Sleep & Circadian Rhythms – 6-Tips from World-Experts

Sleep is fundamental to human health and performance.

Over the last decade, the research on sleep and athletic performance has exploded, highlighting the dramatic impact of sufficient rest on an athlete’s ability to train, recover and perform. 

Talk to any strength and conditioning coach and they’ll likely say, ‘for sure, I focus on sleep’. Talk to any nutritionist or practitioner and you’ll probably hear ‘yep, I emphasize sleep with my athletes’. Talk to any athlete and they’ll say ‘yep, I know sleep is important’.

Today, everyone ‘knows’ sleep is good for athletic performance but here is the uncomfortable truth; athletes still aren’t getting enough sleep!

Are Athletes Getting Enough Sleep?

Despite all the science, social media coverage and focus in high performance and clinical circles, athletes are still struggling to achieve sleep recommendations. 

In fact, the research shows athletes are remarkably poor at rating their own sleep quantity and quality. 

In elite national-level athletes, recent study of over 800 participants found 75% were not getting 8 hours of sleep per night, and more alarmingly, 11% were not even getting 6 hours of sleep nightly.(1)

What about Olympic-level athletes? Surely, they optimize sleep to support optimal recovery and performance? Not quite. Olympic athletes consistently show poorer sleep quality and more fragmented sleep than age and sex-matched controls.(2)

Why do athletes still struggle with sleep? Athletes are people too. Balancing training, work commitments, family and personal life takes up a lot of time in the day. Unfortunately, sleep gets the short end of the stick. 

It’s not just athletes. The general population averages 6.5 hours of sleep per night, below the National Sleep Foundations recommendation of 7-9 hours nightly.(3) Even more troubling, 30% of the population gets less than 6 hours of sleep per night. 

The trickle-down effect on health and performance are profound. If you don’t get enough sleep, your physical output is impaired (e.g. sprint speed, reaction time, etc.), sport-specific skill (e.g. three-point shooting, first-serve accuracy), immunity (e.g. more colds and flu), cognition (e.g. memory, executive function, etc.) not to mention how it impacts your overall health (e.g. increased risk of virtually all chronic disease conditions.)

It’s no longer about raising awareness of inadequate sleep time and quality, but rather, actually getting athletes to implement the strategies!

(It would be great if we, as humans, made decision based purely on logic, but as expert sport psychologist Dr. Peter Jensen PhD points out, it’s not usually the case).

Sleep & Circadian Rhythms - 6 Tips from World-Experts

I’ve had the privilege of interviewing some of the top sleep experts in the world. Here is a quick glimpse into some of their strategies for supporting sleep and circadian rhythms in athletes. 

1)    Set Your Schedule – Sleep Timing

In training, consistency is crucial for achieving success. The same is true for sleep. Dr. Amy Bender, PhD of the Canadian Sport Institute – Calgary emphasizes the importance setting your morning wake time and evening bedtime.  

For athletes, this can be very difficult. Early morning exercise, two-a-day training, and late-night sessions or competitions (not to mention media, work, or school commitments) make it difficult for a lot of athletes to get into a consistent sleep schedule for an extended period of time. Inevitably, this leads to inadequate total sleep time and compromises sleep quality.

Get back to the fundamentals; be consistent with your sleep and wake times. The more you stick to a routine, the more impact you’ll see in the gym and on the field.  

2)    Circadian Rhythms & Weight Gain

When you eat has a big impact on your circadian rhythms and therefore sleep. In my recent interview with Dr. Dan Pardi, PhD he highlighted some important recent research in this area, comparing how night time eating impacted weight gain in mice. In the study, one group of mice were fed their normal meals during the day, while the other group received all of their meals at night (when they would normally sleep). Total caloric intake and physical activity were controlled and exactly the same in both groups.

What happened?  The mice who were fed all of their daily calories during the night - when they would typically be asleep - gained significantly more weight compared to the control group eating during the day. What’s the lesson? Food intake has a significant impact on your circadian rhythms, therefore avoid eating too late at night if you’re looking to keep body composition (and health) on point.

3)    Don’t Be Stupid – Caffeine & Athletes

Physically demanding sports require a special amount of effort and intensity. Not surprisingly, American football, hockey, and rugby players often turn to caffeine and pre-workouts for an added boost. 

Dr. Ian Dunican PhD, recently completed a study in Super Rugby players in Australia and found many athletes were unaware of the amount of caffeine contained in their pre-workout supplement. (In fact, some didn’t even realize it contained caffeine!) 

Too much total caffeine and too much caffeine late in the day can both compromise your sleep total and quality. 

If you’re pushing the caffeine limits hard on game day, make sure to balance your short-term goals (i.e. game day) with your long-term goals of  recovery and health throughout the season. A good heuristic – or simple rule – is for athletes not to exceed 6mg/kg/day of total caffeine and to limit intake in the afternoon.

4)    Morning Larks & Night Owls - Athlete Chronotypes

During pre-season training camp or when you travel on a road trip with your team an important consideration that often gets overlooked by coaches and performance staff is athlete chronotype. In the research, morning larks are defined as early-risers while night owls naturally prefer to stay up later.  

