How do you know if you're getting enough sleep? Based on the things that you study? Yes. Because you hear eight hours.

How many hours do you sleep, by the way?

The older I get, the more boring I am. So I would say nine or 10.

Yeah, I love that. People who sleep less than six hours have higher mortality. They have lower mood, and they are hungrier, as we said, with the It's interesting. What you want to do is really to realize how much sleep you need is when you sleep without an alarm, how many hours do you sleep? And not when you're sleep-deprived.

Oh, I bet I sleep 10 hours. If I don't have an alarm on, I sleep way longer than I think I'm going to.

When you look at the last couple of weeks of your life, the best days, the when you felt the most refreshed, the best mood.

Were the days I got the highest amount of sleep?

By far. That's how much sleep you need. And every American that's listening to this is going to be like, I can't sleep that much. But you think about your best days of your life happened when you slept adequately. It changes your hunger hormones. It changes your hormones in general. For women, especially as we get older, this is important. It changes your mood. It changes your ability to make decisions and your interactions with other people. So why would you want to skimp on that. Why would you say that you'll be like everybody else, sleep when you're dead? When you look at the data, the data says opposite. It says if you don't sleep, you'll be dead much earlier.

That's true.

If you If you don't sleep, you will be more depressed, more anxious, have more hunger and craving signals. You are going to be a version of yourself that is a shell of what you want to be.

So one final thing that I think would be extremely helpful to people. Let's assume that we went to bed early, and we wake up and we get a good night's sleep. Can you walk us through what you would recommend the eating routine or what is on our plate and when are we actually eating? Okay. For complete hormone balance.

Yes. Okay. So as you know, everybody is different and their life circumstances are different. Every time I do this, people say, Oh, but I work night shift, or I have little kids. I get it. I had many years where I didn't get enough sleep, where I didn't get enough sunlight, where I I couldn't make the best decisions because I was just so pulled in all the different directions. So I get it. But we didn't even talk about circadian rhythms, but Mel, sunlight and darkness run our bodies. We have internal clocks in every one of ourselves. So routines are excessively important in terms of our mood and our body, our nutrition. So when you wake up in the morning, you I want to get sunlight. I have a rule that I learned from someone online. Basically, I did this for a few days, and I felt the best I've ever felt, and I'll tell you what it is. When you wake up, instead of scrolling your phone, checking your messages and your emails, go get sunlight first. Sky before screens.

Oh, I love that.

So sky before screens is how you should start your day. Your body is wired to see sunlight in the morning, even if it's a cloudy day. It just has to be bright light. You can just walk out outside. For me, it's my back door. Just walk out for a few minutes. It could be 2 to 10 minutes. For me, I'm usually just in my pajamas, so I'm coming back in and getting ready for the day. You don't want to have food or caffeine in the first 45 minutes of your day.

Why?

I'll tell you why. When you wake up, you feel groggy, right? Yeah. That grogginess is partially, mostly from adenosine in your brain. Adenosine. Adenosine. It clears out, as you know, within 30, 40 minutes, it clears out. Then you have your coffee. Then you eat your food. And the reason why is coffee, the way it works, it blocks our adenosine receptor. So that means that it doesn't help get rid of that adenosine. It just blocks it from actually binding. So if you don't let that adenosine clear out and you just drink your coffee, when the coffee wears off in a couple of hours, that adenosine is still there. And it just binds those receptors, and you feel excessively tired.

And that's why you think you need another cup of coffee.

And then you're fully dependent. Like the people that wake up and they need the coffee right then, and then they need it again at 10:00, And then they need it again at one o'clock. It's because you're not letting that adenovine go. You need to let that clear out.

I'm guilty of this. So I am going to try this tomorrow. I am going to absolutely have my coffee, and then Oh, no, I'm not. I'm going to wake up. I'm going to wait 45 minutes. Then I'm going to have my coffee. I'm going to see if I have a craving for a second cup. Yes. That is fascinating. Okay.

So you want to let it clear out naturally because it's not going to clear out naturally if you start the caffeine cycle right away. Got it.

So clear it out for 45 minutes. Get our son in. What's next?

Eat.

Okay. No intermittent fasting.

So everybody... I love intermittent fasting.

Then why are we eating?

Because I do it the opposite way.

Talk to me.

There's very good evidence that for thousands of years, we ate in one scheduled way, which is daylight hours. There was no microwave Uber Eats. They had a fire, and you'd maybe eat an hour or two after sundown. That's it, right? Yeah. You are not snacking at midnight. There's nowhere to store the food thousands of years ago. Our internal clocks are set so that when melatonin hits 2-3 hours before bed, your organs shut down. You cannot process sugar as well as you did. You can't take it into your muscles. You are not processing You're not releasing digestive enzymes. So basically, when you're eating late at night, you're waking your body up in the middle of the night and asking it to do a math problem. Your body is going to be like, I don't want to do this. I'm going to make mistakes. You wake up and you're tired and you're pissed that someone woke you up in the middle of the night. That's what happens when you eat late at night.

Holy smokes. You put your body in conflict with itself.

Yeah. So intermittent fasting, everyone's They're doing it the wrong way. They're eating way late into the night, and then they don't eat all day when the sun is out, right? That's the time that your body is ready for food, right? So ideally, you wait an hour because nobody needs to be eating every minute of every day. Americans, we just eat 14 to 16 hours a day. It's just too much, right? So you wake up, maybe you get some movement in, you get your sunlight, you eat about an hour or two, even after you wake up. You don't need to push it to two, three, four. People are doing this thing. There's good evidence that skipping meals is actually bad for you and that people who do it habitually actually have worse health outcomes. Got it. So eat your breakfast. You want to have a high dopamine breakfast. Let's have cottage cheese, eggs, tofu, scramble, veggies, nuts, berries.

Great. When do I eat next? Because I'm already hungry. No. Am I hungry right now? When I eat vegetables, I would eat vegetables right now. There you go. Then you're hungry. So that must mean I'm hungry. But I got to have a glass of water first, and then I'm going to ask myself that again. See, I'm learning.

Then you tune in with the inner mouth, the brain-gut mouth. So then you can eat when you're hungry. Again, you can use your inner cues. Could be 12, could be 1, whatever your inner cues. You'll notice your Ghrelin is set on a Timer. Every day, you'll get hungry at the same time.

So hello, Ghrelin. It just, I think, dumped on me. So what do you eat For lunch?

So basically, lunch is a chance for you to get... The healthier you eat earlier in the day, the better your chance of sticking to it. So they always say exercise and eating healthier foods, breakfast and lunch is your best chance. For me, I automated. I had already talked to you when we had talked before that I try to eat the same things every day. What do you eat for lunch? I eat a salad for lunch. I usually put a protein source on it. It could be different beans, nuts, it could be tofu, it could do eggs, you could do salmon, whatever you want. Protein and veggies, a salad with protein on it. And I always have a fermented probiotic food with my lunch because that's the best time for you to get in at least one to two servings of the kimchi, of the sauerkraut. It could be kombucha for a drink, apple cider vinegar in your dressing. So that's when you have the best chance. Really simple. It can be very simple. And then your dinner is when you want to eat. If you are someone- Serotonin, baby. Yes, you're learning. I'm paying attention.

I know it's not sexy to say eat carbs, but carbs actually can be very healthy for you, especially in vegetable form, sweet potato, quinoa, whatever it is. You can eat that later in the day if you want to have that big boost of serotonin.

And what about snacks? If I'm legit hungry, but I'm not really craving anything, Yes. But I'm legit hungry midday, what's your go-to snack?

So remember that protein has this effect on your body that it tells your hunger hormones to stop. So if you want more leptin, eat more protein. So your snack can be yogurt. Your snack can be a protein shake, your snack can be a piece of cheese, something with protein, because that will keep your dopamine Humming levels up, and it will keep your hunger hormone stable. So protein snack. I think women, especially, we're eating just too little protein. There is a theory that the reason we get fat from eating ultra-processed food is because it's so low in protein that your brain never gets the signal that you're full. Your protein threshold is never met.

Wow. One final thing I want to ask you because we didn't I can't really cover it, gluten. Everybody I know is gluten-free.

Yeah, it's not the gluten. There's very few people who are actually allergic to gluten. It is very common to have GI issues with processed gluten. So when you eat a lot of bread, pizza, carbs, but that's not the gluten itself. It's the fact that you're eating processed food. So gluten gets mislabeled all the time. What I say to people is, go gluten-free for a few weeks, three to four weeks. See how you feel. When you add the gluten back, don't add back the bread, the cookies, the cakes, and the processed gluten. Add back a small wheat bulgar, like in a salad. Add back a healthy sourdough bread. Add back wheat in small unprocessed amounts. And then see How You Feel. And what I realized is that people villainize gluten all the time. And in America, gluten-free has become such a tagline that those foods are more unhealthy.

