Sleep, Weight Gain, Eating, and Health
We spend over a third of our lives asleep, so it must be pretty darn important—but why? What is going on in our brains when we sleep? What makes sleep so crucial for our overall health, and how does it affect our eating, weight, energy, and mood? And perhaps most importantly, how can we improve our sleep. Today, a conversation with Dr. Param Dedhia on all things sleep: circadian rhythms, blue light, Eddie's trials and tribulations in medical school, and more!
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Guest
Param Dedhia, MD is an internal medicine doctor and integrative medicine practitioner. He is certified in Sleep Medicine as well as Obesity Medicine.
The Takeaways
Sleep serves a vital function in our health: it allows time for the brain to clean itself, for the body to repair, for the brain to learn and form memories, and for cells to regenerate.
When we sleep, we cycle through different “phases” of sleep throughout the night. See graphic here.
Perhaps the most well-known sleep phase is Rapid Eye Movement sleep, or REM sleep. This is when we dream.
It is not only important to get the proper quantity of sleep, but also the proper quality.
Going to sleep at the same time everyday and waking up at the same time everyday help to also promote good sleep hygiene because our body runs on a circadian rhythm.
This circadian rhythm is largely modulated by blue light.
Having poor sleep can not only impact appetite, it can also make us crave more unhealthy foods.
Having poorer sleep during a calorie deficit also causes more muscle loss and less fat loss compared to those with the same calorie deficit with more sleep.
You can promote good sleep hygiene with the following:
Set up for the night in the day: Get sunlight in the morning, exercise, don’t eat too close to your bedtime, try to take moments throughout the day to destress.
Create a bedtime ritual to start to wind down that you’re excited about: Candles, room sprays, and so on.
Dim the lights a few hours before bed.
Give yourself permission to stop working so that your brain can begin to wind down.
Try not to spend time in your bed scrolling on social media or working because then your brain associates bed with being awake.
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Juna [00:00:00] Food, We Need to Talk is funded by a grant from the Ardmore Institute of
Health home of Full Plate Living. Okay. How many times has this happened to you? It's
starting to get later in the day. You came home from work. You have all this stuff to do.
You're working somewhere. Oh, my God. Now it's time to go to bed. And you're trying to
go to bed. And you're trying and trying. And your mind is racing. And you're talking faster
and faster and you just can't fall asleep. Meanwhile, it's the daytime. You're at work, it's 1
p.m. and you're like, Time for coffee, number 35, because I'm literally falling asleep at my
desk. Okay, like there's something going on here with our sleep that we're really, really not
understanding.
Eddie [00:00:42] Juna, so many of my patients tell me that they make progress with their
eating. They can make progress with even like learning how to cook. But the sleep, that's
what suffers, as one woman told me. Where do you think I found the time to follow your
recommendations? To exercise and cook? Something had to go. So I just get less sleep.
Juna [00:01:01] And not only that, maybe she's taking away time from her sleeping, but
then taking away time for sleeping also makes you hungry and makes you want more
sugar and also doesn't make you want to exercise. So I just feel like I don't even know why
I spend time sleeping. Or do I spend more time meal prepping and less sleeping? It's just
like it's so confusing.
Eddie [00:01:20] So I have to say that we have the same chocolate bar in the same
cabinet, and it looks so different on a night when I slept well. I just can't convince myself
not to eat it. Let me tell you this one story about my medical internship. So this was by far
the worst sleep year of my life. Okay. I was in the hospital since the prior morning, so it's
now the next afternoon. And I finally sneak off to a call room to crash. Okay. Before we're
going to have the afternoon rounds. Okay. So to make sure that I wouldn't sleep through,
like, the night. From 4 p.m. on. I asked a friend. Could you, like, just call me on the pager?
Now, in those days, they were like,.
Juna [00:02:00] What's a pager?
Eddie [00:02:01] What?
Eddie [00:02:03] This was like a voice pager. So you would hear someone's voice and just
had. You only had one chance to listen talking.
Juna [00:02:09] Like a walkie talkie?
Eddie [00:02:09] Yes. A one way walkie talkie. Okay. So I managed to wake up on my
own. I crawl into a crowded elevator in the hospital, and I wedged myself into a corner and
I am possibly asleep on my feet.
Eddie [00:02:21] Okay. Like. Like a flamingo.
Eddie [00:02:23] Yeah, but not quite as pretty.
Juna [00:02:24] Right.
Eddie [00:02:25] And just then, in an otherwise quiet elevator, my friend's voice booms
out. Eddie, wake up. Get your ass out of bed. Rounds in 5 minutes.
Juna [00:02:36] That's so funny.
Juna [00:02:41] So today we're going to be talking all about the thing we spend a third of
our lives doing. No matter who you are, you spend a third of your life roughly, asleep. How
much sleep do we need? Why is it important? Why do we even sleep in the first place?
Eddie [00:02:56] And what can we do to actually get enough sleep?
Juna [00:02:59] I'm Juna Gjata.
Eddie [00:03:00] And I'm Dr. Eddie Phillips, associate professor at Harvard Medical
School.
Juna [00:03:04] And you're listening to Food, We Need to Talk a podcast that is quite
possibly helping you fall asleep right now.
Eddie [00:03:23] Regular listeners may know that we usually interview the experts on the
show in advance and then bring their thoughts and quotes into the show when Juna and I
are talking.
Juna [00:03:31] We bring you an abridged version, guys. Abridged version of their
thoughts, the important parts.
Eddie [00:03:34] But today we thought we'd shake things up a little bit, you know, wake up
fresh and try something new. We are thrilled to welcome Dr. Param Dahdah, a physician
born in obesity, medicine, sleep medicine and integrative medicine. He's speaking on
behalf of the American College of Lifestyle Medicine.
Param Dedhia [00:03:50] Hello and greetings. How's everyone doing?
Juna [00:03:53] We're doing wonderfully. We're all well slept. Actually, I'm horribly slept.
But we want to start off by talking about basically the purpose of sleep. Because I think if
we think about sleep just logically, it makes no sense, right? Because we're lying down
and unable to fight. Not reproducing and not finding food. Like I feel like it very much does
not make evolutionary sense. So can we first talk about like, why do we spend so much of
our lives sleeping?
