m 53.

      Eat well, be well.

  17. Regarding the impact of circadian rhythm on the impact of chemotherapy agents, I’ve noticed that there are quite a few published peer-reviewed papers on the topic but I like to see one/some specifically about Capecitabine used with radiation therapy against rectal cancer. Help? :-)

    1. I did a PUbMed search and while I put in Capecitabine in relation to circadian rhythms, I received this article which seems to speak in general about all chemotherapy which you may wish to review: Molecular Aspects of Circadian Pharmacology and Relevance for Cancer Chronotherapy
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666849/ As you’ve indicated there are several other general articles like this.
      To find specific information focusing on capecitabine I’d also recommend that you seek more information from the doctor or oncologist staff administering this specific medication to see if they might have more detailed information on best timing for medication administration. Best of luck & information to you in this search.

    1. Joe,

      That is so sweet.

      I know that I was sitting at the video, trying to learn because I have circadian rhythm problems and severe sleep problems and because nobody had shown up yet and I can annoy myself sometimes.

      I would really love it if hundreds of people showed up and added topics, but my posting one thought at a time before people get here is annoying.

      But you are seriously sweet and I appreciate it.

      My having brain problems and trying to figure things out is annoying to me, too.

      So, Ron, I agree with you.

      I just do suspect that most of the people here sleep at night and eat breakfast and probably don’t have weight problems, so my commenting too much when nobody else is talking is annoying.

  18. Wonderful and thought-provoking video, as always.

    Thanks you very much, Dr. Greger!

    Minor nit: the sound still isn’t up to the quality of everything else. Not terrible, just a bit ‘boomy’. The more you increase the volume the less intelligible the voice. Perhaps a new microphone or better echo-controlled surroundings would help.

    Thanks for everything you do!

  19. Looking for a solution to my mother’s macular degeneration I finally found something that might work: Melatonin.

    Most doctors and researchers currently suggest there is nothing useful for this disease. But one group in Italy found that melatonin was indeed helpful.

    The question is: Does it help directly, or is a better sleep cycle the key?

    I’ve also seen groups researching longevity that seem to be gathering around melatonin as a primary tool.

    Very interesting stuff.

    Thanks!

    1. Sleep patterns are related to macular degeneration.

      https://www.medscape.com/viewarticle/859177

      Melatonin supplements can slowly stop working. I have had that happen.

      Dr Greger has a video of how to increase it with things like 2 pistachios.

      Pretty sure he said that 2 pistachios are equivalent to a dose of Melatonin.

      He also has a diet for macular degeneration.

      https://nutritionfacts.org/video/dietary-prevention-of-age-related-macular-degeneration/

  20. There was a person I knew who developed a disease where they had to post 27 times on a 4 minute video for another health forum.
    I think it might have been a type 1 diabetes site or something to do with blood sugar.
    Now the person was able to combat that issue, but now he thinks he might have a slight problem with being a kleptomaniac.

    Question for the doctor:

    Is there anything he can take for it?

    1. According to the Urban Dictionary

      Yerky means

      A fat butt; big behind; booty
      Brian:Yo look over thee, she got the fatty.

      Chris:Yeah she definitely got the yerky.

      1. Fumble,

        Instead of reading Urban Dictionary and worrying about names of people why don’t you do something like
        doing a critique of the NY Times Best selling book entitled, “Younger Next Year” By Dr. Henry S. Lodge, which came out in 2004 and was a big hit
        with the baby boomers and sold in the millions. You can turn back the clock and aging and be 80 but look and feel 50.
        I am not sure if Dr. Henry S. Lodge is still alive or what happened to him but he was a real diet and health expert with a specialty in Geriatrics.

  21. I found more interesting things about how inflammation affects the circadian rhythms.

    The researchers said that a high-fat diet might affect the perception of time at the tissue level through the mechanism of inflammation and that Inflammation polarizes autophagy toward the breakdown of mitochondria.

    https://www.sciencedaily.com/releases/2018/10/181031124858.htm

    I remember looking that up before because people like Dr. Fung suggest that oils help with healing the mitochondria, but the studies I am reading high fat diets cause the mitochondria to break down and mess up our circadian rhythms.

  22. I really need the coming video on night shift, because I work night shift. No, switching to days is not an option for me, before anyone suggests it… I need to know if there’s any way to circumvent the problem with the rise in my cholesterol and blood sugar because of working nights. I already changed my diet and I am very strict about my sleep schedule.