Oh, because of all the processing. Look at you, Dr. Amy. Is there anything else on this topic that we did not get?

I think we covered so much. I think, like you said, and I have taken this to heart, is that there is no pill that's going to save you. There is no person that's going to save you. When you learn about all this, when you actually listen to your own self, you're going to be the one who saves yourself.

Can you explain why we sleep and why it's so important?

It's a great question, actually. Not stupid at all. It's something that we've been looking for an answer to for the last 50 years, probably 70 years, and actually longer than that. But it's not easy to come up with an answer because there are so many answers. There's so many things happening during sleep that can't happen at any your time. That new answers keep bubbling up. So sleep is great for the immune system. It's great for cognition. It's great for the emotional system. It's great for growth and repair.

What is the difference between And being awake and being asleep? Is there a physiological or neurological difference between the two?

Yeah, it's huge, actually. So when we fall unconscious and into sleep, neurotransmitters, chemicals in our brain completely change their composition. So there's a set of neurotransmitters that are associated with wakefulness and being able to intend to the environment, have conversations, think thoughts, and they completely switch when we fall asleep. So that one main one, which is called acetylcholine, which is really important for attention to the environment, switches off. And that's very characteristic of non run-REM sleep, which is the first state we normally go into when we fall asleep. So acetylcholine turns off in animals that sleep unihemispherically.

Okay, that's a big word. What is unihemipher? I can't even see the thing. I'm going to feed the thing, seriously.

Unihemispherically means one hemisphere at a time. We have two hemispheres in our brain, and each hemisphere controls half of our body. And so the right hemisphere controls the left half of our body. So one hemisphere of the brain is asleep and the other hemisphere is awake, and the hemisphere that's asleep switches off the attention acetylcholine neurotransmitter, the chemical. But your brain is doing all kinds of essential things that can't be done during wakefulness, it's another work time. It feels quite different than waking work. Then you can justify, Hey, I need this. I'm going to feel better. I'm going to be able to tackle my next day better.

Never even occurred to me that it goes way beyond rest, because what we're about to learn today is there's all these really critical health and mind functions that can only happen when part of the brain is in sleep mode. Is that right? That's right. Absolutely. Holy cow. So why don't we start with what the perfect night's sleep, based on your 30 years of research. What does a perfect night's sleep look like? Just so that we have a benchmark for what would be ideal.

I think if you just look at a 10-year-old, you'll get what the perfect night's sleep looks like. They sleep beautifully. They have a beautiful homeostatic, which means it responds to what you're doing during the day, a response, and how long you've been awake. They have a beautiful circadian, which means their body knows what time of day it is and what time they should go to sleep and what time they should wake up. And so the 10-year-old's sleep is perfect. Don't ever wake up a 10-year-old if you can possibly help it. They're doing a lot of really important things. And after that, our sleep changes during our teenage years, and we need just as much sleep as a 10-year-old, which is about 10 hours or 9 or 8, 8 to 10:00 hours for sure. But teenagers, circadian rhythms change a little bit so that they fall asleep a little later and want to wake up a little later. So it's also a beautiful night's sleep if they are calm and not too engaged with social media at the wrong times. But anyway, that's a great night's sleep. Our sleep is actually pretty great until So we're about 40 or 50 years old, and then varying depending on the individual, your sleep can start to become less efficient.

And so what does a perfect night's sleep look like in terms of how long you sleep, the various phases of sleep?

Right.

Okay, so the perfect night's sleep for health as an adult is something around seven and a half, eight hours, plus or minus an hour, something like that. Okay. You should be awakened by the sunlight, essentially. So that's something that resets our clock every day. And then so you work back from there, from the time you need to waken, to get at least seven and a half, eight hours of sleep a night. Different people need different amounts of sleep. Some people need more like nine. Some people are fine with six for a while. How do you know? You just have to know from your own body. Some people, if they get six hours of sleep, they know already immediately when they wake up and going throughout the day, it wasn't enough. And so your body will tell you. And other people wake up at 6 hours and they're fine. They feel great. And one way to know is how sleepy you feel during the day. Okay.

You already said one takeaway that I want to make sure that you listening got from us, which is you start with the time that you want to wake up, and then you roll the you roll the clock backwards, and you're basically saying that it's seven to eight hours, give or take an hour. So you roll the clock backwards, probably seven to nine hours, and that's when you need to fall asleep.

That's right.

And what happens when you fall asleep? What are the phases that we go through as we're sleeping?

The very first stage is, of course, dozing. And we don't really know when we're dozing, except that we come conscious once in a while and say, Oh, wow, okay, what happened in the last couple of minutes, I don't know, because our memory starts not recording what we've been doing. And that lasts on average about two minutes. For example, if you're reading a book and you fall asleep reading the book, you won't remember the last two minutes of reading, or if you're listening to a podcast, you won't remember the last few minutes of the podcast before you actually fall asleep.

Or if I was talking to my husband and next thing you know, he's snoring. He doesn't remember the last minute and a half of what I said. That's exactly. Exactly. So there's that dozing period, which I rather like. I love that you drift from your mind spinning to all of a sudden, almost like you're floating in a pool. That only lasts two minutes?

No, stage one is variable. It's about two to five minutes, something like that.

Okay, and you need that stage one of dozing to get into stage two. What happens next?

Then stage two is really exciting stage. So between stage one and stage two, there's something called hypnagogic hallucinations, which-I'm not even going to try.

Hypnagogic solutionations? Hallucinations. Hallucinations.

It's our brain losing hold of reality and all kinds of imaginary, imagination things happen. For example, it can be as boring as feeling like you're falling off a step because not all of parts of your brain are asleep at the the same time as you drift into it. And so you feel the muscles relaxing and part of your brain says, I'm falling, and the hallucination is incorporated into that feeling of falling. And so you think you're falling off a step.

Wait, is that why they call it falling asleep? That makes so much sense. And I have had that experience before, where I do that dozing, my favorite part, you can drift off of the pillow, but then I every night have a jerking sensation, and it is like falling. It's almost like you're moving into the phase where your body is clumsily trying to turn your muscles off so you can drift into the deeper one. That's pretty cool. Now I know why I do that.

Or it can be as horrifying as feeling like there's a monster jumping on your chest and shaking you. And it can be very, very disturbing as well if you wake up from it. So pretty vivid hallucinations, almost like the dreams we have in rem sleep, only you don't have the atonia, which is all your muscles being inhibited to prevent you from acting out the dream. So oftentimes people, if they have a vivid hallucination that's scary, can wake up from that and then feel like, oh, what just happened? Was there a monster in my room? Really? I think that's the idea of nightmares. It comes from that idea So just the hallucinations, the weird hallucinations.

And this is as your brain is trying to drop itself into a deeper state of sleep. Oh, interesting.

I didn't know that. Yeah, and not everybody, and most people, in fact, don't wake up from that. N2, it's called. N1 is dozing. N2 is that state of sleep, which has pretty vivid dreams, but they're not long story-like dreams like we have in rem sleep. But We'll get to that in a minute. So then from N2, which our brain is very active, we go into N3, which is also a time of activity, but it's really synchronous activity, like waves of activity going through our brain, and it's disconnected in time one wave from another, so consciousness can't be maintained. And if you wake someone up out of N3 sleep, slow wave sleep, and ask them what they were dreaming, they will not report having dreamed anything. It will be a blank slate. And it's actually pretty hard to wake someone up out of that state. It's a deep. It's called a deep sleep.

And what's the purpose? You use the word wave. What is actually happening in your body when you're in that third phase and the wave is happening?

Yeah. So that's a time when we know that our brain is cleaning itself, actually. Wait, what? Yes.

It's cleaning itself?

Yeah, it's cleaning It's like the filling itself. Of what? Of all the junk that builds up during the daytime when we're awake and alert. What junk builds up? Well, proteins get unfolded. So things break down, energy is used. All of that gets restored in that deep state of sleep.

What would happen if you didn't get that deep stage of sleep? And the wave, the cleaning wave. I'm seeing somebody coming in after a big party and cleaning up all the cups. It's like this wave comes through your brain. It's like a wave comes through your brain?