Param Dedhia [00:04:19] Well, I have to smile and say in jest that you're in agreement
then with the great Thomas Edison. Edison once said that sleep was nature's mistake and
he himself is a wicked insomniac, but he would not call it insomnia. He did a lot of micro
sleep is what he did, and that can be great for different purposes, but not for health and
healing and living the best life. Great question. If there is this seemingly dead time, why do
we do this? The magic of sleep is really amazing. It really wasn't until the last 40 years that
sleep medicine became real because passively you look at it is just as you mentioned.
There's nothing going on defenseless, not doing anything productive. Underneath it all,
there's so many things that are going on. And what we want to be able to appreciate it
does a lot of things. Number one, for health. And that's reason why I as a physician get to
talk about this. Sleep is just amazing. If you take a look at every single organ system, there
is healing and repair that goes on every single night. Said another way athletes, these
folks that are getting paid millions of dollars are getting paid to recover. There's a huge
part of health that is about recovery. And we do know in order for whether it be about one
topic or another, it's head to toe. Let me really even go a little deeper if we can go into the
science. Yes. American Academy of Sleep Medicine really blossomed 22 ish years ago.
There was a famous study called the Sleep Heart Health Study. Once they connected
sleep to heart health, it was no longer this woo woo topic for those people complaining and
bellyaching that had nothing to do right. And number one, cause of death and dying in the
world that you and I live in is heart health, heart disease.
Param Dedhia [00:06:03] Anything good for? The heart is good for the brain. So that just
begins to help us appreciate. Every single night we cool down. We know the nervous
system does a lot more repair. Surgeries are done at cooler temperatures. From there, all
the hormones get a chance to recalibrate, reset the heart and the brain, get a chance not
just for the chemical functions, but also their endocrine functions. I could go on and on, but
sleep is an antioxidant. It's an anti-inflammatory, resets hunger and resets the ability for
the body to rejuvenate and be active. It really is, in my opinion. And yes, biasedly my
opinion, the great connector to all of health.
Eddie [00:06:38] So so I'm thinking back to I don't know our ancestors out on the
savannah it's been a hard day. You've managed to catch a wildebeest.
Param Dedhia [00:06:48] You've had a good day of being on a savannah. Yeah.
Eddie [00:06:50] And, you know, you schlep this thing home and you cooked up some of
this meat, and now, I don't know, all the other wild animals are ready to pounce on your
leftovers, and then you decide to take a nap. Is that what did other people before our time
think about sleep? Because in our society, it's almost.
Juna [00:07:10] A nuisance.
Eddie [00:07:11] Yeah, a nuisance. Or, you know. What is it, Frank? Zap. I'll sleep when
I'm dead, you know? Kind of, yeah. What do you think the perception was before kind of
modern times about sleep? Was it just something natural that happened, or did they fight it
like we do?
Param Dedhia [00:07:24] Yeah, I will share that. There's so much been written about this
in different books. And also this really kind of emanated from this concept is are we meant
to go to sleep, be asleep all night, and then pop up without any interruptions seven, eight,
9 hours later? Classically, a lot of the older discussions have been written about the first
sleep and the second sleep, and they often talk about sleep being done in different
experiences. So sleep really has been a debate and looked out there. Interestingly, the
oldest writings are on dreams, a whole nother fun topic, but when you take a look at sleep,
they really thought about it as a time. And some of the older writings, again, about dreams
is that, you know, the mystics would talk about the gods speaking to them and therefore
their dreams and what was going on in that other parallel. And the people that were
dreamers and especially lucid dreamers were really thought to be divine. And there were
for part of the royal court, part of the military for helping with strategy to be able to create
some of these insights. But also interesting about this whole evolutionary conversation
which is. Really interesting. Some of us on this call and this conversation on this chat are
morning people and other ones of us are evening people. Yeah. Know yours truly. I'm an
evening person. Oh, really? Yeah. And interestingly, if you leave me to my druthers, I'm an
evening person. I'm a night owl. I also have a sleep disorder. More than one. And I didn't
have any sleep problems until I started studying. It's a warning. Anybody listening? Really?
You're about to get diagnosed or self-diagnose. All right. Medical school syndrome. So I
have restless leg syndrome. And it's classically noted that those of us who have restless
legs have a low dopamine, and we're lower than other individuals. So we tend to have this
angst, this ability to move, this ability to want to move. So we were there to guard the fire
to make sure that the village was kind of looked after in those early night hours. And then
the morning people would kind of take the baton from us and go from there. Again, no
written record, but it's kind of fun to think about what if that was true?
Eddie [00:09:20] Wow. So this restless legs serve the purpose back.
Param Dedhia [00:09:24] Yes, yes.
Eddie [00:09:25] Outside of the cave. Because you'd be the do it up all night. Yeah, yeah.
Param Dedhia [00:09:29] I love that there was no apps to surf at night, so you just kind of
I guess we'll check what's going on in and out of the cave.
Eddie [00:09:34] And back to those ancient times. The only cue was really light. Yeah,
right. I mean, so how have we perturb that? Our whole in our society.
Param Dedhia [00:09:45] Which did take a big step back. You know, there used to be the
three big pillars of sleep quantity quality. But the third pillar really is rhythm. Better, you
said, as to circadian rhythm. And a reason why bringing that up is it really just hit the
Western medicine literature in the last decade or so. The Nobel Prize was given out
roughly five years ago to those that defined the circadian rhythm. Now, reason why I bring
that up, it's really intriguing. Whether you believe it was written by the ayurvedic medicine
practitioners or the Chinese medicine practitioners, they talked about the need to have a
set bedtime in a set wake up time and end. They talked about the importance of getting
sleep before midnight because what they talked about was each of the organs had
different healing cycles. I read this many years ago, and guess what we're finding now in
the Western literature?
Juna [00:10:34] It's true. Yes, it always happens.
Param Dedhia [00:10:36] Isn't that hysterical? Right. So, yeah, I mean, I used to tell
everybody like, just get your 8 hours of sleep. But now I'm like, hey, can you go to bed
before midnight? As you can imagine, I lose a lot of friends and I don't get invited to many
dinner parties when I talk about some of these conversations, because it's not really part of
the common world or the social world that you and I are a part of.