  23. Hi everyone. My Mother is on blood pressure meds, taken 30 mins before food each morning.
    What would be the best way to do this at night, to simply have a small supper of nuts and dates beforehand? Or does it need to be a full meal? (She could take before dinner, likely better than mornings?)
    I found the Spanish study from 2019 (below), and I also googled for advice, but could find no mention of the importance of food/meals and BP meds.
    .
    Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial
    https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz754/5602478

    1. In my experience with my own prescriptions, they tell you to eat 30 minutes before food because they want it taken on an empty stomach. You might google your mom’s meds to see if they really mean she needs foods 30 minutes later, or if they just want her to take it on an empty stomach. When I took a beta blocker in the evening for HBP, I took it on an empty stomach before bedtime. Fortunately, I no longer need it, but it did work better in the evening. My doctor had me switch to taking my BP meds in the evening after his partner had a fatal stroke in the night. He looked into how that could be and contacted all his BP med patients to ask them to switch to evening. Family doctors are often so run off their feet that they don’t have time to catch up on this stuff.

    2. It looks like you already received sensible, helpful replies. I would just add that speaking with her doctor WITH the recommendations on the drug insert AND the printed transcript of this video might be helpful. There doesn’t seem to be a specific research reason to have a full meal v just a snack before any med and her doctor may recommend that (snack) before her BP meds at night- somewhat of a compromise. I’m glad your mother has you looking our for her health and that you are following this website.

      1. Hi Anne & Joan. Thanks for your advice. :)
        Yes, the 20mg Lercanidipine is to be taken on an empty stomach, as oil/fats in foods can increase the effects of the meds. Should also avoid grapefruit & grapefruit juice for the same reason.
        My Mother is also on a low dose (25mg) of Losartan – advice here is to avoid salt substitutes such as Lo-Salt (too much potassium).

  24. Ditto. My husband is on high blood pressure medicine—three different pills. His doctor told him to take two in the morning and one at night. Since they’re three different medications I don’t understand why he can’t take all three at night. With or without food?

  25. photoMaldives, I recently switched to taking blood pressure pills at night. I take them with/after dinner. (I have never seen any mention of food regarding bp pills.. don’t think it matters) I tried taking them before bed but I would forget, or fall asleep earlier and miss taking them. I use a separate pill dispenser with tiny compartments for each day so I can keep track. As an aside, I feel much better and sleep better taking them at night vs the morning.

    1. Hi Barb. Thanks for your advice. :)
      Unsure if you’ll see this, but just for the record and for anyone else – the advice my Mother was given was to take her 20mg Lercanidipine on an empty stomach, as oil/fats in foods can increase the effects of the meds. Should also avoid grapefruit & grapefruit juice for the same reason.
      My Mother is also on a low dose (25mg) of Losartan – advice here is to avoid salt substitutes such as Lo-Salt (too much potassium).

  26. Interesting info about taking Blood Pressure meds at night rather them morning. I take Cholesterol med at night. Any problem with those two at the same time ?

    1. Tom, I take both at night. I was told by a nurse practitioner that statins work best at night … perhaps because of how the liver processes while we are asleep and fasting.

      Pharmacies will usually include information printouts with every new medication that describe uses for the medication, potential side effects, when to take it, potential conflicts with other medications and more.

  27. Thanks, Barb. Yes, I thought it was strange but my Mother says the info on the BP meds box specifically says “30 mins before food”. I’ve asked her to send me a photo, so I can see the type/brand, and google for more info.

  28. Meanwhile, I compiled this info that might prove handy. Of course, check with your doc before making changes.
    .
    MORNING
    – Diuretics “water-pills” (if you need a second dose, take it by mid-afternoon).
    .
    NIGHT/BED TIME
    – High cholesterol statins
    – High blood pressure – Take at least one blood pressure-lowering medication at bedtime. Don’t miss a dose as swings in blood pressure are bad.
    – ACE inhibitors (angiotensin-converting enzyme inhibitors), including Lotensin (benazepril hydrochloride) and Vasotec (enalapril maleate).
    – ARBs (angiotensin II receptor blockers), such as Avapro (irbesartan).
    – Beta blockers, such as Lopressor (metoprolol).
    – Calcium Channel blockers, such as Norvasc (amlodipine besylate).
    – Rheumatoid arthritis meds.
    .
    SPECIFIC TIMES
    Osteoarthritis NSAIDs – take 4-6hrs before the worst pain.
    Heartburn (cimetidine, famotidine) – take 30 minutes before your evening meal.
    Asthma – midafternoon (oral medication), or late afternoon (inhaled steroid).
    Hay fever antihistamines – evening (once-a-day); morning+evening (twice-a-day).
    .
    https://www.aarp.org/health/drugs-supplements/info-12-2013/timing-of-daily-medications-key.html#quest1

    1. Thanks photoMaldives! Very helpful for lots of folks in this situation. I get an info handout with each medication I take that will say what time is best to take it, and they put a sticker warning on the label if I should take it with food. People should go with what their doctor or pharmacist recommends. I switched mine to donner time because I take a beta blocker that is sedating and I may as well use it to my advantage in trying to get sleep.