Dr. Michele Lastella, PhD has examined the effects of athlete chronotype on performance and found some emerging evidence on performance and recovery. A recent study found baseball players who were morning larks had significantly higher batting averages in day games.

In practice, an important take home message for coaches is to carefully consider whom they pair together as roommates; combining morning larks with night owls could lead to more disturbed sleep for both and compromise recovery (and ultimately performance).

5)    Can You Make Up A Sleep Debt? Memory, Executive Function & Sleep

It’s not just physical performance that is impaired from lack of sleep, mental performance also takes a big hit. Dr. Norah Simpson, PhD from Stanford Medical School recently found in her study on sleep and performance that 17-19 hours of wakefulness significantly compromised your cognitive performance (and the equivalent to having a blood alcohol level past the legal limit!

Does this mean you can simply catch up on sleep on the weekend after not sleeping enough through the week? Unfortunately, Dr. Simpson’s work says no. 

You need to be consistent on a night to night basis to reap the full benefits of total sleep. If you don’t get enough sleep at night, it will compromise memory, attention and executive function. In short, your brain game will suffer (important on the playing field or the boardroom). 

6)    The Nappucino – Pros & Cons

If you’re seriously running low on sleep, but still need to be sharp and perform, the coffee nap or ‘nappucino’ has become a popular new strategy to support cognitive performance after an afternoon nap. 

Why has this become so popular? A recent study found having a small coffee before your nap (e.g. coffee + nap) outperformed having a coffee or having a nap, respectively.(4)

How does it work? Dr. Cheri Mah, MD, sleep expert and consultant to professional sports teams, explains it takes approximately 15-minutes for caffeine to begin to exert its effects in the body. As such, after you wake up from your 20-minute nap your mental acuity gets a small boost from the power nap (increasing alpha-brain wave activity) as well as an additional boost from the pre-nap caffeine hit. 

Of course, Dr. Mah warns you need to be sleep-deprived for this to be truly effective. What qualifies as sleep-deprived? You must feel so fatigue you could fall asleep within five minutes. If that sounds like you, Dr. Mah finds it’s a great tool to keep cognitive performance running on all cylinders.

The Bottom Line

Sleep is a key pillar for recovery. Get back to the fundamentals and figure out how to best apply them in your setting, with your athletes, for long-term success.

Strength coaches aren’t looking for ‘new’ exercises to train and develop athletes; they have the tools already, it’s simply a matter of fine-tuning them. 

The same mentality should be applied to supporting improve sleep time and quality. You don’t need any ‘new’ strategies (or tech), you just need to figure out what evidence-based strategies your athlete will actually implement. It takes time, it takes experimentation, and it takes willingness on the part of both athlete and practitioner. 

Implement some of the fundamentals from the 6 world-experts in sleep science discussed in this article, or listen to more in-depth discussion in Season 3, Episode #9 of the Dr. Bubbs Performance Podcast).

Knowing you need more sleep is the first step, but in and of itself, rarely leads to behavior change.  Take the time to uncover what will inspire and motivate your client or athlete to take action and keep your focus on sleep fundamentals for long-term success.

 

Dr. Marc Bubbs, ND, MS(c), CISSN, CSCS

 

Want to learn more? Take a deep-dive into sleep and circadian science in Chapter 1 of my new book PEAK – The New Science of Athletic Performance That Is Revolutionizing Sport.

Pre-order on amazon and get free bonus material… as well as a chance to win prize packs, 1-1 visits with dr. bubbs or a talk for your gym or facility1

Pre-order on amazon and get free bonus material… as well as a chance to win prize packs, 1-1 visits with dr. bubbs or a talk for your gym or facility1

Question about sleep and circadian rhythms? Leave it in the comments section below…

Exercise-Induced Muscle Damage: Why Does It Happen? (And 5 Nutrition Solutions To Support Recovery)

Athletes train hard. They train almost every day, often twice a day, in order to be elite..

Does this mean athletes are constantly in a state of delayed-onset muscle soreness (DOMS) or fighting off excessive inflammation to effectively adapt to training to achieve their goals? Maybe. What about an athlete’s training phase, does that play a role? For example, if an athlete is optimizing for competition versus adapting to get bigger, stronger, or faster? 

What about recreational clients?

For many people, the sensation of mild to moderated delayed DOMS that creeps into your muscles 24-48 hours post-training is a sign of a good workout. You feel like you’ve trained and are making progress toward your goal. However, if it persists for more than 48 hours, if it limits your range of motion (ROM) or muscle function is it still helpful?

 Exercise-induced muscle damage (EIMD) is a complex and nuanced topic. 

A better question is when does exercise-induce muscle damage become so pronounced it requires specific nutrition strategies to mitigate the effects? I interviewed expert Dr. Daniel Owens PhD from Liverpool John Moore’s university to talk about his research in this area and what nutrition solutions you can turn to for evidence-based recovery support. 

First, let’s define exercise-induced muscle damage.

Listen to Daniel Owens PhD talk exercise-induced muscle damage on the Dr. Bubbs Performance Podcast!