Juna [00:10:56] Okay, so I took a sleep in circadian rhythms class in college. This is why I
became very passionate about sleep. Like, I'm very, very passionate about sleep. I wear
red glasses 3 hours before bed. It looks ridiculous. Anyways, I bring this up because I
didn't realize when we talked about circadian rhythms before I took this class that like your
cells actually have internal clocks and there's like a specific part of your brain that actually
runs on a 24 hour cycle and keeps the rest of your body running on these cycles. And I
think, like knowing that that literally is happening is such a bigger incentive to like actually
follow a sleep schedule because, you know, when people would say like, oh, I go to bed
early, I was like, Yeah, whatever, who cares? But when I saw these graphs of like how
your cells oscillate on the cycle, I was like, Oh my God. Like, this is actually a real thing
that your body keeps time for you. It's crazy.
Param Dedhia [00:11:44] Unreal, and it's so much fun to if I may piggyback on what
you're saying right there, because we do know that the brain in terms of being the master
pacemaker called the master clock, the super high asthmatic nucleus. Right. If you want to
get really technical about the AC and that's where light hits. Basically the back of the eye
goes to the fastest nerve that we can record and it wakes up the brain. But there are, as
you're getting at different parts of the body and thought to be every single cell of the body
also has its own clock and its own pacemaker as well. And there's obviously the brain and
that which call it the supercomputer that speaks to it. There was an interesting study many
years ago and it never made sense to me, but it was making the point that light in the
bedroom was affecting you. So even if they gave people shades, meaning more or less
some eye mask, where if they put a light behind the knee, they were able to shift people a
bit in terms of circadian rhythm. And it was like that light behind the knee. It must have
been the heat. But now we're thinking, right, being in a hot sunny room or in a lighted
room. So there is a conversation where, again, going back to what we said, if we're in the
cave, we were in darkness and then we were meant to be able to really be daytime
creatures, which really is a hard thing to think about given our 24/7 world that we're now
living in.
Juna [00:13:05] Right? So before we start talking about all the things that disturbs sleep,
including things that disturb our circadian rhythms, can we get a debrief on like the
different phases of sleep? Like what are the main phases and what do they each do in
sleep? Like how they function.
Param Dedhia [00:13:20] Yeah. Such an important question. Right on off? Not exactly.
And again, it really gets back to electricity of doing the EEG, the brainwaves of the night.
And it's really fascinating. So I'm going to give it the big bucket turns and I'll get a little
granular. Just enough to give us some science to it. So we go through these things called
night sleep, deep sleep and dream sleep. Now they also give them numbers just because
in science we like to give things different routes. We have to.
Juna [00:13:49] We need the numbers.
Param Dedhia [00:13:50] We need the numbers. Right. So stage one, stage two. Stage
one is that causes that twilight. Like if somebody is falling asleep and you shift them like,
hey, what's up? I'm awake. I wasn't sleeping, you know.
Juna [00:14:02] That's my mom in front of the TV when she's watching, like. Yeah, you
know what I'm saying?
Param Dedhia [00:14:06] Exactly. So that's that stage one. And it classically happens at
the beginning of night, but it also happens throughout the night because we're known to
have a sleep cycle, meaning different stages that happen every 90, to 120 minutes. So
then we fall into stage two, you know, stage two, part of stage one and stage two.
Altogether, it's called light sleep. When I first heard this, I'm like, Who wants to be a light
sleeper? I didn't know what I didn't know. So I actually I spent my first set of months
learning sleep and look at how to get rid of this light sleep. No was wrong. Light sleep
being roughly 60% of our night is healthy, normal. It's garden variety stuff that does a lot of
great things. But the challenge of it is that it really has been shadowed by stage three
sleep. Now there's also technically stage four, but the new nomenclature is condensed
stage three and four. I just call it three. So three is deep sleep. Four is deep, deep sleep,
which really only happens in teenagers. So now we just comment that it's very deep sleep
instead of calling it stage four, because then as we get older, we don't see stage four and
we feel like we're missing out on something. So and then finally comes the conversation of
rapid eye movement, better known as dreams. That gets confusing. It's the dreams that
are like those movies bizarre as they may be, but they kind of have image, sound, some
kind of plot to them or not. But one of the things is we could have dreams and other
stages, like a little sound, a little fragment, a flash of light, all these different things. But the
dreams, as you and I know what for inspiring songs and aha moments and inventions are
those rapid eye movements that we are looking at. Really interesting rapid eye movement.
What is the meaning of dreams? Now I'm not going to get into the imagery and
interpretation and Freudian and any other and.
Eddie [00:15:56] Have at it if you want.
Eddie [00:15:57] Yeah.
Juna [00:15:58] That's a whole other podcast episode.
Param Dedhia [00:15:59] Yes. Kokoschka would love to take a year off and just study
fascinating, especially lucid dreaming, which is, you know, you're in a dream and you can
manipulate the dream. Fascinating.
Juna [00:16:09] Yes.
Param Dedhia [00:16:10] Really cool stuff. So what we do know is this. We talk about,
again, quantity and quality. Quality is essentially getting sleep time, but really, it's going
into the getting the sleep stages as well. And so you guys have perhaps heard me say
this. At what age where we the best sleepers and this gets back to staging.
Eddie [00:16:30] This always makes me laugh when people say, oh, I slept like a baby.
And I'm thinking, you woke up every 45 minutes screaming. And then you had your diaper
changed?
Juna [00:16:40] Yeah. Oh, snap. For sure. Teenage For sure.
Param Dedhia [00:16:43] Right?
Param Dedhia [00:16:45] And babies. 16 hours. They eat, sleep, poop, eat, sleep, poop.
But teenagers, what do they do? They go to sleep. They stay asleep.
Juna [00:16:53] It was awesome.
Param Dedhia [00:16:54] Right?
Juna [00:16:55] I would kill for that sleep quality now as an adult.
Param Dedhia [00:16:58] Well, we can actually talk about not having to kill, but actually
get that so. So, yeah, you know, what did we do? Amazingly, as teenagers, we got a lot
more deep call it stage three. But that's what we did without even trying. Right. You just did
it. Now, I want you know, and as we're here talking about lifestyle medicine and talking
about how it's connected, it's so cool or physical, mental, emotional, cause, spiritual, the
way we eat, the way we move, get our sleep under stress. It's all intimately connected. So
what I wish for us to appreciate is the first half of night is more deep sleep. The second
half of the night is more dreams. So what goes on? So let me answer that question that
was asked. What goes on during sleep? The first half of the night is more physical repair.
