December 30, 2023

Muscle Strength Depends on Circadian Rhythm.

Shift Work Can Hurt Us.

 

Muscle building and repair 

Strong muscles day and night 

 

Healthy foods eaten in a window of 6 to 10 hours per day limit insulin production and allow HSL (Hormone Sensitive Lipase), an enzyme, to “cut” (cleave) long chain fats into small pieces of fat called triglycerides. HSL “opens the door” of fat cells to release fats. Fats (fatty acids) exit the fat cells and travel via circulation to muscle cells. Muscles burn fats for energy production during the day and especially at night via oxidative metabolism. Muscles repair and build at night. ATP energy is produced in abundance via fat burning in muscles. 

 

 

 

 

Muscles are repaired and built while we sleep if we fast for 14 to 18 hours via water only fasting at night.  

 

 

Weak muscles 

 

Eating in a window longer than 10 hours per day and/or eating greater than 30 to 40% of energy intake (calories) as carbohydrates causes the pancreas to be overworked. In stage 1 of insulin resistance, the still healthy pancreas produces way too much insulin.

High insulin production raises insulin levels and inhibits the enzyme HSL (Hormone Sensitive Lipase). That is why it is called hormone sensitive lipase, because it is sensitive to how much insulin is around. 

Because HSL, the enzyme that allows fats to leave fat cells, is turned off by insulin, fats become trapped in fat cells. The result is excess insulin “shuts the door” of the fat cells and fats cannot leave the fat cells to be burned by muscles. 

Muscles are deprived their preferred energy source which is fats. Muscles waste away. 

Meanwhile in the face of high insulin production more fats are made in the liver and sent to the fat cells to be stored. 

In the final stage, the swollen pancreas Beta cells eventually become exhausted from being over worked; they shrink and produce less insulin, but it is still enough to block HSL from working. However, it is not quite enough insulin to allow all the excess sugar to enter cells. Blood sugar rises leading to metabolic syndrome, prediabetes, and type 2 diabetes. Fats continue to enter the fat cells. 

 

Fat cells continually store fats due to prolonged eating and/or excess carb intake. High insulin levels shut the HSL door so fats cannot leave fat cells. Muscles are deprived of energy from fats and waste away. 

 

Stage 1 of insulin resistance deprives muscles of their preferred energy source, fats. 

 

 

Final stage of insulin resistance deprives muscles of their preferred energy source, fats. 

 

 

How do we know we have our own internal circadian clock rhythm? 

 

We know our rhythm is our own internal biological clock because when we are removed from our environment and moved to a different environment, the rhythm and the cyclic behaviors and processes it controls continue on their own. This is true for plants, animals, and humans.

The first famous experiment that pointed to plants having their own internal clock(s) was done by an astronomer, Jean Jacques d’Ortous de Mairan. He noticed that the leaves of mimosa plants opened toward the sun during day and closed and drooped at night.

He wondered what would happen if he placed the plant in a dark cabinet. He was surprised to find that the leaves of the plant continued to unfold and then fold and droop even if the plant did not have any light. The plant continued its 24-hour routine as if it had its own internal clock. What makes our human circadian clock rhythm so elegant is that over time our circadian rhythm can reset if we move to a new time zone. It adjusts to connect us to our new environment. 

 

Circadian clockwork --- 2017 Nobel Prize 

 

While we have known for years that we have a circadian rhythm and it helps us to anticipate and adapt to our environment, how the clock worked was not known until 2017. The Nobel Prize in Physiology or Medicine was awarded to Jeffrey C Hall, Michael Rosbash, and Michael W. Young when they discovered the way we adapt our biological clock rhythm and synchronize it to the Earth’s revolutions. 

The Nobel Prize winners isolated the gene for the circadian rhythm. The gene was given the name PERIOD. They went on to show that the PERIOD gene produces a protein named PER during the night that then degrades in quantity during the day. Finally, they showed that high levels of PER block the gene PERIOD which creates an automatic feedback system where high levels of PER prevent its own synthesis. Thus, the quantity of PER protein oscillates over 24 hours in sync with the circadian rhythm. 

The next mystery they solved was this: The PERIOD gene is in the nucleus of the cell where m-RNA is made from it. The m-RNA moves out of the nucleus to the cytoplasm of the cell where PER protein is made from it. So, the question was how did PER protein move back into the nucleus of the cell to inhibit PERIOD gene in the nucleus? Michael Young discovered another clock gene TIMELESS which encodes to make a protein call TIM that is required for circadian rhythm. He discovered that when TIM binds to PER, together the 2 proteins can enter the nucleus of the cell and inhibit PERIOD gene creating the feedback loop for our perpetual circadian clock. 

One ultimate question was what controlled the frequency of the oscillations? Michael discovered yet another clock gene called DOUBLETIME that codes to make a protein called DBT that helps match the oscillations to 24 hours. 

Later, our exposure to light (especially bright light and blue light) was discovered to further fine tune the synchrony of our circadian clock. After these discoveries, circadian science developed into a vast field with rich rewards related to our health and wellbeing. 

 

The time of day influences how well medication works. 

We do not know all the reasons why. 

Time of day is rarely considered in medical practice. 