Listen to Daniel Owens PhD talk exercise-induced muscle damage on the Dr. Bubbs Performance Podcast!

What Is Exercise-Induced Muscle Damage?

Exercise-induced muscle damage (EIMD) is characterized by symptoms that come on directly after training and persist for 1-5 days afterwards (although potentially all the way up to 14 days post-training). That’s a pretty wide margin, what happens if you get your training plan or recovery process wrong? 

For the athlete, the consequences of EIMD include is a direct effect on functional capacity (e.g. strength, range of motion, etc.), muscle soreness, muscle capacity and sense of force production and limb position.(1,2,3,4) How long and how intense these symptoms are for you depends on the intensity and duration of exercise and how your own individual susceptibility to the damaging stimulus of training.

For the athlete, loss of muscle function and increased muscle soreness likely have the greatest potential to negatively impact performance. 

Can targeted nutrition strategies help to offset these effects? Could this allow you to train more frequently or more intensely, thereby increasing the likelihood of achieving your goals? Or could it actually interfere with the recovery process? 

It’s a matter of balance; adequate training stress combined with sufficient recovery. Let’s take a deeper-dive into what causes exercise-induced muscle damage.

What Causes EMID?

Training of any type can cause exercise-induced muscle damage (EIMD), however there are a few types of training that may trigger greater muscle damage, such as; resistance training, prolonged or downhill running, and high-intensity interval training.(5,6,7,8)

Muscle damage is amplified during eccentric actions, particularly at longer muscle lengths, with greater forces, and faster angular velocities.(9,10,11) Interestingly, if you perform a training session with more eccentric loading, it may actually reduce the EMID in the subsequent sessions, a phenomenon known as the “rebound effect”. 

What are the underlying mechanisms that cause EMID? Let’s review.

#1 Primary Muscle Damage

Experts aren’t exactly sure the principle reason why eccentric training is more damaging to the muscle, however the consensus seems to be the mechanical loading during exercise.(12) Eccentric contractions have a lower motor unit activation compared to isometric and concentric contractions (when force is equal), putting an increased mechanical stress on a smaller number of muscle fibers during eccentric movements, and thus more muscle damage.(13)

#2 Secondary Muscle Damage

After the initial primary damage of training, a secondary effect occurs when calcium moves into cells, as the mitochondria attempt to maintain homeostasis.(14) The resultant inflammatory response is a crucial and natural process that clears away damage tissue, triggers tissue repair, and ultimately adaptation.

#3 Satellite Cell Activation

Muscle fiber recovery and regeneration requires the activation of muscle stem cells called satellite cells. Satellite cells are activated post-training, specifically in response to eccentric compared to concentric contractions.(15) The research highlights that sustained activation of satellite cells provides the muscle with the capacity to adapt more effectively from training.

To sum up, impaired muscle function, increased muscle soreness, elevated inflammatory levels and activation of satellite cells all play a role in exercise-induced muscle damage. 

What does all this mean for you the athlete?

 Nutritional strategies to target these areas - when used in the right context – may improve recovery from exercise-induced muscle damage. Let’s review five evidence-based nutrition strategies. 

Dietary Solutions for EIMD

Now you’ve understood the mechanisms underlying exercise-induced muscle damage (EIMD), you can better appreciate what nutritional interventions influence those mechanisms in order to exert a desired effect. 

There is a lot of nuance when it comes to application.

You don’t want to limit or buffer the exercise-induced stress and subsequent beneficial adaptations to training. The nutritional strategies we’ll discuss impact inflammation and oxidative stress – known to be important stimuli for adaptation - so it’s important to consider why you’re using them (i.e.  to cope with increased training volume and/or intensity) and when you’re using them (i.e. adaptation versus optimization phase).

The following are five potential evidence-based nutritional strategies.

#1 Protein

Protein is crucial to muscle protein synthesis and adaptation to resistance and endurance exercise.(16) Experts can’t say for sure whether protein around intense or damaging exercise can limit EIMD, but recent evidence suggests it can improve markers of muscle damage and accelerate recovery of force.(17,18) Aim for a protein intake of 0.2-0.5g/kg/meal around exercise, with bigger athletes trending toward the upper end of the range.

#2 Tart Cherry Juice

Dietary polyphenols are most commonly found in the diet via fruit, vegetable, tea and coffee consumption. Polyphenols have shown to exert significant antioxidant and anti-inflammatory effects, possessing the ability to attenuate cyclo-oxygenase (COX) 1 and 2 output to a similar degree compared to common, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs).(19,20) 

In particular, tart cherry juice stands out from the pack when it comes to recovery.

Research in resistance training using heavy eccentric bicep curls combined with two servings of tart cherry juice per day found an accelerated rate of recovery and reduced muscles soreness.(21) 

A key benefit to using a “food first” approach to performance nutrition is that it’s unlikely to interfere with the primary muscle damage response from exercise and thus not limit positive adaptation to training (compared to supra-physiological doses in supplements). Where functional foods like cherry juice can exert its effect is during the secondary phase, when inflammation and oxidative stress ramp up post-training.