Put in growth hormone. You put in proteins that repair the body. You had a good workout.
You want to get the full benefit, get your sleep.
Juna [00:17:52] Yeah.
Eddie [00:17:53] So if you're having trouble following all of the stages of sleep from Dr. De
to go to food, we need to talk e-com where you'll see a beautiful graphic.
Eddie [00:18:01] They're very.
Param Dedhia [00:18:02] Helpful. Awesome, awesome. So you'll see when you see that
graphics that you oscillate in and out of different stages. But the first half you get more of
that deep and the second half and they get more of dreams. Now, so many things going
on in dreams. I'm going to be very starchy as a former academic and talk about the limbic
system. No need to memorize it. Just remember. That's where. Your emotions get
basically stored and you open up and you clear the limbic system every single night in
dreams.
Eddie [00:18:29] Can you can you store your emotions when so many people that just
released them as soon as they have them?
Param Dedhia [00:18:34] Yeah, they think they do. But again, it seems like an endless pit.
Right. The guy who cut off somebody said something rude to us at all. Negative thought
that just won't go away. And if we don't do some of the clearing during the daytime, it will
still need to come out. And therefore, the least resistance is when you're not distracting
yourself from this 24 seven world. Is that the second half of the night? So here it is. You
know, most people talk about sleep disturbances. I want us to think about this because this
is the perfect time for me to interject this. Yes. There's troubles getting to sleep. What's the
next biggest, biggest complaint that I get about sleep, not snoring. But interestingly
enough, hey, man, I get to sleep just fine. Around three or four in the morning, I wake up.
Param Dedhia [00:19:18] Spinning and I can't shut it all back.
Juna [00:19:20] fall back to sleep. Yeah.
Param Dedhia [00:19:21] And what tends to go on is. No, you paid off your physical
exhaustion. Mm hmm. The mind starts clearing. And if you are emotionally puking on
yourself and he goes in there, all of a sudden the mind gets spinning. So, therefore, one of
the greatest things that I want everybody to always learn is whatever mindfulness,
whatever breathing, whatever centering technique, being present because it is tough,
especially in the set of years we've had with this life we're living. It's a lot. So sleep is such
a big part of get your deep sleep, get your dreams. But what I also will share before we're
done talking today is really get in an appreciation that this concept needs to be
understood. Your daytime sets up your night and your night sets up the next day. So that's
really how I see a huge opportunity for sleep beyond the pills, beyond all these gadgets
that we can speak of. Your way of eating, your way of moving, your way of honoring your
mental and emotional health is so important to get to sleep stay asleep and wake up
feeling refreshed.
Eddie [00:20:23] So I'm just going to interrupt and we're going to just take a brief break.
And then when we come back, we're going to hear more from Parham about exactly what
you might want to do during your day to set up a better nighttime. Food, We Need to Talk
is funded by a grant from the Ardmore Institute of Health, the home of Full Plate Living.
Full Plate Living helps you add more whole plant based foods to meals you're already
eating. These are foods you're already familiar with apples, beans, strawberries and
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includes weekly recipes and programs for weight loss, meal makeovers and better blood
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Juna [00:21:29] We're back. Parham When we left off, we were talking about how our day
sets up our night. And I guess one of our biggest questions for you is, first of all, do we
know that people are getting worse quality sleep today because it feels like they are, but I
don't actually know if there's data on that. And second of all, what are the biggest things
that people are doing in their day that are really serving as like disturbances to their later
sleep? I know you mentioned one of them was not being mindful, but what are some other
ones?
Param Dedhia [00:21:56] Yes. Now the great challenge is how do we compare an apple
and an orange? Years ago, we don't have the technology we have now. Yet it's been
noted that we basically are sleeping 90 minutes less on average by survey compared to
our great grandparents. So in the last hundred years.
Eddie [00:22:13] Oh, my God.
Param Dedhia [00:22:14] Yeah, yeah. To have a little fun thing to put in there. How old is
the light bulb? The Light bulbs roughly 109 and 110 years of age.
Juna [00:22:21] Oh my God. Alert.
Eddie [00:22:23] Back to Thomas Edison. Okay.
Juna [00:22:24] Thomas Edison ruined our sleep. He was an insomniac and he wanted us
to be insomniacs.
Eddie [00:22:28] He wanted a light to keep on. Keep him up all night.
Param Dedhia [00:22:31] Yeah. I'm born and raised in the state of Michigan. We all went
to Edison's lab. Yeah. Oh, really? Okay, cool. Yeah. Know Thomas. So, you know, is that
without question, we have been getting less sleep. So there's again the quantity and then
again the conversation of quality. Now the quality discussion. Again, I want us to tag on to
that conversation of dayrime sets up night and vice versa. And the reason I love to really
push are not seeing anybody writing about it, speaking about it. It's one of the more
passionate statements that I want us to all make. And, you know, I was lucky enough to be
a former academic that landed in sleep. So it gave me a chance to see lifestyle medicine
and sleep and as I was learning them together to solve myths. So I was really lucky to be
in the places and spaces and at the scientific meetings that I was. So here's a few
thoughts to that. Right? Let's think about that deep sleep. Remember the best sleep of all
time, teenagers and their sleep. So what do we know? Deep sleep is basically a
conversation of more adenosine in the brain. So when you put adenosine in an animal
model or rats and everything else that we study, we shoot up more adenosine, we give
them more deep sleep. Hmm. So let's think about how do you and I manufacture self
manufacture more adenosine? So remember from back in biology class, that stuff called
ATP adenosine triphosphate.
Juna [00:23:58] Yes.
Param Dedhia [00:23:59] What happens during the daytime as you burn up more energy,
as you are more physically active, what do you have? ATP breaks itself down and you
eventually release adenosine go from ATP, ADP and adenosine. So we do know is that it's
important. Think of it. You've been hiking all weekend, gardening all week and helping
your friend move. And what do you say, Sun? Hoo am I going to sleep good tonight? So
there's an important part of having enough physical activity. And think of the world we're
living in. Are we getting as much activity as we used to? We don't. We have remote
controls. Whether we're opening our garage door or turning our channels, we don't have to
get up nearly as much as we needed to just a handful of decades ago. So that's one
conversation there. And so what is something else related to the adenosine hypothesis?