It's like a wave cleansing the brain. Yes. And there's one per minute or so. Actually, one per second, actually. So a lot more often than that. And it sweeps from front to back, and it just pushes all the junk into your cerebral spinal fluid and out into your body.

Is that why my back hurts?

I don't think so.

I'm just kidding. But yeah, that's a good question.

Yeah, so If you don't get it, you actually don't get a chance to clean your brain like that. So you really need it. And that's the sleep you get, mostly in the first half of the night after you fall asleep. So you go from N1 to N2 to N3. N3 lasts 20 to 30 minutes or so. And then you go back into N2 briefly and then into rem sleep, which is called rem sleep.

How is that different than the wave?

It's very different. It's actually also called paradoxical sleep, because if you look at brain activity, it looks just like someone's awake.

Really?

Why? Thoughts are going through and dreams are happening. It's really strong imagery in your dreams. If you wake someone up out of that state of rem sleep, they will always report a dream, 90% of the time. Even people who, if you ask, say, Oh, I never dream, or I never remember my dreams. If you wake them up out of that stage, they'll remember. I think the reason why people don't remember their dreams is because they are solidly asleep and don't wake up out of that state. So don't worry, you are dreaming.

What is your brain doing when you're dreaming? Yeah, in that rem stage.

Yeah, you are... Well, first of all, you're creating dreams. It's also important for the process of creativity and for changing your mind. It's actually an extremely plastic state. So it's paradoxical because electrically it looks like wakefulness, but chemically it's very different. So two of the neurochemicals that are off during dream state are two neurochemicals that keep you attuned to things that are novel and they're coming in from the outside world and help you learn from things in the outside world. And those are norepinephrine and serotonin. They are off during rem sleep. So instead, you're attuned internally to internal thoughts and internal images. And so you can actually build your own schema from the things that you learned during the day that are now registered in your brain. It's not a time for new learning. It's not a time for listening to new podcasts and getting that information in. It's a time to assimilate the things that you've already learned into coherent patterns that make sense.

I want to see if I can give that back to you to make sure that you listening are tracking, because I just had a big, whoa, aha moment here. So you said that the first four hours of sleep are critical for creativity. And I've also, I think, read in your research that it's also critical for the making of memories.

Yeah, for the assimilation of memories.

What is What is the difference between making and assimilation of memories?

Making memories requires us to pay attention to things in the outside world and put them together. And assimilating means you've taken those things from the outside the world, and now you're putting them together into packets we call schema, which are related pieces of information. And it's good for creativity because these new pieces of information get assimilated assimilated into different schema in ways that we can't do when we're awake.

Okay, I think I'm actually getting this. Okay. You're basically saying that neuroplasticity isn't happening when we're learning. The neuroplasticity is happening when we're sleeping. There's that saying in the exercise world that your abs are made in the kitchen, not in the gym, because of food being medicine. And what you're basically saying is habits are made in your bedroom while you're sleeping, not while you're out in your life living, because that's when your brain locks in all the learning that you did today. That's so freaking cool. The chemicals, or I don't know if that's the right word, but the chemicals in your brain, which are serotonin and noreporefrin, or however you say it.

Noreponefrin, neuroadrenalin.

Neuroadrenalin. That's easier for me to say. Neuroadrenalin, they're not present, which means you're only tuned into the information that is in your brain and your body from your experience today. And because those two chemicals aren't present during this sleep cycle, your brain is locking in these new patterns and habits and skills and memories. You're calling them from an academic standpoint, like each one of these memories or this new skill or this new neurotransmitter that gets created is a schema.

Yeah, it goes into a schema. Schema are things like, what is Christmas? There's a whole host of things that are associated with Christmas or what does summer mean? There's a whole host of things, and that's a schema into which a lot of things get built. Yeah.

So it's almost like our own internal search architecture. Yeah. I think about it like Legos. Summer Lego box. There's a whole lot of little Lego cubes in it of different colors, and you can create different things. This is really cool. And so neuroplasticity and habit formation, one of the huge takeaways that you've already given us is that sleep is critical for that to happen. You have to have sleep in order to have that formation happening in your brain and body. That's right.

Because during the day, you can collect these Lego pieces, but you don't assemble them into a coherent schema. Wow. Yeah. I think if you think of sleep as laziness or a time when you're not doing anything, then it's harder to justify in our workaholic world that time we spend to sleep. But instead, if you know that your brain is doing all kinds of essential things that can't be done during wakefulness, it's another work time, even though it's a pleasant work time and it feels quite different than waking work, then you can justify, Hey, I I need this. I'm going to feel better. I'm going to be able to tackle my next day better. And so you can schedule it in just like you schedule everything else into your life.

I'm sorry. I just think this is so cool. Now, I also read that sleep cycles last about 90 minutes. What does that even mean and what is in a sleep cycle and why should we care?

Yeah. On average, it's 90 minutes. And that's when you go from N1 to N2 to N3 to N2 to rem. And The whole process takes on average in us about 90 minutes. In other animals, it's shorter or longer. So we don't know why it takes the amount of time it does, but it seems to be important that it happens in the order that it happens, because if you disturb that order, if you get rid of one element of it, the whole process does not work nearly as efficiently or at all. So for example, if you just eliminate the rem sleep part, you can't consolidate your memories and put them together. If you eliminate the deep slow wave sleep part, the N3 state, the cleaning part, you will wake up with a junky brain and not be as efficient and able to handle the day.

Well, that makes sense because if you haven't brought the zamboni into your brain to clean out all the junk, then you're not working with a clear palate when it comes to locking in the things that are new. Yeah, that's right. Exactly. How many sleep cycles do we do in a night?

About Five. A five would be ideal, actually. So that's four, five, six and a half, seven hours of sleep, something like that. The first sleep cycle is a little longer than 90 minutes, probably because that N3 state is a little longer, and you don't have as much of it in the later part, the last half of the night. You don't have nearly as much N3 sleep. So if you miss the first half of the night, you'll miss most of that N3 sleep, which is the cleaning stage. So you don't want to miss that first half.

How would you miss the first half?

Staying up too late, staying up three hours later than you normally do. If you go to bed at 11:00, and now it's two in the morning, and you're falling asleep, you'll get lots of that rem sleep, but you won't get near as much, if at all, any of that cleaning state.

Okay, hold on. Now I'm confused. Okay. Because I thought that if you fall asleep, that's like, let's just say the clock's at zero, you fall asleep, whether it's at nine o'clock at night or one o'clock in the morning, that's hour zero. No. No? Wait, what?

Your body knows what time it is of day it is. So your Nobody knows the difference between nine o'clock at night and two in the morning. So if you chronically go to bed late, your brain is jumping to the second half of sleep?

No. Because I don't understand how you would miss the the wave coming through and cleaning your brain out if it typically happens in the first.

So if you go to bed late chronically and wake up late chronically, then your body says, okay, it's aligned with your wake up-time. It's actually what it aligns with best is the light that you're exposed to during the day.

Okay. What is the purpose of the second half?

The second half is for... I like to think of it as more creative. It's creative part. It's emotional resolution and creative building of new schema. The first half of the night is, let's do a little correction, it's more for locking in, like you said, strengthening and sealing the things that you learn during the day. But the second half of the night, or rem sleep more like, every rem cycle, is more for building new schema and making new connections and changing your mind and resolving the emotional aspects of your memory. So for example, if you remember a painful event Whether it's emotionally painful or physically painful that happened a year ago or 10 years ago, you will want to remember that because it's adaptive and it's good to have those memories. But you won't want to recall when you're remembering the event, the actual pain. Pain. You don't want to feel the pain again, either emotional pain or physical pain. That's not adaptive. You don't need that part of it. And so in our research right now that we're doing in collaboration with a few other laboratories stories, we're discovering that it is that rem sleep period, specifically the rem sleep period, and you get much more of it in the second half of the night, that helps to separate out the novelty and the immediacy and the physical reality of the emotions of those memories from the facts, the semantic facts that you put together that you can recall for the rest of your life.

And that's what happens normally. But people who have insomnia and they don't have good quality of rem sleep, their noreponephrine or noradrenaline is too active because they're too anxious while they sleep, then they don't have that distancing from the immediacy and the saliency and the sense that it just happened today. So that's what we're looking into.

That's really profound and exciting in terms of that insight, because if you think about it, I would imagine it's also applicable to somebody that has a lot of trauma. Yeah. Somebody that has a lot chronic pain, that all of that is a very real, lived, stored experience in your body. And if your brain is not able to get that seven to nine hours of sleep where it can do all of this functioning for a health and a mindset and neuroplastic. I think the implications of that, because what you're basically saying is that having good sleep habits and consistent sleep habits actually can help you heal.