#3 Omega-3

Omega-3 polyunsaturated fats, specifically eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), are important nutrients that exert anti-inflammatory effects. Omega-3 fats like EPA and DHA are found in highest abundance in cold, deep-water fatty fish (e.g. salmon, mackerel, anchovies, sardines, herring, etc.), seafood (e.g. oysters, mussels, etc.), grass-fed beef and nuts like macadamia and walnuts

Numerous studies have shown beneficial effects of omega-3 on inflammation, oxidative stress, and muscle function after intense exercise.(22,23,24,25)

Interestingly, there appears to be a “loading phase” of approximately two weeks to see changes in muscle omega-3 composition. A recent study found a highly effective loading protocol to be 5g/day dose of fish oil capsules (providing 3,500mg EPA and 900mg DHA), however this is much higher than the current recommendations.(26) Typically, a dose of 1,000-1,500mg (combined EPA/DHA) is suggested in athletes, however more research is needed in this area to confirm an ideal dose.

#4 Vitamin D

Vitamin D isn’t really a vitamin. In truth, it’s a seco-steroid hormone acquired by the body through exposure to the sun (e.g. ultraviolet B radiation or UVB). Sedentary lifestyles in the general population and athletes training indoors (or even outdoors in sun-shy athletes wearing skin covering apparel) has led to a large of number of athletes and active people being diagnose with deficient (< 30 nmol/L 25[OH]D) or insufficient levels of vitamin D. 

In the last decade, new technology has allowed for discoveries of the important effects of vitamin D on muscle function and performance.

Vitamin D is a potent regulator of the immune system and has shown to exert potentially important effects on athletic recovery; anti-inflammatory response post-exercise was found to correlate with the individual’s vitamin D levels, runners with low vitamin D exhibited increase inflammatory responses post-exercise, and athletes performing eccentric-concentric jumps on a plyo-press displayed faster recovery at higher vitamin D status.(27,28)

#5 Creatine

Creatine is keystone supplement in many athlete’s nutritional arsenal. However, many are unaware of the impacts of creatine on recovery. Creatine has shown beneficial effects on satellite cell number and muscle function post-training.(29)

DOWNLOAD THIS INFOGRAPHIC of EVIDENCE-BASED RECOVERY SOLUTIONS to inform your practice below…

DOWNLOAD THIS INFOGRAPHIC of EVIDENCE-BASED RECOVERY SOLUTIONS to inform your practice below…

The Bottom Line

Exercise-induced muscle damage is an important and natural phenomenon that triggers the positive and beneficial adaptations to exercise. In the general population, training stimulus and volume is unlikely to require additional recovery support beyond the nutrition fundamentals of adequate protein, omega-3 and vitamin D intake are likely all you need to support your training goals. 

In athletes, the stakes are much higher. Greater training volume and intensity, as well as two-a-day (sometimes three-a-day training in MMA athletes!) increases the need for the application of functional food strategies to support quicker recovery. 

As always, think about the typetiming, and total amount of the supplement, functional food, or nutritional strategy you’re implementing with clients and athletes.  

(Now get back to your training!)

Dr. Marc Bubbs ND, CISSN, CSCS

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References

1)    Byrne, C., Eston, R. G., & Edwards, R. H. T. (2001). Characteristics of isometric and dynamic strength loss following eccentric exercise-induced muscle damage. Scandinavian Journal of Medicine & Science in Sports, 11(3), 134–140.

2)    Marcora, S. M., & Bosio, A. (2007). Effect of exercise-induced muscle damage on endurance running performance in humans. Scandinavian Journal of Medicine & Science in Sports, 17(6), 662–671. 

3)    Twist, C., & Eston, R. G. (2009). The effect of exercise-induced muscle damage on perceived exertion and cycling endurance performance. European Journal of Applied Physiology, 105(4), 559–567. 

4)    Paschalis, V., Nikolaidis, M. G., Theodorou, A. A., Giakas, G., Jamurtas, A. Z., & Koutedakis, Y. (2010). Eccentric exercise affects the upper limbs more than the lower limbs in position sense and reaction angle. Journal of Sports Sciences,28(1), 33–43. 

5)    Burt, D. G., Lamb, K., Nicholas, C., & Twist, C. (2014). Effects of exercise-induced muscle damage on resting metabolic rate, sub- maximal running and post-exercise oxygen consumption. European Journal of Sport Science,14(4), 337–344. 

6)    Millet, G. Y., Tomazin, K., Verges, S., Vincent, C., Bonnefoy, R., Boisson, R. -C.,...Tarnopolsky, M. (2011). Neuromuscular consequences of an extreme mountain ultra-marathon. PLoS One, 6(2), e17059.

7)    Chen, T. C., Nosaka, K., Lin, M. -J., Chen, H. -L., & Wu, C. -J. (2009). Changes in running economy at different intensities fol- lowing downhill running. Journal of Sports Sciences, 27(11), 1137–1144. 

8)    Leeder, J. D., van Someren, K. A., Gaze, D., Jewell, A., Deshmukh, N. I.K., Shah, I., ... Howatson, G. (2014). Recovery and adaptation from repeated intermittent-sprint exercise. International Journal of Sports Physiology and Performance,9(3), 489–496. 