Juna [00:24:48] Caffeine.
Param Dedhia [00:24:49] Yeah.
Juna [00:24:49] Sorry. I got excited. I got really excited.
Param Dedhia [00:24:52] All right. So, you know, some people could take an espresso
and go right to bed. We do know caffeine blocks the ability for adenosine to bind and help
to give us a deeper sleep. So something else to think about.
Eddie [00:25:06] And it lasts for how long?
Param Dedhia [00:25:08] Depending on who you're reading out. We're really an
interesting time of genomics and understanding the liver and the liver genetics. So the
standard conversation has been roughly 7 hours to degrade caffeine by 50%. So an 8 am
cup of Java is a half a cup at 3 p.m. and at 10 p.m. it's a quarter cup.
Eddie [00:25:27] Which may be enough to keep some people up.
Param Dedhia [00:25:29] Might be for some people. And again, if you get that afternoon
lull, which again is when the rhythm naturally dips. Yes, ask your friends who work as
baristas-- they are slammed in the morning and they're slammed after lunch. And then if
you get that afternoon, again, caffeine, a little tickle that unfortunately can really struggle
with some people. And again, some people were learning that their faster metabolizes of
caffeine than others in a handful of years will be knowing everybody's genomics genetics
for this. But for the meantime, that is really what we need to think about. But getting back
to that exercise, I always like to us remember when you work out so hard that you're in
pain, does pain help you sleep? No. So please, you know, little is good, more is better. It's
Goldilocks just the right amount. So you definitely don't want to do too little too much. We
want to honor consistent activity. A little bit of push and pull, please.
Eddie [00:26:23] What's the wisdom on the type of activity? Is it lifting weights? Is it doing
your yoga? Is it going for a brisk walk?
Param Dedhia [00:26:31] Yeah, a lot of the studies that I've seen has been more related
to aerobic activity, and the biggest concern has been the timing. And basically when they
have a what they call more, how should I recall how they wrote it and when it was more
vigorous? I believe that's the word they used in literature. Vigorous exercise was deemed
as basically you could not hold a conversation with someone. In other words, you were
working out hard that you would have to be able to. Take some breaths while you're
working out.
Eddie [00:26:59] That's that. That's the that's the talk test. That's the easy one. That's the
vigorous. Okay.
Param Dedhia [00:27:03] Yeah. So not doing that an hour before. But we do know one of
the great hypotheses of falling asleep is cooling the body. So they often talk about
afternoon activity has been related to better sleep is because you warm up the body and
then you slowly cool down come the evening hours. Another way to kind of move through
that is what? A lovely nighttime ritual. And I love talking about rituals is a warm shower
bath before bed. You go in to the water warmed up and you come out. The ambient air
touches you and it slightly cools you. We don't need a shiver, but cooling. And therefore
you don't warm yourself up like when you're exercising, which you really get a much more
core heat production. But that's something else that it's really lovely. And a great thing
about showers and baths is you're not texting, arguing or doing something that's.
Juna [00:27:54] True, speak for yourself. Hey, I'll take my phone to the shower.
Eddie [00:27:58] And you may you may not know that Juna has a thing for cold showers.
So I just want to understand that.
Juna [00:28:04] I did for a bit guys, but I can't do it anymore. Hot showers before bed do
sound good. So cold showers in the morning.
Eddie [00:28:09] So it's the cooling coming out of the shower that begins the cooling. And
then when you're getting into bed, what is the best temperature and do we need to buy a
special mattress?
Param Dedhia [00:28:19] Thank you for that.
Eddie [00:28:20] To Cool ourselves off.
Param Dedhia [00:28:22] Almost Every year there's a new number put out there and it
like we're going to talk about numbers. Yeah. Yeah. And almost every year I get phone
calls saying, oh, my gosh, you know, I'm freezing at 68 and I'm like chattering. My teeth
are like too cold. So cool, not a number. And what we love to do is we like to publish a
number. They take a data set, they find the average number. How many of us like the
same food? How many of us like the same art? So we need to appreciate cool rather than
a temperature and cold.
Juna [00:28:54] Right. So okay, we have things that are just probably disturbing. Our
sleep would be not moving a lot, having caffeine especially closer to your bedtime and
then, you know, exercising right before bed. Not good. Being too hot, not good. And all of
these things if they're disturbing your sleep quality and or quantity. Can we talk about how
they affect your weight and your, like, food behaviors and your movement behaviors?
Because that's what we talk about a lot on the podcast. I'm sure our listeners are very
interested to find out. Just personally, when I was sleep deprived and I was very stressed
at the end of finals. And this could be also be the stress, right? Like obviously it's not just
the sleep, but I remember like I would never, ever like eat fries in the dining hall. But when
I was sleep deprived I would come into, the dining hall, I could smell the grease. And I was
like, These smells so good. I'm cooking fries. And it was like I was never full. I was always
craving, like, really high fat, high sugar food. And when I sleep enough, I feel, like, so
energized and so, like, ready to eat my normal food. You know what I mean?
Param Dedhia [00:29:56] Brilliant. Brilliantly laid out. So I'm here with you all as a person
who's been 45 to 50lbs heavier than he is now multiple times in my life. Very fascinating to
me in medical training that I was not going to get formal nutrition exercise. And that's a
whole nother fun story. That's for another day. Getting to that. One of the things that I
share is I thought to myself, if I could just learn everything about nutrition, everything about
exercise, I'm going to have this thing all figured out.
Juna [00:30:26] Right?
Param Dedhia [00:30:27] Many of us, many of us know what to do, but don't always do it.
Juna [00:30:31] Yeah, yeah. Then this podcast wouldn't exist, right? Everybody would just
be doing the right thing. And it would.
Param Dedhia [00:30:37] Yeah, it's like that great movie, you know, The Matrix, you just
put a chip in, you download and to all of a sudden. What we do want to appreciate is the
following: It's neurochemistry, craving the sleepy brain and the stressed out brain. Neuro
chemically makes you want what? Sugar, fat. And when do you want it? Now.
Eddie [00:30:58] Now.