Yeah, absolutely.

Not only can help you, but it's necessary.

It's necessary to heal. It's necessary to heal.

How does breathing impact your sleep?

In terms of insomnia, there's two times it can manifest. Insomnia affects about 30% of the population. Wow. And 10% have it chronic. One is that we go to bed at night, but we don't fall asleep readily. Typically, we should fall asleep in a few minutes. That's an ideal situation. But if we have over-stimulation of the mind, we're not going to fall asleep so readily. It's very important to be able to go into relaxation before we go to sleep. Now, that would involve, I would say, use blue light filter glasses and follow sleep hygiene. Your bedroom is cool, it's airy, it's dark, and all of that stuff. But also, we need to tell the body that we're going into rest and digest. You could be sitting down, you might be watching some light TV, you might have your blue light filter glasses on. As you're sitting there, really take a soft breath in through your nose, almost that you're breathing less air. That's what I would like you to do. You're taking a really soft breath in through your nose, and you're having that light and a really slow, slow, slow, relaxed, gentle breath out. Then when you need to breathe in again, instead of taking your normal 100% of the breath, maybe take in about 70% of the breath in, and then a really soft and slow, gentle breath out.

The whole aim is to breathe about 30% less air into your body than what you're normally used to. You know you're doing it correctly if you feel a slight air hunger. Now, as you do that, pay attention to the saliva in the mouth. We'll Continue for one more minute. I would like you to under breathe, Mel. I would like you to breathe in a way that you feel that you're not getting enough air. How do you do that? Take a very soft, gentle breath in, almost as if your breath in is imperceptible, and a really relaxed and slow and a gentle breath out. So gently soft and slow down your breathing so that you're taking 30% less air into your lungs. If you get stressed, just take a rest. But keep working on this because now what you're doing is you're telling the brain that everything is okay. And pay attention then to the saliva in the mouth. When we get stressed, our mouth tells us because our mouth goes dry. When we are ready for rest and digest, rest, we feel sleepy. Digest, we have increased watery saliva in the mouth. When we alter our breathing, we're stimulating the vagus nerve, which is secreting that neurotransmitter acetylcholine, which is telling the heart to slow down, the brain is interpreting that the body is safe, and the brain is also spying on our breathing at the same time and interpreting that the body is safe.

So we feel sleepy, and we do this for 10, 15 minutes before we go to sleep.

I know that you recommend people try this tape on their mouth when they sleep, and I tried it for the first time last night. I did not have this fancy O-ring, so I used packing tape. I know that that's probably not what you recommend. And when I pulled it off this morning, I think I gave my upper lip a wax. But I put it from the nose down so that the sides were exposed, and I learned something really interesting. I I put the tape on my mouth so that I would be cuing myself to nose breathe. And it's how I sleep. And I'm a fantastic sleeper. And I realized I sleep predominantly with my mouth closed. And my husband, on the other hand, he has this sound that he makes that goes... It drives me freaking crazy. I know it's sleep apnea. I also know that 1 billion people around the world have obstructive sleep apnea, 1 billion. How does this nose breathing improve even people's lives with obstructive sleep apnea?

Okay. So obstructive sleep apnea is when the person stops breathing for 10 seconds or more during sleep, that would be an apnea. Or a hypopnea is when there's a reduction in the flow of their breathing due to partial collapse of the airways, that their blood oxygen saturation drops down by 3 or 4 %. The problem with sleep apnea is that it arouses you from deep sleep, but it's very stressful. It's very stressful on the cardiovascular system. There are four characteristics in obstructive sleep apnea. It's not just the anatomy. Insomnia that we spoke about earlier on is one of them. It's very important to be able to downregulate. Upper airway muscle recruitment, getting Taking these muscles to do their job is very important. There's a therapy called myofunctional therapy that's excellent for that. Mouth closed with the tongue resting up in the roof of the mouth with good recruitment of the die from, helps to open up the airway. You think of the typical middle-aged man. We're drinking a few beers. We're putting weight on the belly. This is impacting the movement of the diaphragm. We're now breathing more up her chest. This is reducing lung volume and the throat collapses more easily.

Our diaphragm breathing muscle, as I said earlier, is connected with the brain, but the diaphon is also connected with the upper airway dilator muscles in the throat. So coming back to mouthpuffing, and the mouth closed is really important with obstructive sleep apnea. Apnea. There are a group of people with severe obstructive sleep apnea and people who may be obese as well. They're more prone to mouthpuffing. You still need to allow them to mouthpuff during sleep. And we were lucky with the design of the tape, the Myo tape, because it allows the mouth puffing. Whereas before that, we were using 3M, one-inch micropore tape, which is going right across the lips, but that doesn't allow mouth puffing, and that can make sleep apnea worse than some people. So I'm going to come back to sleep apnea with taping of the mouth. Tested in people with mild obstructive sleep apnea, just getting your mouth closed reduces the AHI, which is sleep apnea severity severity by 33 %.

Wow.

So just with mild, just by getting the mouth closed, that's not looking at how do you improve your breathing patterns. If you have somebody with obstructive sleep apnea and they bring nose breathing into their everyday life, they learn to slow down their breathing. They learn to have good recruitment of the diet. From all simple skills that you bring into your everyday life, that will help your sleep up there. For moderate to severe, overall, it helps when you get them out closed all also. But for some people with moderate to severe, they need to be allowed to mouthpuff. So whatever you use as a support to get the lips together, make sure it allows you to mouthpuff.

Got it. Well, I'm going to make sure to tape my husband's mouth with your tape, and I'm going to stop shoving him or pinching his nose when he goes... Patrick, you are a gift to all of us. You have just given us all a free tool that we were born with to activate our natural intelligence, to lower our stress, to get better sleep, to be more present in our lives, and to learn how to access the profound power of breathing in and out of your nose, low and slow.

For the travel day, wear the stretch pants. Okay.

Got it. Okay. First of all, ladies and gentlemen, let's give a round of applause for triple bird certified Dr. Amy Shaw, who just told us all soft soft pants, people. Soft pants. You're traveling, you're feeling bloated. Let's get rid of the zippers and the buttons. Soft pants. So I got it. I'm taking it away. I am following it. You talked about the intestines and the stomach. Is that where this is happening, or are there other parts of your body involved when bloat is happening to you?

From the minute you take food in, you're chewing your food, the bloating can start to happen there. We all know with gum, with sparkling drinks, these are foods that can cause bloating because you're swallowing a lot of air from the time you put it in your mouth. Did you know that?

Gum causes bloating?

Yeah. Did you not know this? No.

Sparkling beverages causes bloating?

Yeah. What? So, yeah, you need to know this. This is why I'm telling you, this is the reset. So sugar-free gum, which is all gum now, right? You can't really get gum. I think bazooka used to be our gum when we were younger that had real sugar. But now it's all sugar substitute gum, and those sugar substitutes are very irritating to our gut bacteria. And just the act of swallowing a lot of air or chewing gum can push that air down into all the way. It's one tube, right? So from your mouth to the esophagus, to the stomach, to the small intestine, and the large intestine. So it's all one tube. So it can start from up there. Then you have people like us who are always in a rush and always eating too fast. And so it can even be an issue with just eating too fast and it's going through that one system, that one tube from your mouth to your anus, too fast. You're not taking breaks and you're not chewing enough. It starts with... It's not just a particular food, it's just that you're eating food too fast. Then you have foods like the foods that you consider super healthy: Brussels Sprouts, broccoli, cauliflower, cabbage, and mel.

Mel, you're being a great student. You're like, I want to eat all the fiber in one day. That is going to create a havoc in your gut because your gut bacteria are going to be like, We love this fiber, but not all at once. It's like giving them too much work in one day, especially when they're not used to it. And so you're going to get a lot of gas production while they're trying to digest this. So it can happen in your mouth. It can happen in your esophage because you're eating too fast. It can happen in your stomach because you ate too many really hard to digest fibrous foods. It can happen in your small intestine and then in your large intestine, too. So it's all the way through. You can get bloating from different causes.

Okay. Can we just stop on that? I have so many questions. I'm trying not to go all over the place because now you've sparked my interest because all those of things you ticked off, I did not know that sparkling beverages, gum, or eating all these things that I would say are super healthy foods, like broccoli and Brussels Sprouts and cabbage and that stuff, that That actually can contribute to bloat. So thank you for explaining that. I want to focus on the foods that you just mentioned, cabbage, broccoli, and Brussels Sprouts. Let's just call the trifecta right there, because I If I hear you correctly, you're basically saying if you're already bloated and you throw that into your system, you're going to literally inflate the balloon even more. Yes. However, when you debloat and you get your gut back into balance so that your gut bacteria aren't mad at you anymore, introducing those into your diet, not as a smorgasborg, but as part of what you're eating, as part of keeping the gut bacteria healthy. Is that correct?