9)    Child, R. B., Saxton, J. M., & Donnelly, A. E. (1998). Comparison of eccentric knee extensor muscle actions at two muscle lengths on indices of damage and angle-specific force production in humans. Journal of Sports Sciences,16(4), 301–308. 

10)  Nosaka, K., & Sakamoto, K. E. I. (2001). Effect of elbow joint angle on the magnitude of muscle damage to the elbow flexors. Medicine and Science in Sports and Exercise, 33(1), 22–29. 

11)  Chapman, D., Newton, M., Sacco, P., & Nosaka, K. (2006). Greater muscle damage induced by fast versus slow velocity eccentric exercise. International Journal of Sports Medicine,27 (8), 591–598. 

12)  Proske, U., & Morgan, D. L. (2001). Muscle damage from eccentric exercise: Mechanism, mechanical signs, adaptation and clinical applications. The Journal of Physiology,537(Pt 2), 333–345. 

13)  Enoka, R. M. (1996). Eccentric contractions require unique activation strategies by the nervous system. Journal of Applied Physiology (1985), 81(6), 2339–2346.

14)  Ebbeling, C. B., & Clarkson, P. M. (1989). Exercise-induced muscle damage and adaptation. Sports Medicine, 7(4), 207–234. 

15)  Hyldahl, R. D., Olson, T., Welling, T., Groscost, L., & Parcell, A. C. (2014). Satellite cell activity is differentially affected by con- traction mode in human muscle following a work-matched bout of exercise. Frontiers in Physiology,5, 485. 

16)  Phillips, S. M., & Van Loon, L. J. C. (2011). Dietary protein for athletes: From requirements to optimum adaptation. Journal of Sports Sciences,29(Suppl 1), S29–S38. 

17)  Buckley, J. D., Thomson, R. L., Coates, A. M., Howe, P. R. C., DeNichilo, M. O., & Rowney, M. K. (2010). Supplementation with a whey protein hydrolysate enhances recovery of muscle force-generating capacity following eccentric exercise. Journal of Science and Medicine in Sport, 13(1), 178–181. 

18)  Nosaka, K., Sacco, P., & Mawatari, K. (2006). Effects of amino acid supplementation on muscle soreness and damage. International Journal of Sport Nutrition and Exercise Metabolism, 16(6), 620–635. 

19)  Seeram, N. P., Aviram, M., Zhang, Y., Henning, S. M., Feng, L., Dreher, M., & Heber, D. (2008). Comparison of antioxidant potency of commonly consumed polyphenol-rich beverages in the United States. Journal of Agricultural and Food Chemistry, 56(4), 1415–1422. 

20)  Wang, H., Nair, M. G., Strasburg, G. M., Chang, Y. -C., Booren, A. M., Gray, J. I., & DeWitt, D. L. (1999). Antioxidant and anti- inflammatory activities of anthocyanins and their aglycon, cyani- din, from tart cherries. Journal of Natural Products,62(5), 802. 

21)  Connolly, D. A., McHugh, M. P., Padilla-Zakour, O. I., Carlson, L., & Sayers, S. P. (2006). Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage. British Journal of Sports Medicine, 40(8), 679–683. discussion 683. 

22)  DiLorenzo, F. M., Drager, C. J., & Rankin, J. W. (2014). Docosahexaenoic acid affects markers of inflammation and muscle damage after eccentric exercise. Journal of Strength and Conditioning Research, 28(10), 2768–2774. 

23)  Gray, P., Chappell, A., Jenkinson, A. M., Thies, F., & Gray, S. R. (2014). Fish oil supplementation reduces markers of oxidative stress but not muscle soreness after eccentric exercise. International Journal of Sport Nutrition and Exercise Metabolism, 24(2), 206–214. 

24)  Jouris, K. B., McDaniel, J. L., & Weiss, E. P. (2011). The effect of omega-3 fatty acid supplementation on the inflammatory response to eccentric strength exercise. Journal of Sports Science & Medicine, 10(3), 432–438. 

25)  Phillips, T., Childs, A. C., Dreon, D. M., Phinney, S., & Leeuwenburgh, C. (2003). A dietary supplement attenuates IL-6 and CRP after eccentric exercise in untrained males. Medicine & Science in Sports & Exercise,35(12), 2032–2037. 

26)  McGlory, C., Galloway, S. D. R., Hamilton, D. L., McClintock, C., Breen, L., Dick, J. R., ...Tipton, K. D. (2014). Temporal changes in human skeletal muscle and blood lipid composition with fish oil supplementation. Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA), 90(6), 199–206. 

27)  Barker, T., Martins, T. B., Hill, H. R., Kjeldsberg, C. R., Dixon, B. M., Schneider, & E. D. (2014). Vitamin D sufficiency associates with an increase in anti-inflammatory cytokines after intense exercise in humans. Cytokine, 65(2), 134–137. 

28)  Willis, K. S., Smith, D. T., Broughton, K. S., & Larson-Meyer, E. D. (2012). Vitamin D status and biomarkers of in ammation in runners. Open Access Journal of Sports Medicine, 3, 35–42. 