Param Dedhia [00:31:00] Sugar, fat -- now. So I just need more willpower. I'm terrible. I'm
awful. And bleep, bleep. I'm like, whoa, ease up there. What we do know is willpower is not
even come to the conversation. I like to say it's in the next timezone. It is still in bed. It has
not arrived yet. So what I want is to appreciate whether you call it neuropeptide Y while
you're calling it orexin, ghrelin, leptin. There's an alphabet soup out there, but those are
raging and want to eat sugar fat now.
Juna [00:31:28] Right?
Param Dedhia [00:31:29] So please appreciate honoring their stress on an hour. Sleep is
not a luxury. And on top of that, let's go one more step into the hormones. Every single
night, you make growth hormone, you make testosterone. What do you feel like doing if
you have a low growth hormone testosterone? Do you want a push pull, bike? Ehh,
tomorrow, Monday. No after that big thing, we got to finish. Then we'll get right on it.
Eddie [00:31:55] Right. Right.
Param Dedhia [00:31:56] So I want to appreciate that because it's not, again, that we
don't want to, but if we do not get regenerated and on top of that, want us to appreciate
how positive are we? When we're exhausted and tired?
Juna [00:32:08] Oh, my God. So negative.
Eddie [00:32:10] But the regeneration that goes on is that back to the quantity of sleep or
the quality of sleep or all of the above.
Param Dedhia [00:32:20] All the above. Quantity. Quality and the rhythm. Because we do
know the body loves habits and love cycles. And you know, this 24/7 world jet setting as
we do. It's hard.
Juna [00:32:32] So these like eating behaviors and exercise behaviors, I guess they're
kind of the direction goes both ways in terms of the relationship, right? Like eating poorly
kind of messes up your sleep. Yeah. But then also bad sleep messes up your eating and
it's like this like feedback loop, you know what I mean? Because when you eat too much,
you also can't really sleep that well, like you feel horrible.
Param Dedhia [00:32:51] There was a study and I never saw it published, but it was
presented. People who ate more real food, as we would call "whole food based". They
tended to burn up more energy because they didn't have that sugar swings, the insulin
swings that they would have. So eating basically more of that healthy, balanced, traditional
great grandma's kitchen kind of food would definitely allow us to have more ATP, more
energy burn. Help us with that nighttime eating. Remember the old English proverb, you
know, king for breakfast, you know, a queen for lunch and a pauper for dinner. We tend to
have so much bigger meals at nighttime. And again, there's intermittent fasting, which it's
really interesting. One of my dear colleagues, brilliant behavioral psychologist, and he
says, You know what? I have a really good track record in one or two sessions of helping
people sleep better. I'm like, Really? What are you doing? He goes, I restart breakfast. I'm
like, Whoa. What? And he says, Well, think about it. He says that people not having that
cue that it's morning time. You need my energy. Right. And we can debate over time. What
does that mean with intermittent fasting? But I really think it's intriguing when you can help
people understand that. And again, not to use these other ways of energizing ourselves
with caffeine and, you know, carboloading ourself to just get through the next hour.
Eddie [00:34:06] So you volunteered a couple of minutes ago about having had significant
weight fluctuations personally? Yeah. As you think back to what was led to your success in
losing weight, how much like where does the sleep come into it versus the the above? Or
was it all all at once?
Param Dedhia [00:34:26] You know, I'll share this. First and foremost. It was the aha
moment of nutrition matters, movement matters. Right. So with that came my oscillations
of 40 and 45lbs, went down to oscillations of 30lbs. And then from there, you know, being
on call, not being on call. I mean, all those things, it wasn't really until I got out of that crazy
loop and then this aha of lifestyle medicine kind of came through that I was able to now
stabilize my weight and get it down to that next level of 20 lbs and whatnot, kind of
fluctuating. And then when it came through with much more realizing that me and my little
popcorn like monkey brain, I really needed to get into some practice of stillness, some
practice of mindfulness. So I look back that it was different layers of this lifestyle medicine
that really was helpful for me to be able to now oscillate less.
Eddie [00:35:20] It sounds like an evolution and I'm sort of seeing the waves calm out
where you're you're not going up as high. You're not coming down as low, perhaps.
Param Dedhia [00:35:29] Well said.
Juna [00:35:30] That's actually really interesting, because I've also seen studies on people
who are in a calorie deficit and they'll compare people who get less sleep on the same
calorie deficit as people who get more sleep. So just for our listeners, as a reminder, being
in a calorie deficit means you are eating less calories than you're burning, which should
physiologically, you know, cause weight loss. And you would think it would cause the
same amount of weight loss in both people because they're in the same calorie deficit.
And basically the people that sleep more lost like a pound on average, more a week just
because they were sleeping an hour and a half more a day. So it seems like sleep is
really, really important if you're especially if you're like an athlete and you need to recover
or if you're a person that is like watching the nutrition more making nutrition changes like
sleep is just as important as everything else you're doing in your day.
Param Dedhia [00:36:17] And if I can add one more thing to that study, and I believe it
was either that same study or it was corollary that we do know that when somebody was
basically with that conversation a calorie, but when people under slept, they lost more
muscle mass because.
Juna [00:36:34] Yes. They lost more lean body mass.
Param Dedhia [00:36:37] Right. And then what happens to metabolism when you have
less lean mass?
Juna [00:36:39] Slows down. Right. So, guys, if you remember back to our metabolism
episode, if you go back and listen to our episode with Dr. Herman Pontzer. You'll
remember that your lean body mass is one of the most important determinants of your
metabolism. And if you're ever in a calorie deficit, we want to make sure that the weight
you're losing is as high of a percentage fat as possible and low percentage muscle as
possible to maintain your metabolism as you lose weight. And it's just like Parham said,
like the less people slept, the more muscle they lost versus fat. Mm hmm.
Eddie [00:37:09] So Parham, here's a phenomena that I was seeing with great regularity
in my house at one of my 20 something children who was remarkably getting up at 7 a.m.
for work Monday through Friday. Amazing would go to Hawaii every weekend, which is
about five time zones removed from East Coast of the United States, waking up without an
alarm at noon.
Juna [00:37:33] So figuratively go to Hawaii. He wasn't flying to Hawaii every week.
Eddie [00:37:36] Nobody but.
Eddie [00:37:37] The sleep schedule was.