That's right. So Okay. If you're at a party and there's this raw Cruciferous vegetable plate, I don't know if you've ever seen. I don't know how why people- What's Cruciferous?

What is that?

That's the family that we're talking about, the cauliflower, the broccoli, the Brussels press, the cabot. So A lot of times- Those four are related?

So they're like siblings, the Cruciferous?

Cruciferous family. And they have these amazing sulfur compounds that are so good for cancer reduction and inflammation reduction. So they're like powerhouse vegetables. But often at a party, they're on a tray, like raw, right? I don't know about you, but I have had a few too many of those at once, and you definitely feel it. What I would say, someone, if you're already bloated, Don't go to the raw vegetable tray and pick up the cauliflower and the broccoli because you're just going to really hate yourself later that night because it's going to start to digest and produce all this gas.

I'll tell you who else is going to hate you? The person you're sleeping next to because you're going to be lifting the sheets up as you're farting so you don't create a hot box in there. But you know what's great about you telling us that? Is because if I'm feeling uncomfortable in my pants And if I'm feeling bloated, especially if you're in wedding season or the holiday seasons or you're on a vacation, I would walk up to a raw vegetable plate and I would go, Oh, I should clearly have some broccoli and some cauliflower because I feel I'm bloated right now. And I didn't know until you just said it, that that would literally stoke the flames and make me feel worse if I'm already feeling bloated and my gut bacteria is mad. So what do I eat instead?

Okay. And then I want to tell you another one that will do the same thing. So say you're at a party and you wake up the next day and you're like, Oh, I feel so bloated. I feel hungover or whatever. I feel bad. And you take a whole bunch of ibuprofen or aspirin, right? That is going to make you more bloated. And a lot of people- What? A lot of people- Why?

This is my morning routine after a party. What are you talking about?

So medications are a big cause of bloating, especially NSEDs.

What's an NSED?

What do you mean an NSED? Ibuprofen, and Motrin, and Noproxine. Those are a class, again, cousins in a group of medications called NSEDs. Non-steroidal anti-inflammatory medication. Sonsets all have the same mechanism of action. So some people like napsin, some people like ibuprofen, some people like Motrin, and all these different versions, but they're all the same parent medication. Same with aspirin. Aspirin is very similar to all of them, but their side effect is bloating. And so you ate a bunch of cruciferous vegetables, you took a bunch of ibuprofen, and it's the week before your period, and then you You wake up and you're like, Oh, my God, I look six months pregnant. And that's what is happening. And so I'm going to tell you what you need to do to reset that.

Thank God. I hear a lot about gluten, and and bloating. So is there a connection? What are the foods, other than the cursipheresses that you just explained, what are the foods that tend to cause bloating in people?

Gluten is definitely one of them. I mean, we all know there's so many people out there who feel bloated after pizza and bread and pasta. And sometimes it's not necessarily a gluten. You can have a sourdough bread and be okay, but you have pizza and you're not. So it's not necessarily Sometimes the gluten itself, but the way it's prepared. There's also, I think, 68% of the world population is lactose-intolerant.

What does that mean?

That means that when you eat dairy foods, you get bloated because your body can't break down the lactose sugar. I don't know. Are you one of those people? So everybody's different, right? I have no idea. So 68% of the world population can't digest a glass of milk or a big scoop of ice cream. They get bloated from it.

What are some other symptoms or things that you've seen in helping people to reset their gut, Dr. Shah?

Well, I talk about this all the time, but your mood and cravings has a huge connection to your gut. So we talk about this gut-brain connection. Just to bring it back to hormones again is like, when you're bloated or it's right before your period, You feel bloated or you're in menopause, you feel bloated, but you also feel really sad, and you feel like you're craving certain foods. And so what we're learning now is that this disorder gut bacteria that's happening, and for that, it's hormone-based situational, but is disrupting things in our brain. And we have this gut-brain connection. And so if you're feeling down, fatigued, having cravings for strange things, that could be your gut bacteria talking to you and saying, I don't feel good, and we're sending signals to your brain that we need to be healed. And at Mount, nobody Really, even in modern medicine, this is not talked about. Very few people, when they go to the doctor and they say, I'm depressed, I'm anxious, I'm feeling tired all the time, very few doctors are going to be like, Let's look into your gut health. It's not even... It's like, go, here's some medicine, here's some antidepressants, or go talk to someone.

They don't even think that it's related, but it's completely related. I mean, we have a study after study after study saying, Okay, take some fiber. And all of a sudden, people get improved cravings and mood and eat some fermented food, and all of a sudden, they feel better. So there's a huge connection with mood and feelings of anxiety.

So, Dr. Shah, what foods make you bloated?

So we talked about cruciferous vegetables, including your broccoli, Brussels Sprouts, Cabbage. We talked about artificial sweeteners, like in your Diet Coke and in your gum, et cetera. Those are huge causes of bloating. We talked about sparkling drinks being a cause of bloating. We talked about dairy for so many people, gluten for so many people, high amounts of sugar for so many people. I actually, in my plan, in my gut reset plan, I have every single person take out the foods that they think are triggering, like gluten, dairy, white sugar, and put themselves on a food elimination diet, at least for a week, if not four weeks, to identify which foods are triggering your bloating. So for me, it was gluten and dairy and sugar. And for a lot of people, it is all three. But for some people, it's just one of the two. So for some people, it's all three. So you have to do a food elimination diet. Did you know, Mel, that food sensitivity testing is not validated? And all those tests that people get for food sensitivity, it's in 2023, we don't have a validated food sensitivity test. We can tell food allergies, like if you're going to have anaphylaxis to peanut, we have a test for that.

But there's no test that's better than a food elimination diet for checking for your food sensitivities, the foods that are causing you to bloat.

Let me see if I'm following you. Because I was about to ask you, how would you know if you're lactose-intolerant? How would you know if you are sensitive to gluten? Because you asked me, Mel, are you lactose-intolerant? I'm like, I have no idea. I have whole milk in my coffee every morning. I eat cottage cheese. I love that S-K-Y-R yoga. So I don't know. I'm ingesting this stuff. I don't burp afterwards. I don't fart afterwards that I know of. But so am I bloated by it? I don't know. So are you saying that the only way to determine whether or not you are getting bloated or triggered by certain foods is to eliminate them from your diet and then to see what happens when you add them back in?

Yes. The gold standard for food-related gut discomfort is to eliminate the foods and to add it back. When you add it back, that's really the test. I don't know if you've ever gone a long time without eating, say, certain food, and then you add it back to your diet, and then you get this huge bloating reaction. That's the sensitive food that you are eating. So You're only going to know if you're lactose-intolerant or if you're not tolerant to dairy. If you stop eating it and then you add it back and see what happens to you, that's the gold standard for checking which foods that trigger you. There's certain foods that trigger everyone, but There are certain- What are they? That trigger only few people. The insoluble fiber is a thing that bloats everyone.

This is the- What is insoluble fiber?

You know those vegetables that I was talking to you about, the raw vegetables? Yes. So they're made up of insoluble fiber. They have there's soluble fiber. So for example, things like baby spinach that's cooked really well, right? That has a lot of soft fiber is how I would think about it. And it's easier to digest for the body. Whereas a raw broccoli or a cauliflower has a lot of insoluble fiber. It's really hard for the body to digest, and it takes a lot of work. It's like marathon on training. Eventually, you'll get there, but you don't want to start with huge amounts in the beginning. And then alcohol. Let's talk about- Oh, do we have to?

Come on. This is coming out during the holidays, talk to No, let's talk about alcohol, because the truth is I have this love-hate relationship with alcohol where I tend to go for periods where I don't drink at all, and I feel a thousand times better, and I sleep better, and I know it's better for my health. Then particularly around the holidays or in the summer or when we're celebrating something, I'll have a drink, and the next thing you know, I'm sliding into drinking a little bit more frequently. I definitely notice I don't sleep as well. I definitely notice that I'm tired in the morning. I have not really noticed bloating, but maybe I'm not understanding the signs or the symptoms to look for.