29)  Olsen, S. (2006). Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training. Journal of Physiology, 573(Pt 2), 525–534. 

 

 

Are You Suffering From Adrenal Dysfunction?

Did you know that four out of every five visits to the doctor’s office is stress-related? In today’s 24/7 society, stressors present themselves in many different forms: mental stress from a busy work day, physical stress from an intense training session or constantly being on the run, or emotional stress from relationships with family or friends. Although stress is essential for overall health (it provides the mental and physical challenges required to stimulate positive adaptation), if you have chronic or excessive stressors or poor coping mechanisms it may result in adrenal dysfunction and/or altered cortisol rhythm.

Why Are Your Adrenals So Important To Stress?

Your adrenal glands are small triangular-shaped glands positioned on top of your kidneys that secrete specific hormones in response to stressful stimuli. The glands are made up of two parts: the inner medulla that produces the hormone adrenaline in response to stress and the outer cortex that produces cortisol. Let’s take a look at how these two hormones drive your response to stressors in your environment.

When adrenaline is produced, it triggers the breakdown of body-fat for fuel and acts by raising your blood pressure and heart rate to increase your alertness. If you enjoy a cup of coffee in the morning, you’re getting a nice little jolt of adrenaline from the caffeine that helps to increase mental focus and work capacity during exercise. This happens instantly via your sympathetic fight or flight nervous system, which is a direct connection between your brain and adrenal glands.

Whereas adrenaline preferentially catabolizes (breaks down) fat, cortisol breaks down muscle tissue to provide fuel for your body. Like adrenaline, its job is to increase your blood sugar levels to provide energy for the body to overcome the stressful event. From an evolutionary perspective, this was critical for escaping from wild animals or other threats. Nowadays, you experience a boost when you’re in the gym or training hard, but when your session is over, your stress levels should return to baseline. (If you adrenals are out of balance, this isn’t always the case and has significant negative repercussions).

Today’s Stress Response

In nature, a stressor is short-term then subsides. For example, a zebra grazing in the savannah might spot a lion in the distance resulting in a boost of adrenaline and cortisol to increase the heart rate, breath rate, and shunt blood to its working muscles should it need to run for its life! The subsequent chase might last 10-20 minutes, then it would be over and the zebra could go back to relaxing and grazing.

Thankfully, in today’s world we don’t often have to run away from lions or bears, but “modern” stressors actually exert a much more debilitating toll on our body. How is this possible?

Today, stressors last all day long! The emails don’t stop, the deadlines don’t stop, and the commitments don’t stop. Your body – and more importantly your brain – are experiencing constant and prolonged stressors, far longer than would be experienced in nature. This leads to a heavy burden on your adrenal glands and your body.

What is Adrenal Dysfunction?

While the physiological mechanisms have evolved over millions of years, the realities of sitting at a desk and having to juggle all the mental tasks from work and home life can leave your brain (and body) stuck in “fight or flight” sympathetic overdrive. For some this can manifest itself as the over-production of adrenaline and cortisol, while for others the reverse can happen and you may feel sluggish or fatigued.

In years past, clients complaining of prolonged fatigue were often diagnosed with ‘Adrenal Fatigue’, the inability of the adrenal glands to keep up with a person’s busy life or increased number of stressors. Today, we understand this is not the whole story. A new area of medicine called psycho-neuro-endocrine-immunology (now that’s a mouthful!) or PNEI is uncovering that your brain is really the root cause of adrenal dysfunction, and therefore the key player in supporting your adrenals and stress response. In short, the hypothalamus area of your brain is the master switch that tells your adrenal glands to ramp up the production of adrenaline and cortisol (over-performing adrenals), or dial it back (under-performing adrenals).

Do You Have Symptoms of Adrenal Dysfunction?

In clinical practice, I see many patients with either over-performing or under-performing adrenals. There are symptoms on each end of the spectrum that indicate adrenal dysfunction. If you have difficulty waking up in the morning, poor energy during the day, feel better after eating meals, or have diminished libido then chances are your adrenal glands are underperforming.

If you’re a person with naturally high energy levels, have high blood sugars, experience excessive sweating, have difficulty falling asleep, or feel like your mind continually races with a list of tasks and deadlines then you may be suffering from over-performing adrenals. This constant fight or flight sympathetic dominance chronically elevates cortisol levels and may lead to roadblocks in your quest for a slimmer waistline, faster 10k run time or better overall health.

There is one more piece to this complex puzzle. Your daily cortisol rhythm can also get thrown out of balance by stress. In the morning, your cortisol should be at its highest to wake you up from deep sleep and get you ready to attack the day. In the evening, your level starts to lower and should be at its lowest point at bedtime. This allows the sleep hormone melatonin to ramp up and prepares your body for deep, restorative sleep.