Eddie [00:37:37] Going to her, which.
Eddie [00:37:38] Seemed fine until Monday morning, came around and then had a fly
home, so to speak. And it was just it was not pretty by Monday morning. So can you talk a
little bit about what I understand is social jetlag?
Param Dedhia [00:37:52] Absolutely. And let me share. One size doesn't fit all. There's
some people that can be able to switch their schedules better than other people. And
obviously, biasedly, I tend to see people who essentially are more challenged with their
sleep. So I'm really much more asking them to keep their schedules similar during the
weekday and the weekends. Mm hmm. So we do know, again, we want to be a part of the
world? We don't want to miss out. And I get that completely. But going beyond that, one of
the things that I want everybody to appreciate is that if I'm hearing somebody on the
weekends sleeping in and not having an alarm clock, that they need to think about what's
happening during the weekday. Are you getting the quantity and quality of sleep and are
you again being that great student, being that great family member, that employee and
learn to suck it up and then finally give yourself that chance to do the recovery on the
weekends. And of course, you know, a lot of things are happening in the evenings after
Friday night when people get off work and want to be able to decompress. It is one of
those things without question. We know that the body can figure out itself one ish hours or
so. So if you normally are shifting your clock by one hour, the body kind of does that really
relatively well. When you get to two plus, that's when it starts to slip. And then that, you
know, conversation and I love how you put it from, you know, the East Coast to Hawaii that
five hour shift. We would prefer people not to do that, but we do know that without
question, people have and will. And just knowing that long term, that's not going to be
sustainable.
Eddie [00:39:23] So I don't have to wake him up at 7 a.m. Saturday morning.
Eddie [00:39:32] So talking about getting good sleep during the week, can we talk about
some things we can do to actually actively improve our sleep quality? And I know you're
very passionate about rituals. And using your day to set up your night. So let's talk about
some of the things we can proactively do.
Param Dedhia [00:39:49] Beautiful. So let's talk about from the time we wake up, we want
to make sure that we appreciate that as we can have a set wake up time. So important.
Many people talk about a bedtime. You can't force yourself to go to sleep. With some
displeasure, You can force yourself to wake up. And the reason why that's important is that
it's one of the greatest ways to help set the circadian. Hmm. Because when you do that,
then you would give yourself a chance to be sleepier at an earlier time, and you have to be
consistent with it. Which, again, if you're not having good sleep, meaning a sleep of
quantity, quality and that of a rhythm, people might fight it. But those people that work with
me that really stick to that wake up time, they phenomenally do much better. As already
mentioned, somebody's not sleeping well. Have breakfast. You don't need it. Denny's
Grand Slam. I'm not endorsing that at all. But some nourishment and please, you know,
get all the nutrients and not just a carb load, get your nutrients and make it yummy. Your
life needs to be enjoyed. Get into the light, get some sun, get some shine. Guys like that,
honor the light boxes of the world. You don't need to stare at it. Heavens knows, my
ophthalmology friends dont want you doing that. But even having it next to your side and
having it in your presence, it's going to be very, very important.
Eddie [00:41:03] And is that an early morning thing to do?
Param Dedhia [00:41:06] It is great to do it within the first, you know, set of hours in the
morning. First couple of hours. Okay. Yeah, very great. Thank you for slowing that in and
bringing that in. Beyond that, the other thing that I think would be really important for
everyone is to get some movement. And again, I know that for myself, I know I'm not a
hospital physician anymore. I'm not walking up and down stairs anymore. I'm not walking
from one wing to the other wing. But whatever we can do to get more movement in so
important, you know, give yourself that stretch break. Sitting at the computer, rotating in.
Please give yourself a chance to take a break.
Param Dedhia [00:41:41] Eddie's bike desk! Eddie has a bike desk. He bike and he
works. And that's how he does his meetings, too.
Eddie [00:41:47] They they persuaded me not to bring it into the studio.
Juna [00:41:51] Just here pedaling. The whole time.
Juna [00:41:53] And huffing and puffing and.
Param Dedhia [00:41:54] Yeah, I love it. I love it.
Eddie [00:41:56] I wanted to share with you. My wife and I went off for a yoga retreat. Oh,
there's a lovely place in Massachusetts, Kripalu, you know, and did all sorts of different
yoga. And the most challenging yoga for me was called Yoga Nidra. And the only
instruction as they went through this process was to not fall asleep. And I failed miserably.
Param Dedhia [00:42:19] Right. Now, let me share with you. We call that paradoxical
intention. So for the people listening, you've got to stay up. You've got to stay up. You've
got to stay up. And the other, got to fall asleep. Guess what would happen universally?
The opposite. So interesting how the brain we we program and almost seemingly give
ourselves the ipsilateral the opposite of what's going on.
Eddie [00:42:44] Like teenagers, right? Like teenagers.
Juna [00:42:46] It's so true because I've been stressed out about trying to fall asleep
because I know I need more sleep recently and I feel like I stay up so late because I'm
paranoid about not sleeping. And it's like, anyways, and that's a good transition to talking
about our nighttime rituals, which I think is what you were going to get to next.
Param Dedhia [00:43:01] Yes. And the last part of the morning, if you enjoy your caffeine,
keep it in the morning hours, it's oh. Coffee. Tea, great. Antioxidants, you know, those
other colas and other energy drinks, even if there are four, five vitamins. But keep your
caffeine to the earlier hours and then. Yes, taper into the night. It is so amazing. Right. We
want to go, go, go. And then suddenly stop and fall to sleep.
Juna [00:43:26] And just pass Out.
Param Dedhia [00:43:27] Right. And I understand why that would be what people want,
but that's not what really is helpful. And again, so many of us, you know, want to be able to
be a part of everything. Yours truly is involved in that as well. So if I can just push one
more hour to get a little bit more work done. You know, the family's sleeping now I can get
some work done. We do need to give ourselves permission. First, second and third. Give
yourselves permission. And not only physical, mental and emotional. We go through, we
honor our great families. Our great companies are great societies. What we do know is
usually at the end of the day, people want me time. Now, it's not an easy sell, but the
ultimate me time is sleep time. Physically, mentally, and emotionally spiritual. It is so
important. But what I want people to appreciate is finding that me time and I love to talk
about it as almost a ritual, almost spa like. Really, we talked about a shower about bath.