Well, let me tell you the problem with alcohol. The problem with alcohol is that, number one, a lot of us are ingesting it later in the evening. And so I told you that our body, just like our brain needs sleep, our gut bacteria needs sleep as well. They need rest. If we're eating big meals and lots of drinks late into the night, you're already short-changing your growth hormone, you're cleaning all the things that happen during the night in your gut. And so you're just more likely to be bloated in general. It doesn't mean that every single person is going to wake up the next day bloated. It's just contributing to this overall circadian rhythm misalignment that we have in our world. People are going days without seeing natural light, and then they're eating really late at night with bright lights. We're in this world where our circadian rhythms are getting thrown off all the time. And one of the biggest causes of bloating is that we're eating late at night and we're drinking alcohol late at night. So not only does alcohol cause bloating, it also is usually consumed later in the evening, closer to bedtime for a lot of us.

Now, there are people who have it earlier in the day. I would say if you are going to have alcohol around the holidays and you are trying to manage your bloating and just in general, better health, start earlier in the day. And that way your body has time to metabolize it. It's not going to disturb your sleep as much, and it's not going to disturb your gut health as much.

What would be your recommendation for how much time you need between your last meal and your last drink with calories or sparkle in it, right? Whether it's alcoholic or not, and when you fall asleep, sleep? Do you need three hours, two hours, five hours? What is going to help your gut process what you ate and drank, and then also get the rest that it needs, which helps your gut bacteria not be so mad at you.

Yeah, exactly. Our gut bacteria are our biggest allies. We want them to be our friends, and we don't want to starve them to death and kill them in all these ways that we're doing. Fasting, at least circadian style. So something natural, like taking a break from food for 12 hours, which sounds like it's nothing, but most Americans are eating 16 hours a day and just taking a quick break for eight hours or less. So we want to extend the time that your gut gets rest. So it might be 2 to 3 hours before bed, you stop eating, and you're only drinking water or decaffedated tea, that thing, clear liquids. And then go 12, 13, 14. So it may be 6:00 PM to 6:00 AM 7:00 PM to 07:00 AM. That would be ideal timeings according to circadian rhythms.

You just said that the average person is eating for 16 hours a day. And I stopped for a second and thought, Oh, my God, you're right. Because you start eating the second you wake up and you eat until you go to bed. And I've never heard anybody talk about the fact that we're eating for that long of a period of time. And I've noticed that whenever we talk about intermittent fasting or fasting for a twelve-hour window as a health and digestion and a gut bacteria tool, people go crazy, right? About, oh, yeah, yeah, yeah. But when you focus on the fact that it's not healthy to eat for 16 hours a day either. I mean, that was a ha, aha, aha moment for me. Me too.

When I read the circadian rhythm data that says basically the Nobel Prize in medicine a few years ago went to the scientists that were looking into how circadian rhythms actually run our bodies, that 80% of our body's functions work on circadian rhythms. This means that our gut needs rest, our gut bacteria needs rest. When it's dark outside, that is a time that our body switches into a different mode. And when I understood that, I was like, Wow, why is it that we're eating so late into the night and then we're not giving our gut a break? We know we need sleep, so why don't we ever talk about giving your gut a rest, which is just as important as giving your brain a rest? And that could improve so many things in our body that you know, and I know, you have an early dinner, you have a great night's sleep, because now you have your growth hormone that is pumping, it's repairing everything. You wake up and you feel like a different person, like a million bucks, right? And we know that, but we still don't do it. In America, at least, we don't do it.

And so I think the circadian rhythm science is just going to get stronger and stronger because people just still are starting to understand what an impact that's going to have. Taking a break, just a break. It's not intermittent fasting, per se. It's just being... It's how our bodies were designed. I mean, thousands of years ago, you didn't have Uber Eats to call at like, midnight.

I'm just laughing because I'm sitting here going, It's not like we call sleep intermittent wakefulness. It makes a lot of sense that your medical recommendation, based on your expertise, is that your gut needs 12 hours of not having to digest food in order to have your gut bacteria remain healthy and have your gut in balance. I mean, it makes sense.

Yeah. And we know how much poor sleep we talk about all the time, right? Poor sleep makes you depressed. Poor sleep makes you eat more. It's the same thing when you get poor gut rest and you're eating all the time. The studies are very clear. Now, why intermittent fasting got such a bad rap is because the colloquial signs, I don't want to say bro signs, but the fitness world said, Oh, if you want to do intermittent fasting, the way to do it is eat late into the night and then don't eat all day. Don't eat till 12:00 or 1:00 or 2:00. Actually, that's not been shown in the science to be helpful in weight loss. It's not been shown to be the way to do it in optimal health because our bodies don't work on that cycle. We are supposed to be eating during the wakeful hours. Now, that can be delayed. We don't need to eat first thing in the morning. But eating an early dinner and having the fasting start in the evening is something that I don't see a lot of fitness and health influencers talk about, which is the way it's supposed to be done.

We're supposed to give our body a time to digest. So we get better sleep, better growth hormone production, more rest to our gut so that we can wake up less bloated and we can be happier and healthier. I have this morning routine, the three Fs. Every morning, I wake up and I'm like, Fasting is number one. Have I fasted for 12 hours? If I have it, I'm not going to have my first meal yet. Because I might have stopped on some days later, 7:30 AM, and I might say, I wake up at 6:00 AM and I'm like, Okay, I'm not going to eat yet. I'm actually going to go exercise. So fitness is the second F. So fasting, fitness. And then when I'm ready to eat, it's fermented and fiber food. Those three Fs, fasting, fitness, and the food, those make up my morning routine so that I'm not as bloated. I fix my circadian rhythm so our gut bacteria are happy with us. And we start our day with something that is nourishing for that gut microbiome so that over days and weeks time, we can experience less bloating, we can have better body composition, who doesn't want that, and better hormone health.

First of all, I love it. It's super simple. Secondly, I love the fact that when you said fasting, you basically wake up when you wake up and you go, Okay, wait a minute. I'm just not going to eat until I give my gut a 12-hour rest. Even if you were at, let's say you were at a wedding or at a party last night, and you were out and you stopped on the way home for some pizza. It was eleven o'clock at night. You're sound asleep by midnight. When you wake up at nine o'clock in the morning, ask yourself, Okay, first half is fasting. Twelve hours would be that I don't have my first meal until eleven o'clock this morning. And then you said fitness, which is how much fitness? How long do you need to exercise? Can it be a 10-minute walk? Can it be anything? What is fitness for you?

Fitness for me for the morning routine is anything. So total in the day, I want to get about 30 minutes. You want to get 30 minutes of sunlight, of movement. So the best way to get this done and over with and checked off is go for a 30-minute walk and you're done. And it makes so much sense because our bodies are designed to see light in the morning. We're seeing now, you see all these research coming out about how important it is to get natural light. You just check it all off in one walk because the gut bacteria... Did you know that the best probiotic, the best debloating is actually exercise? Because exercise makes- No, I did not know that.

I didn't know that because I was just about to ask you, how does taking a walk for 30 minutes outside stop bloating and help my gut bacteria be happy? How does that help?

So just like your gut bacteria needs sleep, like I said, they're organisms, live organisms, and they need rest. They also love when you get sunlight and when you exercise. It makes them very happy. They do this crazy dance that produces these chemicals in your body called short-chain fatty acids. They go all over the body. They calm your inflammation. They make you happy. It is the best probiotic you could ever take. That's so cool. I know. That is so cool. We're trying to produce short-chain fatty acids through so many different things. Everyone's like, take this pill to produce short-chain fatty acids. Do this. All we have to do is exercise in sunlight And look, all of a sudden, our body produces it for ourselves.

Well, the other thing that I like about what you're saying is the second that you said your gut bacteria is mad at you. And if I think in simple terms, which I like to do, because if a concept is simple, I can apply it to my life, right? When you tell me, the game here, everybody, is make your gut bacteria happy. And when you tell me that, okay, there are some things that you can do every single day to just make your gut bacteria happy, which is going to help with bloating, which is going to help with how you feel, which is going to help with your mood, Mel, one of which is getting good sleep and getting rest from needing to digest, which you just said is about fasting. The other one is take your gut bacteria for a walk 30 minutes outside, and all of a sudden it's like doing its happy dance, and it's making you feel better. And we all know this to be true. And then you said the third F is fiber and something else. So what does that mean?