If you suffer from general fatigue, poor recovery from workouts, low mood, and your short-term memory is poor (e.g. you often forget what to pick for dinner, where you left your phone, or your client’s name) then poor daily cortisol rhythm may be your area of adrenal dysfunction. If you struggle to get out of bed in the morning, hit snooze multiple times, or feel desperate for a coffee to get going then chances are your morning cortisol rhythm is out of balance. If you struggle to fall asleep at night, wake up throughout the night, or classify yourself as a night owl then you likely have an altered evening cortisol rhythm.

It is important to address adrenal dysfunction and/or altered cortisol rhythm as they can lead to serious negative consequences. These include increased inflammation, poor memory, increased risk of anxiety or depression, reduced testosterone production, slow thyroid function, increased belly-fat, decreased lean muscle mass, poor blood sugar control or insulin resistance, and cognitive decline.1 If you’re not sure whether your adrenals are functioning optimally, you can request a salivary-cortisol test.2

The Adrenal Dysfunction Fix

Diet

Diet is the first place to start when correcting adrenal dysfunction. It’s critical to obtain the building blocks essential for supporting a healthy stress response. The Paleo diet is the perfect place to start.

First, increase your intake of healthy saturated fats, such as butter, ghee, or coconut oil. Studies show that fatigued and over-stressed athletes are better able to recover and maintain performance on a high fat diet, in particular when high in saturated fats.3

Next, make sure you are achieving an adequate intake of protein, as high cortisol levels will quickly break down precious muscle tissue and leave you in a catabolic state. Aim for 0.7-0.9g of protein per pound of bodyweight.

Finally, it’s not only what you add to your diet, but also what you remove. If you’re suffering from adrenal dysfunction or altered cortisol rhythm then discontinue your caffeine intake – coffee, black tea, chocolate – for 4 weeks. Sugar and caffeine cravings are classic signs of adrenal dysfunction, so be sure to eliminate all processed sugars and carbs for 4 weeks.

Meditation

Busy work days or long hours in the gym can leave you burning the candle at both ends and therefore being stuck in the fight or flight sympathetic overdrive. If the root cause of adrenal dysfunction starts in the brain, it makes sense to incorporate techniques that directly impact your central command center.

Meditation is an ancient technique that helps restore your cortisol rhythm and adrenal function by stimulating your “rest and digest” parasympathetic nervous system via the vagus nerve in your brain.

Not convinced? A recent study of medical students showed that those engaging in daily mindfulness meditation practices had much lower blood cortisol levels compared to a placebo.4 Meditation has also been shown to significantly improve anxiety and depression, classic symptoms of adrenal dysfunction.5

Try this simple technique before bed to improve your “resiliency” and capacity to cope with stress:

  • Start by sitting with your eyes closed.
  • Inhale deeply through your nose; let your belly expand for three seconds
  • At the end of your inhale, hold your breath for one second.
  • Exhale deeply through your nose for another count of three seconds; let your belly draw inward toward your spine.
  • Repeat for 5-10 minutes.

Sleep

Did you know that today we sleep a whopping 500 hours less each year than our grandparent’s generation? This sleep debt places a tremendous burden on our resiliency or capacity to cope with stress.

If you get less than 7 hours sleep per night, struggle to fall asleep, or wake up frequently during the night your cortisol levels will be elevated and you’ll be cutting yourself short on the recovery front.6 To support deep sleep, make sure your bedroom is set up for optimal recovery. How can you improve your sleep quality? Here are some simple tips:

  • Turn down the lights in your house after 9 p.m.
  • Shut off your television or laptop at least 45 minutes before bed.
  • Make sure your bedroom is completely dark. Try using blackout blinds or an eye mask to prevent unwanted light.
  • Keep your bedroom cool and wear loose-fitting clothing or sleep naked

We’ve got a in-depth article on how to get better sleep if you want to know more.

Nutrient Support

There are several herbs that can support adrenal dysfunction, depending on whether you suffer from over-active or under-active adrenals, or cortisol rhythm dysfunction. A key nutrient called alpha-GPC can benefit all types of adrenal dysfunction. Supplementing with alpha-GPC provides the hippocampus with the right building blocks to restore normal cortisol rhythm by supporting the production of acetylcholine, a key neurotransmitter concentrated in the hippocampus that can be depleted by busy work schedules, lacking sleep or high stress.7 Take 500-1,000mg daily upon rising for 8-12 weeks.

Prioritize the fundamentals of diet, sleep, and controlling your stress response (e.g. proper breathing) to upgrade your adrenal function and correct symptoms of adrenal dysfunction. Train your brain and fuel your body correctly to increase your resiliency and keep your stress response system in balance.

Dr. Marc Bubbs ND, CISSN, CSCS

Want to learn more? Listen to Dr. Doug Kechijian talk "Mental Performance In High Stress Situations" on the Dr. Bubbs Performance Podcast...

 

Check out more articles in the "Cortisol Stress" Series...