  29. I’ve watched many Dr. Greger videos — big fan — but I must say the new format with his on camera presence is very distracting. Makes it difficult to take in charts and text. Content still great.

  30. If you don’t want to be on Facebook, will Dr Greger answer questions on YouTube for the Q&A next week? I am wondering about recommendations from groups like Viome that tell you your superfoods include cows milk yogurt, flaxseed or olive oil. That doesn’t seem to agree with the research Dr Greger has reviewed. It’s very confusing.

    1. DebO

      Dr. Greger does do a Q&A on YouTube. I find it not easy to ask questions on that format. I got a question through the first try in the Webinar format, but Facebook and YouTube are generally packed full of questions. Moderators will come here and help, but Dr Greger already has a lot of videos on those topics.

      He is against oils, in general, because of how they paralyze the endothelium. https://nutritionfacts.org/topics/oils/

      He has talked about the study in the Mediterranean diet where the group that got walnuts instead of oil had something like 25% fewer strokes. It wasn’t the oil that made the Mediterranean diet healthier.

      Cow’s milk, he has a LOT of videos on things like how it correlates to acne, breast cancer, Type 1 Diabetes, Parkinson’s and how the saturated fat affects things like Alzheimer’s and Diabetes, and how Casein turns cancer on and off.

      https://nutritionfacts.org/topics/milk/

      I was a big dairy person, but I will tell you that the fat does affect weight and I really developed serious brain problems. When I read information on Finland, and how parts of it got in such trouble with high fat dairy that people were dying at 50, and lowering the fat really helped them, it made a big impact on me.

      Yogurt was the exception in dairy where it can have some correlated benefits, except that they have more sugar than a Mars bar, I think he said Mars bar, but Men were from Mars and women were from Venus in his joke, so it could have just been a candy bar.

      You can also get any potential benefits from making your own Plant-Based yogurt.

      1. Thx Deb, I understand Dr Greger has reviewed buckets of studies on these foods. But my question is about the results one gets from Viome (in my case) which says my microbiome considers these “superfoods”. It’s hard to understand how Viome could promote these foods.

        1. They are looking narrowly at the microbiome. Not at the whole health of a person.

          A lot of those sites also consider the greatest amount of diversity the best and compare people to “normal” and you don’t want to ever be compared to “normal” America.

          1. Dr Greger does have a video series on healing the microbiome.

            The good news is that you can change your microbiome in a few weeks.

            Were you on antibiotics or something that makes you think you need something more?

            Right now, the science of the Microbiome isn’t complete enough for sites like that to give you real answers. You should be skeptical if they give advice that sounds wrong. Generally, I have learned to wait and keep researching for a long time if anything niggles you at a subconscious level. There currently may be more con artists trying to make money using the Microbiome than there are real scientists studying it.

            https://www.nature.com/news/microbiology-microbiome-science-needs-a-healthy-dose-of-scepticism-1.15730

  31. If BP meds work better in the evening, how about the natural BP lowering herbs? I’m thinking of hibiscus tea and amla. Would anything that lowers BP be better at night because we have higher blood pressure at night?

    1. Anne S., blood pressure starts going up in the morning. In most people it peaks in the early afternoon. Then starts dropping. Lowest, of course, when you sleep. So, no, not higher at night.
      Amla, hibiscus, etc. can be taken several times a day if they help you.

    2. Anne,

      People have strokes first thing in the morning more than any other time and sometimes while they sleep.

      Things like a glass of water before bedtime and taking your meds then affect the blood pressure of the next morning.

      1. Anne,

        Dr. Greger will be having a Webinar on Strokes soon. The sign-up link is over in the Blog section.

        Ischemic strokes tend to happen in the morning – with something like 14% happening while people sleep or when they first wake up, which makes it harder to get them to the ER within the first 3 hours, so you want to do things to lower your blood pressure and thin your blood the night before.

  32. I have a technical suggestion: can the search box be made more sophisticated so we can search phrases? It doesn’t currently recognize the quote mark convention. For instance, I would like to search “olive leaf” and get results with that phrase, not everything that has the word “olive.” This would make the website so much easier to search!

  33. I’m wondering if there are studies on the impact of vigorous exercise timing, that could affect health and possibly recovery/performance. For example, I’m an older guy and play ice hockey late at night (well past my bedtime). Most times it’s hard to recover and I’m concerned that it could have some negative affects

  34. \Great video. Now I understand why my calorie consumption is about 20% less with no effort. I switched my meals a few days ago so that my largest meal is breakfast, followed by smaller meal at lunch, and then dinner is my smallest meal. I am dieting and use a program to track calories and nutrients, so I can see the difference in my total calories. It is nice to see a probable link. Thanks!

