Wesley S. Youngberg. DrPH, MPH, CNS, FACLM

Transcription

1 iming and Exercise

2 King Solomon For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die... a time to weep, and a time to laugh; a time to mourn, and a time to dance... a time to keep silent, and a time to speak; a time to love, and a time to hate

3 Chronobiology of Exercise for Men: Timing of physical activity for optimal therapeutic outcome Wesley S. Youngberg DrPH, MPH, CNS, FACLM

4 EXPOSOME

5 You are what you think! Resentment Vs. Joy Flu Vaccine Study Dr. Richard J. Davidson Laboratory for Affective Neuroscience University of Wisconsin Proceedings of the National Academy of Sciences

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7 Biological clock in the brain Human beings have an internal biological clock that is synchronized with the light and dark cycle of the physical world.

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9 Time is of the essence in adipose tissue. Energy metabolism is strongly influenced by circadian rhythms.

10 What Health Strategy is Most Important? Good Nutrition Regular Exercise Optimal Water intake Sunlight/Vitamin D Avoiding Smoking and Alcohol Daily Fresh Air Proper Rest & Sleep Forgiveness/Trust

11 Researchers find that lack of sleep contributes to obesity.

12 Shorter sleep duration increases obesity by 3 fold in 4-8 yo boys and by 5 fold in 9-13 yo boys and girls. Int. J. Obesity Oct. 2010

13 5-6 hours/night Vs 7-8 hours/night 69% increase risk of Obesity J Clin Endocrinol Metab 2010.

14 Thus, as with the iceberg, whose tip provides only a glimpse (roughly 10%) of what is below the surface, the importance of circadian temporal organization for health and disease could be profound. Indeed, what we

15 are going to do with time in medicine at the beginning of the twenty-first century is what Einstein did with time and physics at the beginning of the twentieth century. What we have now is just the tip of the iceberg.

16 Epigenetic Change and Your EXPOSOME

17 Sleep restriction leads to hepatic and peripheral insulin Resistance J Clin Endocrinol Metab 2010.

18 Tip of the Ice Berg

19 GOODBYE DIABETES, HEART DISEASE, DEPRESSION & CANCER RISK The Natural Way to Prevent and Manage Chronic Diseases

20 Got diabetes? Get rid of it! Dean Ornish, MD

21 A simple cure is possible for essentially everyone with type 2 diabetes. John McDougall, MD

22 Timing of Exercise & Insulin Sensitivity

23 what causes high blood sugar?

24 THE FIVE STAGES OF HIGH BLOOD SUGAR Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Time From Food Intake Optimal Blood Sugar High Blood Sugar High Blood Sugar Prediabetes Advanced Prediabetes Diabetes Fasting plus hour plus 2 hours plus 11.1 Published by DPHSS in July 1997 with CDC grant

25 June 2013 in the journal Diabetes Care Dr. DiPeitro, Chair, Exercise Science, George Washington University School of Public Health & Health Services

26 Three 15 minute walks after each meal were as effective in reducing blood sugars as 45 minutes of walking once daily but much more effective in reducing blood sugars after the larger evening meal. After meal moderate exercise may be a key to lowering A1c levels and DM2 related complications.

27 Dr. Sheri Colberg, Professor, Exercise Science, Old Dominion University July 2009 in the journal American Medical Directors Association, Vol 10

28 20 minutes of self paced mild to moderate intensity walking was more effective at lowering blood sugars after evening meals when done shortly after the meal compared to immediately before the meal.

29 20 minutes of self paced mild to moderate intensity walking was more effective at lowering blood sugars after evening meals when done shortly after the meal compared to immediately before the meal.

30 MICHAEL

31 Test Baseline 3.5 Weeks Later Weight 230 lbs. 221 pounds Blood Pressure 150/100 with meds Cholesterol /90 with meds 157 (no meds) Triglycerides Fasting Blood Glucose Michael s Labs Hemoglobin a1c 10.8% 8.2%

32 CHRONOBIOLOGY OF LAB TESTING BEST TIME TO CHECK BLOOD SUGARS

33 HYPER-INSULINEMIA Suboptimal Vs High Risk Fasting Insulin: > 7 Vs >10 1 hour Insulin: >15 Vs >30 2 hour Insulin: >10 Sub >25

34 A REAL METABOLIC MESS HIGH BLOOD INSULIN LEVELS INSULIN RESISTANCE Current insulin users were 30-50% greater risk for developing CANCER.