 

References

Reynolds G. The Hormone Edge. J of Physio. NY Jan 14, 2012.
Manetti L et al. Usefulness of salivary cortisol in the diagnosis of hypercortisolism:comparison with serum and urinary cortisol. 2013. Eur J Endocrinol 168(3):315-21
Antonio, J et al. Essentials of Sports Nutrition and Supplements. Humana Press. New York, NY.
Turakitwanakan W et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai 2013 Jan;96 Suppl 1:S90-5.
Wurtzen H et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. Eur J Cancer 2013 Apr;49(6):1365-73.
Leproult R, Copinschi G, Buxton O, et al. Sleep loss results in an elevation of cortisol levels the next evening, Sleep. 1997;20:865-870.
DiPerri R. et al. A multicenter trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia. J Int Med Res. 1991. Jul-Aug;19(4):330-41.

How Big Is Your Sleep Debt?

In the Paleolithic or ‘hunter gatherer’ era, from 2.6 million years ago until the agricultural revolution 10,000 years ago, our ancestors woke up with the rising sun in the morning and rested for a good nights sleep not long after sundown.  Scientists estimate that our Paleolithic ancestors averaged about 10 hours of sleep per night.  Of course the absence of an external light source, television sets, and laptops  made it a little easier to get to bed so early, but the benefits are deeply engrained in our DNA.  

Your circadian rhythms are based on the light and dark cycles of the day and have a profound effect on your bodyweight, cardiovascular health, fertility, and well-being. Melatonin, your body’s sleep hormone, is secreted in the evening about 3 hours after your last meal.  It makes you feel tired, drowsy, and prepares you for deep rejuvenating sleep. 

In winter, Paleolithic people slept longer hours – approximately 10-12hrs per night – as the days got shorter and darker.  Your immune and hormonal functions are linked to these evolutionary circadian rhythms of light and dark, and understanding how this effects you will help you improve your energy levels, build muscle, burn fat, and upgrade your overall health.

For example, daylight increases your dopamine and cortisol output, getting you out of bed and ready for the day ahead.  When was the last time you felt energized in the morning? How many cups of coffee do you go through to get yourself going in the morning? Do you need your alarm clock to wake up or do you wake up naturally? 

Your natural hormonal patterns shift throughout the day and by nightfall your cortisol and dopamine levels should be at their lowest, allowing melatonin production to kick in and stimulate your repair and rejuvenation hormone... growth hormone.  Growth hormone is essential for rebuilding your body while you sleep, helping to build lean muscle, burn fat and keep your immune system strong.  (Your body is hard at work while you rest!)

So what’s the problem with our 21st century sleep patterns?

Two generations ago, our grandparents average about 9-10 hours sleep per night, not very far off our Paleolithic ancestors.  Today, the average North American gets between 6-7.5 hours of sleep, about an hour or two less than the recommended 8 to 8.5 hours sleep per night.  Over the course of a year, this would amount to approximately a 500-hour ‘sleep debt’! 

Over-consuming coffee can add to the problem. How do you know if you are over-doing the stimulants?

You’ve been abusing your coffee intake if you don't feel the same ‘kick’ from your morning cup of joe, or if stopping your intake results in   headaches, irritability, or intense fatigue.  Coffee triggers the production of adrenaline from the adrenal glands and stimulates our sympathetic – ‘fight or flight’ – nervous system.  While this is okay in moderation, chronically relying on this form of energy is like revving the RPM’s on your car constantly into the red zone. Before too long, you'll burn out your engine!

So what can you do to start cutting into your sleep debt? 

Let’s start in the bedroom.  The key to sleep is ensuring you have total darkness in your bedroom.  Make sure to remove all light sources (think red lights from the alarm clocks), cell phones on the bedside table, and nearby laptops from the vicinity of your head. All of these stimulate the nervous system and prevent deep sleep.  Next, turn off the television or shut off your laptop at least an hour before bed to allow your body to unwind.  All of these stimulants activate the nervous system and prevent deep sleep.  Finally, get to bed before midnight to increase your number of sleep hours per night. In Tradtional Chinese Medicine (TCM), every hour of sleep before midnight counts as DOUBLE, because they are so valuable for restoring health and wellness.

Make time to 'schedule' in more sleep... it will pay off with better energy, productivity, and performance at work and in the gym!

Dr Marc Bubbs ND, CISSN, CSCS

 

Check out more articles in the SLEEP SERIES...

References:

  1. Sabanayagam C, Shankar A.  Sleep duration and cardiovascular disease: results from the National Health Interview Survey.  Sleep.2010 Aug;33(8):1037-42.
  2. Alvarez GG, Ayas NT.  The impact of daily sleep duration on health: a review of the literature.  Prog Cardiovasc Nurs. 2004 Spring;19(2):56-9.
  3. Ayas NT, White DP, et al. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care. 2003 Feb;26(2):380-4.
  4. Chaput JP, Després JP, Bouchard C, Tremblay A.  Association of sleep duration with type 2 diabetes and impaired glucose tolerance.  Diabetologia. 2007 Nov;50(11):2298-304. Epub 2007 Aug 24.
  5. Vgontzas AN, Bixler EO, et al. Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. J Clin Endocrinol Metab. 2001 Aug;86(8):3787-94.
  6. Kobayashi D, Takahashi O, , et al. Association between weight gain, obesity, and sleep duration: a large-scale 3-year cohort study.  Sleep Breath. 2011 Sep 3. [Epub ahead of print]