  35. Blood pressure meds at evening. I’ll tell the GP about it. Thank you. I have a question about true solar time and meal times. Google solar noon. How sensitive are our bodies to the times we choose to eat? I’m wondering about the benefit of picking optimal times. I’m guessing that it’s not worth the effort.

    1. Arthur,

      I looked it up and, so far, all I found is that it is light that seems to synchronize the master clock of the suprachiasmatic nuclei and the SCN synchronizes peripheral clocks via neuronal and endocrine pathways

      When feeding time (but not energy availability) is restricted, light still synchronizes the SCN, but peripheral clocks are synchronized to the feeding time.

      When you restrict feeding, both the SCN and peripheral clocks become synchronized to the feeding time.

      That is interesting.

      Light stops being the head honcho.

      Sounds like a scene from Little Shop of Horrors.

      Feed me.

    1. Asrar,

      What are you using them for?

      Dr. Greger recently spoke about how testing even from major supplement companies often didn’t have even one speck of the ingredient that was described on the labels and most of the time the studies show that whole food has effects, where what they put in capsules doesn’t have effects.

      That being said, you probably could stuff your own capsules or make tea.

      1. He said that a lot of the supplements had things like Viagra and Prozac and banned drugs and house plants instead of the “organic, all-natural” ingredient.

  36. I firmly believe that a whole food plant based diet is the best for me, seeing what it does for my cholesterol numbers. I’m always interested in tweaking what I’m currently doing if it seems like it can be helpful for overall health. This Circadian Rhythm article has been really helpful; I take a pill for blood pressure and could drop about 5 pounds.

    Question? Any comments on having a high lipoprotein a number, and how to improve the odds of not having a cardiovascular event? Thank you.

    1. Hi, Peggy Anderson! Lipoprotein a has not been covered yet here on NutritionFacts. Elevated lipoprotein a is considered to be hereditary. While some claim that diet and lifestyle have no effect on lipoprotein a levels, at least one study did find an effect with a high raw, whole food plant-based diet. You might be interested in this article: https://www.ncbi.nlm.nih.gov/pubmed/30014498 I hope that helps!

  37. Nice summary here >> https://www.verywellhealth.com/the-best-time-of-day-to-take-blood-pressure-medications-1764094


    Blood pressure tends to vary during the day – higher when you wake up in the morning and and lower in the night. However, there are people whose blood pressure does not drop at night; researchers call these “non-dippers.”

    Most blood pressure medications have been designed for ease of use, meaning they are meant to be taken once per day. Even so, these medications are not equally effective over the entire 24-hour period during which they are active. The action of blood pressure drugs peaks anywhere from four to 15 hours later after you take a dose. Ideally, the drug is prescribed so that the peak concentration coincides with the time of day when your blood pressure is at its highest.

    These drugs are usually taken at bedtime because they can cause drowsiness. More importantly, they are often designed to release the medication slowly so that they remain most effective in the morning hours when blood pressure tends to be at its peak. As you age, your blood pressure no longer dips during your sleep like it does when you’re younger, increasing your risk for stroke and heart attack in the morning.

    > A 2013 study from Spain found that non-dippers, whose blood pressure remains elevated through the night, may benefit most from taking a bedtime dose. Doing so provides better control and may help reduce the risk of heart attack or stroke.
    > A 2015 study in the journal Diabetologia showed that taking these medications at night reduced the risk of type 2 diabetes in people with hypertension.

    The only BP meds that are best taken in the morning: Diuretics, or “water-pills”.

  38. Does cake taste better in the afternoon? I have proof that it does! Anytime a box(es) of donuts lands in our office in the morning, multicolored sprinkled donuts remain all alone in the box. It makes it thru lunch, but never makes it past the 3 PM mark. This is referred to in our office as the “law of sprinkled donuts” and stands right there with Murphy’s law as being a pure act of some perverse deity.

  39. Sometimes I need to wake up very early in the morning — around 4 a.m.

    When does the optimal eating window begin? Would I need to wait until 6 a.m.? 8 a.m.?

  40. Optimal eating window can vary based on your own body and work schedule and trying to tie yourself down to a restrictive schedule that doesn’t work for you will be counterproductive. Yes load up calories early in the day and and if you need to eat as early as 4 to get to work, that’s what you need to do, while recognizing it’s best to time your first meal when the sun starts coming up, perhaps no later than 10. If you can’t eat as early as you get up, then waiting is fine. Optimal eating time is what works for you while paying attention to chrononutrition principles.

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