35 METABOLIC MESS HIGH BLOOD INSULIN LEVELS INSULIN RESISTANCE In 25,964 Diabetics. Current insulin users were 30% more likely to be dx with CANCER. Men and Women dx with DM2 >15 years were 60% and 80% more likely to have cancer vs. those dx <15 years ago. Diabetes Care January 2013

36 METABOLIC MESS HIGH BLOOD INSULIN LEVELS INSULIN RESISTANCE Meta-analysis of 38,940 cancer cases showed a 25-61% increase risk of common cancers in those with Metabolic Syndrome. High insulin, but not a normal level of insulin, reported as risk for cancer initiation and promotion.

37 METABOLIC MESS HAVING DIABETES FOR 15+ YEARS Men 60% more likely to develop CANCER Women 80% more likely to develop CANCER Women were over 2 X more likely to develop BREAST and REPRODUCTIVE CA Men were 3 X more likely to develop Colon CA Men were 60% more likely to develop SKIN CA Women were 120% more likely to have SKIN CA Also greater risk of Melanoma Cancer as well as Urinary Track CA!

38 METABOLIC MESS HAVING DIABETES FOR 15+ YEARS "These results support the notion that exposure to a high circulating concentration of insulin might result in mitogenic effects on breast tissue that stimulate the growth of endometrial stromal cells" Dr. Li - Diabetes Care Jan 2013

39 INSULIN & PROSTATE CANCER 15 year study of 8,000 Men ages One 11 oz. soft drink/day increased PCA risk by 40%. Diet high in white rice, pasta or sugary breakfast cereals were 31% more likely to develop Prostate CA. A diet emphasizing low-fiber refined carbohydrates and without unprocessed whole foods like legumes, whole grains, vegetables and will stimulate excess levels of insulin and increase the risk of cancer and CVD.

40 HOW ARE YOUR SUGARS? Fasting Glucose Test Glucose Tolerance Test Random Blood Glucose Hemoglobin A1C Pepsi-Jelly Bean Challenge

41 after-meal exercise min. after each meal. Increases insulin sensitivity. Significantly reduces unhealthy spikes in blood sugar and insulin levels. Up to 2-3 point blood sugar decrease for every min.

42 GET A MOVE-ON After Meal Exercise: minutes after each meal will decrease blood sugar and insulin spikes. Aerobic Exercise: 45 min., 5 times per week, will improve heart health, lower blood sugars, lower triglycerides, burn fat, improve mood, etc. Strength Training: Aim for 20 min., 2-3 times per week. Intermittent Training: Use to strengthen and tone the body.

43 Aerobic Exercise Improves circulation/ heart health. Lowers blood sugars and triglycerides. Lowers insulin levels and reverses insulin resistance and metabolic syndrome. Aim for 45 min./ 5 times per week. Brisk walking, jogging, running, swimming, biking, etc. When done in early morning sunlight can further support sleep, mood, metabolism and hormonal balance.

44 Strength Training Secret weapon to reduce insulin resistance. Increases metabolism. Strengthens muscles. Prevents mobility problems. 20 min. 2-3 times per week.

45 Intermittent Training (IT) Burns fat. Boosts growth/fitness hormone. Firms/ tones body. Improves thyroid function.

46 JIM FIXX

47 be consistent

48 Chronobiology of Jet Lag

49 Can Sunlight Help Obesity? Almost 2/3 of adults in U.S. are overweight. Obesity speeds a person s aging process by nearly 9 years.

50 Obese women exposed to sunlight for 45 minutes b/w 6AM & 9AM lost weight after 3 weeks. 2 hours of light exposure in sleep deprived individuals rebalanced hormones.

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52 Sleep Deprivation Sparks Changes in Expression of 224 Genes The Allan Institute for Brain Science reports that some 224 genes in mice show a negatively changed gene expression due to sleep deprivation and that thousands of genes appear to be regulated by the 24- hour Circadian rhythm.

53 A week of poor sleep significantly altered 711 genes effecting inflammation, immunity, stress, metabolism, etc. < 6 hours sleep Vs 10 hours sleep resulted in cognitive impairment and inhibition of self repair. Proceedings of the National Academy of Sciences University of Surrey

54 A three day disruption of the sleep cycle sleeping from noon to 6:30pm significantly altered 1,172 of 1,400 genes normally tied to the body s circadian rhythm. Estimated that sleep disruption ultimately impacts about 1/3 of a person s genes. Proceedings of the National Academy of Sciences - January 2014 University of Surrey

55 March 2010 in the journal Aging Dr. Krishnan Oregon State University "This study suggests that young individuals may be able to handle certain stresses, but the same insults at an older age cause genetic damage and appear to lead to health problems and earlier death. And it's linked to biological clocks."

56 Biological clock in the brain Human beings have an internal biological clock that is synchronized with the light and dark cycle of the physical world.