Fermented and fibrous food. So the first meal of your day is your best chance. Research shows that the first meal of the day is statistically shown to be our best chance at improving our health in general, but definitely our gut and hormone health. And what I want to tell every woman out there is that use this opportunity to improve your hormone and gut health. So a perfect breakfast would be something like, yogurt, nuts, berries, and maybe some ginger tea on the side, like a chai. Because ginger and are two things that you can really take to really make your gut bacteria happy. We know that a tofu scramble or an egg scramble with veggies. You want high protein, so 30 grams of protein. You got your fiber in there with your vegetables. And if you're having a yogurt or probiotic cottage cheese, or you're going to have a little spoon of sauerkraut or a little glass of water with some raw apple cider vinegar, you're going to get your fermented food. Use your breakfast as your chance to kill it. This is My hormones and my gut bacteria are so happy because I started my morning with a high protein, high fiber, high fermented food breakfast.

It makes sense because if you apply this advice, everybody, around making your gut bacteria happy, you just gave it 12 hours of rest of needing to just take a break from the constant eating. You then made it do its happy dance with the walk and the sunlight. And now the first thing that you're putting in your stomach is not something that is going to cause all gasses. I don't even know if it's a word, but you know what I mean. It's not going to make the balloon inflate. You're dropping into your stomach the things that it needs to work properly for you and stay happy. And that makes a lot of sense. Can you just give everybody a quick list of all the health benefits that happen when you embrace what you're saying and And you start embracing a protein-forward diet and you prioritize exercise that strengthens your muscles. What are the health benefits and the cognitive benefits of doing this?

Number one, better blood sugar regulation, better energy. You'll be stronger. You'll have better survivability against nearly any disease or issue or problem that life throws in front of you. Skeletal Muscle muscle, again, is the largest endocrine organ organ system in the body. And what else, Skeletal muscle is, is it's a nutrient-sensing organ. It senses nutrients. It blows your mind, right? It actually senses the quality of the diet. It senses the protein quality of the diet, which is incredible. And one of the things that happens as individuals age is that efficiency of sensing protein and those amino acids decreases. So how do you overcome that? And what does it look like when that efficiency decreases? From a very visual perspective, it looks like sarcopenia, which looks like skinny, smaller, frail, elderly individuals. But you can overcome that efficiency issue and make older muscles act like younger muscles by increasing dietary protein. Number Number one. So now you've taken a older, more mature muscle, you've increased the dietary protein intake, and you can get your skelet muscle to respond as if it was in your 20s.

Wow. What is another health benefit? It's incredible. What's another health benefit of following this protocol and paying attention to this?

The other thing is that healthy skeletal muscle is your metabolic sink or your metabolic disposal unit. You'll go to your yearly doctor and they'll say, Here's your blood sugar, here's your triglycerides, here's your cholesterol. The biggest way you can make sure that those numbers are exactly where you want it to be is by having healthy skelet muscle. Number one, we take care of skeletal muscle and we improve its efficiency. Efficient muscle is healthy muscle. Number two, we use skeletal muscle, healthy skeletal muscle, to make sure we don't get diabetes or insulin resistance, and all the things that come alongside with that. So that's number two. Number three, healthy skeletal muscle makes us strong and capable, which I would say, arguably, That's the obvious. And of course, healthy skelet muscle is some tissue. It is the tissue that you leverage through exercise to improve brain health. We We talked about those secreting molecules, those myokines. When those myokines are secreted through exercise, they also impact the brain, which is incredible. And this is where some of the confusion comes into the space because you're hearing a lot of, quote, longevity experts saying, Cut back on dietary protein, you're going to live longer.

Okay, well, let's say potentially that would be true. Let's just say for fun. Number one, how much longer do you think someone is going to live with no or low healthy skeleton muscle Not very. That's right, because I didn't tell you the other thing. I think we're at number five. The other thing is that if you get injured, if you get an illness, what do you think your body relies on to protect you? Where do you think it pulls from those building blocks, those grains of sand? Where do you think it pulls from?

Your muscles.

That's right. Do you know that if an individual were to get cancer, one of the things that they oftentimes pass away from is this thing called cancer capexia, which is this highly metabolic state which ends up destroying skelet muscle. You cannot survive without skeletal muscle.

The list of benefits from the long term is absolutely... I'm sure you're just getting started. Can you give everybody a sense, if you were to make this change of having protein forward, we're going to explain this more, and you were to start resistance training, what are you going to feel day to day? What are the benefits of doing this almost immediately on your day to day life?

If you get your first protein meal right, you will feel better immediately. I mean, it might not be in the first 30 seconds, but after that first meal, you will have more energy You'll have better blood sugar regulation.

You will feel better.

Just anecdotally, we've seen it. And not only anecdotally, we see it in the literature. If you design a diet diet that is protein-forward and balanced with carbohydrates, meaning you're not having too much carbohydrates, so you're not going to have this huge ebb and flow and crash, where all of a sudden you're reaching for cupcakes or donuts, which you better not be at 10:00 AM, but if you were. And then The other aspect of that is you will not be hungry. You are using nutritional science to leverage willpower.

Oh, that sounds sexy. Let's use nutritional science to leverage willpower, everybody. I want to keep digging into the protein.

I think that that's really important to understand because the average American, by the way, the average woman is getting around maybe 60 to 68, if I'm going to be generous, grams of protein a day.

And how many do we need to be getting as women?

I recommend 1 gram, close to 1 gram per pound ideal body weight.

What? Yeah.

And I even calculated this out for you. Okay, you ready for this? I did this calculation for you.

My ALD of body weight is 138. That's when I always feel my best.

So for you, if you were my patient, I would say, Listen, Mel, in order for us to correct for muscle health, metabolism, satiety, then I would put you at roughly easily a minimum of 100 grams of protein, but between 100 to 120, maybe even 130 grams of protein.

I feel like I'm going to gain weight. There I said it. There I said it. No way. I said I'm going to gain weight. That sounds like a lot. I'm so endocrinated. I don't know if there's a salad lobby that has been petitioning all of us psychologically, but I hear that, intellectually, I know. I got to start taking care of my muscle organ. I'm in. I want to think clearer. I want to lose the belly fat. I want to have more energy. God forbid, something happened to me. I want to be strong enough to fight it off. I also look at my 85-year-old mother-in-law who has biceps and exercises and resistant trains, and the woman is an energizer bunny at the age of 86. I want to be like that. And so I'm in. The second you said, Mel, it's between 100 and 130 grams of protein a day. I'm like, I am not becoming a weeble wobble on legs, Dr. Gabrielle. And I think that's exactly what a lot of us women who've been socialized to think that we have to be thin, that's our reaction. But it just goes to show you how fucked up this all is.

Yes, it is. The science isn't fucked up. Our psychology and the mixed messages and the diets we've been sold and the fact that... I'm just going to speak for me, but everybody listening has no idea that this is what your muscles do.

Right. And by the way, I calculated the amount of calories that we would be talking about so I could clarify it for you. Are you ready?

Lay it on me.

So let's say you increase your dietary protein to 100 grams of protein a day. That would be a total of 400 calories. Wait, what?

Now, what are you eating?

Wait, that's it. But there's something I didn't tell you. Okay. I didn't tell you is that the thermic effect of food or this thermic effect of feeding, meaning when you eat dietary protein, because of its impact on muscle increases metabolism. So while you're thinking, Well, I'm going to need 100 grams of protein, and I'm going to get 400 calories, sometimes, depending on how you dose it, you will use 20% of that energy. Just metabolize that protein. It would be very difficult to gain weight. And it would be so difficult to gain weight, you are not going to put on weight from increasing your dietary protein. It would be, and in fact, The studies show that. So they've done overfeeding protein studies. Do you want to know what happens when people, quote, over eat protein?

I do.

Their body compositions get better. And you know what that means? It means they lose fat.

So by eating more protein, the research shows in all these studies and in the work that you've done for 20 years, that when people focus on muscle health, resistance training, and a protein-forward diet, they lose fat.

They lose fat. Obviously, calories have to be controlled, but they lose fat and they gain muscle. You gain tissue, your body composition improves.

Yeah. I just had this visual that traditionally, I keep saying, we keep thinking about this in reverse, everybody. You're focused on losing fat when you should be focused on gaining muscle. And when you gain muscle, you actually lose the extra weight that you don't want. And I keep thinking about the fact that you look at somebody that's sedentary or heavy, and you see the the extra weight that they're carrying, and you think about, Okay, well, how am I going to get them to diet and do stuff so that we can get rid of that weight? And what I just got is inside that body is an organ called muscles. There's the architecture of a healthy human being, and you can activate the healthy human being that is inside the unhealthy body. And as you start to really strengthen your muscles, we'll get into resistance training in a minute, that starts to emerge from the inside out. Yes. And all of the extra weight and all of the disease and complications and symptoms that come with having what is an insufficient muscular system. If you start with strengthening from the inside out, it overtakes all of the unhealthy stuff on the outside, and that's what you see emerging.