So let's mimic nature every single night. What happens outside? Cool, comfortable, dark
and quiet. So if you go into that shower bath, dim the lights, burning candles, give yourself
some smells, some aromas that like, oh, you know, this essential oil stuff. I thought it was
just nice and kind of, you know, cute. As I've studied more of this, I'm like, wait, there's
actually some real chemistry here that we need to be able to take a look at. And everyone
says, Oh, it's got to be lavender. It's got to be no find the smell. And I think some people
love lavender. Some people tell me it stinks and they're both right. You've got to find what
resonates with you. So go find those bath gels, those salts, those candles that just really
give you that are and would also put on some soft music, something that's soothing. What
I would love people to do is to get, you know, that towel, get that pajama on that really
makes you look forward to the night when you get into your bedroom. Oh, remember, the
bed is for two things for sex and sleep, and that's it. Not for thinking working, iPadsurfing,
telling your bed partner they're wrong. And you're right. That's not going to work any time
of the hour, let alone right when you're trying to fall asleep? You really would want to
appreciate that the bed needs to be a place, a sanctuary in your bedroom. We know this
from all these movements of decluttering. When your surroundings are cluttered, you're
cluttered. So whatever you can do but the world behind you start to taper. Do some of
these rituals, soft music, some yoga stretch that warm shower bath. But my favorite is
Breathwork. And, you know, I'm of Asian Indian descent. Born and raised in Michigan. To
give me culture, my parents put me in front of yogis whenever they would come to Detroit.
To say the least, the yogis would kick me out because I was a squirrely kid. Restless legs.
Even during the daytime, I guess, and all I knew about mindfulness meditation was I stunk
at it. I was terrible.
Juna [00:46:25] Same.
Param Dedhia [00:46:26] And, you know, I talk about this with almost everyone and
almost universally I can't to it. I think at it I'm like, Yeah, you're human. This isn't natural
and this is the reason why we need to practice this. And it's so important. And what I want
people to appreciate is creating that stillness like that yoga nidra The goal of yoga, Nidra,
isn't to fall asleep. What do you think yoga needs reform. Sleep. It's hysterical, but it's that
ability. Here's a fun little next bit of trivia. When you take a look at brainwaves, one of the
things we do to calibrate the sleep study every night that we started is we have people
open eyes and close your eyes. And what do we know when you close the eyes still
awake, but close the eyes, you see the brainwaves slow down a little bit.
Eddie [00:47:06] Oh, so some of that answer is, I guess part of my question, which is if
you were to just lie still. Yeah. As my memory of yoga nidra before I fell asleep in them and
the first 5 minutes was just lying still closing your eyes. Is that provide some portion of the
restorative aspects of sleep?
Param Dedhia [00:47:29] Yeah, it does help now is it sleep? It's not sleep, but it's going to
help you move in the direction of sleep. You know, it's one of the funniest things. One time
I was giving a talk and somebody stopped me. A week later said, Oh, that was great. And I
said, Well, tell me what was great. They said, I followed recommendation, I'm like, I usually
tell people a lot of things. What did you feel? I closed my eyes. It helped. And I was like,
What? I love it because it just gives us permission again that if we don't give ourselves that
ability to rest and again, if you fall asleep, right? If not, you're resting. And one of the great
things is not trying to fight yourself or, you know, this push pull life we live in that's not
going to help us sleep. So I just you know, I love this whole episode that we're putting
together because it gives people a chance to come back. You know, listen to this. Listen to
it again. And here at this point, your time, Heraclitus, the famous Greek philosopher, no
man, woman, steps in the same river twice. We're evolving. The world around us is
evolving. So anything that anybody listening is hearing come back to every once in a
while. What resonates with you today may be different. A little bit later, the biggest thing in
my favorite writers that I love to paraphrase, is Emerson. Methods are many, principles are
very few. A man woman chasing methods may or may not find it. Person with principles
will find a helpful method. So we do know the math eating real food, slowing down
physically, mentally and emotionally. These are principles and you'll find the right method.
But honor the few things that you're hearing in this episode in many others. Take away
those principles. Please, please.
Eddie [00:49:08] One thing I love that one thing I was smiling at Juna, is that I've heard
I've heard not ours, obviously, that some people listen to podcasts to fall asleep.
Juna [00:49:18] That's me parham I'm sorry.
Param Dedhia [00:49:18] I hope this podcast puts people to sleep right, isn't that the
whole point?
Eddie [00:49:22] That's exactly right. Thank you.
Param Dedhia [00:49:26] Hopefully nobody's driving right now, so sorry.
Juna [00:49:29] Well, I think that's a great place to end the episode on, thank you so much
Dr. Parham Dedhia for being our first live interview guest. This is so fun.
Eddie [00:49:38] Thank you very much for for your wisdom and for the way that you've
presented it. And I feel like I have more permission to take better care of myself and I
really appreciate your granting me that permission. So thank you.
Param Dedhia [00:49:51] I'm honored. Thank you all. And to everyone listening, wishing
you a great night, deep sleep and sweet dreams. Thank you. Thank you.
Juna [00:50:00] Thank you so much for listening and potentially falling asleep to today's
episode, which I will allow on this episode because sleep is very important. You can find all
of our show notes at our website, foodweneedtotalk.com. You can find us on Instagram
@foodweneedtotalk. You can find me on Instagram @theofficialjuna and Juna Gjata on
YouTube and Tik Tok. You can find Eddie.
Eddie [00:50:22] Trying to get to sleep on time tonight, okay?
Juna [00:50:25] Yes. Okay. Eddie is going to have a good sleep schedule. I'm going to try
to get to sleep on time tonight too. Food, We Need to Talk is a production of PRX.
Eddie [00:50:33] Our producers are Morgan Flannery and Rebecca SYDELL.
Eddie [00:50:37] Our mix engineer is Tommy Bazarian.
Eddie [00:50:39] Jocelyn Gonzalez is executive producer of PRX Productions.
Eddie [00:50:44] Food We Need to Talk was co-created by Carrie Goldberg, George
Hicks, Eddie Phillips and me.
Eddie [00:50:49] Remember, for any personal health questions, contact your health
provider.
Juna [00:50:53] Thanks for listening (And not falling asleep).