If you think about these before and after photos that you see in these big these challenges online or whatever that people use to market diets or weight loss programs or weight lifting programs, we are looking at them wrong because what we're thinking is we're thinking that somebody is somehow dieting and shrinking. What you're actually seeing is the muscle health emerging. I just You just got it.

You got it.

That is so cool.

And it's not about what we have to lose. It's about what do we have to gain. It's this way of leveraging your system to create flux and movement so then this healthy body emerges.

Why is this so important for women, specifically?

I think women have really gotten this constant narrative about, Oh, you've hit menopause. Now you're going to have a menopausal belly, and you're going to gain about 30 pounds, and it's going to be this is how it's going to be. That does not have to happen. There are ways in which you can manage your body composition through diet and training. Again, we are leveraging protein and food as medicine and movement as medicine rather than taking something external. I mean, I guess it would be technically external. But here's what I would tell and why it's so important for a menopausal, postmenopausal woman. There is a natural decline in these hormones, estrogen, progesterone. There's an imbalance of testosterone, which can affect body composition. But one of the ways it affects body composition is we move less. We are less active. The way to combat that is through, very simply, doing some resistance training, which simply means, again, against an external load. It It doesn't have to be complicated. It's not necessarily as difficult as people think. I've been seeing patients since 2006. I have seen a lot of midlife women, and I've seen a lot of success.

Okay, what do we do? Dr. Gabriele, I just heard, do you hear that? That was women in 94 countries around the world turning up the dial. What do we do?

Here's what they're going to do. They're going to make it super easy. Their first meal of the day is going to have between 30 and 50 grams of protein. Easy. I don't care if it's a whey protein shake. I don't care if it's Mel's pea protein shake. I care. I don't necessarily want it to be collagen because collagen, while great for other things, is not great for muscle health. Okay? Got it. So collagen is a different separate protein. It has a protein score of what is considered zero. It's still great, but we're not going to put in the category of muscle health.

Thank you for saying that, because here I am making I'm adding the smoothie, and I'm adding the mushroom stuff for the hot flashes, and I'm adding the protein powder, and I don't even know if it's got the Lupin thing in it. Then I put in the collagen because A, I'm like hair and nails people, and two, I'm thinking that's another 10 to 20 grams of protein, so I can put that in the 50 protein column. What you're saying is, Mel, that is good for your hair and nails, but when it comes to complex amino acids, that protein scores a big fat. So now I'm learning something. This is really good. You're like a pro, homie.

You are a pro.

Thank you.

So all these women in a million different countries, you've got your dial turned up. You're going to make it so simple. This is legitimately fail proof. You are going to have between 30 and 50 grams of protein at that first meal.

Got it.

Then if you were saying, Well, Gabrielle, Doc G, I want to add some carbohydrates. I'm going to say, You know what? Go right ahead. You're not going to have over 30 grams or so of carbohydrates for that first meal because we don't want to skew do this insulin and give you this robust response. Again, I'm giving broad generalizations. Got it. Okay. But we're just going to define it and design it so that people can execute right away. Great. You can have a little bit of berries, you can mix it in water, you can mix it in almond juice or whatever it is that you want, something not major that is calorically dense. Okay, you've done that. You're doing great. Another meal, maybe you want some smaller meal in the day. Maybe it has 20 grams of protein and 20 grams of carbohydrates. What does that look like? That could be three eggs. It could be your chicken salad. It could be whatever it is you want. I'm not so crazy about that one. I love your for that.

Thank you.

You're welcome. The last meal Well, if you're having two larger meals and a smaller meal in the middle, your last meal is also important because you're getting ready to go into an overnight fast. So you woke up in the morning, coming out of an overnight fast, your skeletal muscle, your of longevity is primed for nutrients. You stimulate muscle with your dietary protein. You've done an amazing job. You've improved your signaling. You've made your muscle youthful. You are no longer hungry. Your body is now metabolizing things. We're not gaining weight. We are really setting you up for success. Your next meal is a little smaller. Your last meal of the day is going to mirror your first meal.

Oh, I thought you said it was smaller.

You know, your middle meal is smaller.

Okay, got it. So now I'm doing my 30 to 50. I'm having my protein shake or my hamburger with my salad or whatever else.

The last meal of the day is between 30 and 50 grams of protein. You want your burger, you want your chicken, you want your salmon? Great. You have now nailed it. Well, you will, by the way, if people understand the concepts in this book, you will lose body fat by just addressing the dietary component of protein, which is mind-blowing. You will. You You will improve your body composition by changing your dietary protein for breakfast. By simply doing that, by swapping out your cereal, by adding in dietary protein, we have seen huge changes in body composition, simply by doing that. Also, by the way, some of this data was isocaloric, meaning people both had the same amount of calories. They were both taking in 1,600 calories. The First menopausal women, what one group did was change the first meal of the day to have an optimal protein. It was around 40 grams of protein. And then the second group had around, I don't remember exactly what it was, but it was probably closer to 50 grams of carbohydrates and 13 grams of protein, which is what most women are doing now. And the body composition effects were negative for the carbohydrate group versus the protein group.

They lost weight. Again, calories were the same. So it was simply changing around the macronutrients. Okay.

Can you talk a little bit to the vegetarians and folks that have a vegan diet? What are the considerations as you're thinking protein forward and the amino acid, sand particle aspect of the macronutrient and protein.

Yes. All dietary protein is not created equal. Ideally, you are eating wholefoods. So now this brings us to this category of dietary protein. And what makes up dietary protein? How do we score it? How do we think about it? An overarching way to do this, very simply, is that anything that is of animal nature, that means does it run, does it swim, does it, I don't know, walk, is a high-quality protein. It is considered a high-quality protein. And what defines high-quality protein protein, is we talked about that there are 20 different amino acids. Got it. We're obviously not going into those 20, but there are a handful of essential amino acids.

And are those not present in plant-based proteins?

They're very low in plant-based proteins. So what would you have to do? You would have to over-consume or increase your consumption of these plant-based proteins to bring up that level of essential amino acids. Got it. And I'm going to give you a A very clear example. I'm just going to lay it out on there so nobody has to do any math. Do it. Okay. Let's say you are going to eat three or four ounces of a beef patty, a lean beef patty. That has this essential amino acid, lucine. Lucine is the critical amino acid for muscle health. Okay. Now, remember, you and I were talking about how each amino acid had these dual roles, and we weren't going to go into all 20. But there are a handful that are really important and critical for health and well-being. Okay. One of those amino acids is leucine. And leucine, what's so fascinating, is that it requires a certain amount to trigger skeletal muscle. So essentially, if you're eating under that amount, then you're not actually stimulating this mechanics of skeletal muscle. Oh. Three to four ounces of a lean beef patty would stimulate muscle would give you this whatever number, two and a half grams of leucine to trigger the muscle to begin to have this process.

If you were to try to do that in quinoa, you would need six cups of quinoa because of the difference in the amino acid profile to trigger muscle the same way.

Wow.

That's not a good plan. First of all, it's a lot of quinoa. Second of all, that's carbacid. You don't want to be doing that.

Carbacide is a word?

Yeah. No. Well, it can't be now.

Wow. I think you should trademark that. Is there a supplement for our friends that are vegetarian or vegan that they can take to up the lysine or to get the amino acids without having to overdose on quinoa? It's important to understand because I sit here and I drink smoothies a lot because they're easy, and I use a plant-based formula. Here I am, dumping more scoops in, thinking I'm loading up and I'm protein-forward, and You're sitting here telling me, not really, not necessarily, because it might not have the thing on it. But I know I'm doing something, and that's better than nothing.

You are. Mel, I'm going to interrupt you because you're doing great.

Thank you.

So the plant-based protein powders is a way to begin to balance these amino acids because they made it in a way where they balanced these amino acids.

Okay.

But this is a way to do it.

Great. You're talking about if you're doing Whole Foods. You got to be really- If you're doing Whole Foods, exactly.

If you are doing Whole Foods and not adding supplements, you may need a total of 35 % more dietary protein.

I love that. Okay. Hey, it's Mel. Thank you so much for being here. If you enjoyed that video, by God, please subscribe because I don't want you to miss a thing. Thank you so much for being here. We've got so much amazing stuff coming. Thank you so much for sending this stuff to your friends and your family. I love you. Create these videos for you, so make sure you subscribe.