 

The number one selling family of drugs called statins, for example Lipitor (atorvastatin), used to control cholesterol and blood fats do so by inhibiting an enzyme that has a circadian rhythm. This family of drugs is more effective if taken in the evening than in the morning. Simvastatin (Zocor) was first approved for once a day dosing in the evening, but evening dosing is no longer required in its labeling. Scant prescriptions for this mega family of drugs are written for evening dosing. The FDA does not require statins to be labeled for evening dosing. Ruben, M “Dosing Time Matters” 2019 Science (2044) 

We know that steroid medications (glucocorticoids) like prednisone are best taken in the morning for conditions like arthritis, asthma, and seasonal allergies. This is because taking the steroid in the morning mimics the body’s morning peak of cortisol steroid hormone production in the natural circadian rhythm. Taking steroids multiple times per day or around the clock violates the natural hormone production rhythm and depending on the dose can even blunt natural production of cortisol steroid family of hormones. 

Certain chemotherapy drugs work better if infused at night. Some chemotherapy is more effective if taken when fasting. 

Time of day and circadian rhythm are rarely considered when medical orders are written. Health care providers administer drugs based on staffing levels, timing of when doctors make rounds in the hospital, workload at varying times, convenience, and as needed. However, over 100 published studies indicate that the time of day when a drug is given matters. Yet very little of this has transferred to clinical practice in the field. Only a small handful of the most common drugs have time of day labeling (4 of the top 50 drugs). An animal study found most of best-selling drugs in the US and drugs on the World Health Organization essential medicines list directly target the products of rhythmic genes. (2048)

There is a great deal of evidence that our molecular clocks coordinate circadian rhythms of our heart, hormones, metabolism, immune system, and behavior. Molecular clocks are pervasive in our bodies. Over 50% of our protein coding genes having a circadian rhythm. Virtually every cell has clock genes. What it is coming down to is circadian regulation is a property of most body systems. About 1 out of every 8 circadian cycling genes is a known drug transporter or drug target gene. The goal of circadian medicine is to raise awareness and apply what is known about biological rhythms that occur every 24 hours to drug therapy. Ruben, M “Dosing Time Matters” 2019 Science (2044) 

 

Medications where time of day taken was

important. 

 

 

Read it and weep. Rotating shift and fixed shift work can hurt us. 

 

Shift work can hurt us. Who cares? A lot of us; 1 in 5 of us is a shift worker. (2062, 2289) First and foremost, our firemen, nurses, military, police, airline workers, and other shift workers are our first responders; our very lives depend on them. Evidence indicates that when these people signed up for their jobs to heal us and defend us, they were some of the healthiest people among us. A few years later we see the devastating consequences in their health; they end up being sicker than the rest of us. (2072-2081) “Why these people chose their careers serving others is a very basic foundation; and that is every single person irrespective of gender, sex, nationality, or race has a basic right and aspiration to live a healthy lifestyle from birth to death.” Satchin Panda 

Disrupting circadian rhythm with shift work can derail health. A new study in San Diego firemen is looking to see if circadian eating will be beneficial to firemen. It is nearing completion. The study is being conducted by Satchin Panda’s team at the Salk Institute for Biological Studies. It is taking place during the California fires and Covid-19. Despite the additional stresses from the fires and Covid-19, the firemen have been incredibly diligent to the study, knowing their results may improve the lives of firemen nationwide. It will be exciting to see the results of the study. 

 

Some of us have lifestyles that are equivalent to shift work. 

 

 

Who works at night so others can sleep at night? 

 

Does daylight savings time influence us? 

 

Switching to daylight savings time is a worldwide experience of jetlag. Accidents increase. (2065) We adjust with time after light exposure and food intake help reset our body clocks. Social jetlag is environmental at its root. Social jetlag is living “against the circadian clock”. Social jetlag is correctable by altering lifestyle via timing of food intake and limiting evening light exposure. (2052) Social jetlag is associated with increased BMI (body mass index) and obesity. (2073) On the other hand, being a morning type “early bird” or evening type “night owl” is considered lifelong and is under genetic control. (2052) Study results strongly suggest that work (and school) schedules should be adapted to genetic chronotype whenever possible. (2053) 

 

Which shift worker are we? 

 

 

People care about when they work more than how much they are paid. 

 

I will never forget when the 1000 bed premier hospital where I was working made an unprecedented move. They decided to give nurses fixed work schedules they could count on without rotating shifts. Not only was it the best hospital but this move indicated they really cared about their employees. It cost them a little money, but they reaped bigger rewards described below in return. 

Here was the hospital did. They told nurses if they chose to work two 12 hour shifts on Saturday and Sunday for a total of 24 hours of work per week, they would still

be paid for 40 hours with full benefits. Each weekend nurse was allowed to choose a permanent shift of day or night shift. Night weekend nurses were paid the most. This effectively doubled their salary. 

Nurses who wanted to work weekdays were allowed to choose permanent 8-hour shifts, (day, evening, or nights) for 5 days per week. They could form cohesive teams and work consistently together and have weekends off with their families. Nurses working weekday evenings were paid some extra. Nurses working deep night weekdays were paid more. This allowed a nurse to triple her salary if she wanted to work 7 days per week on night shift. She doubled her salary by working weekends and she could keep her weekday night shift as well. Other nurses worked weekdays only but would fill-in on a weekend occasionally for extra income if a weekend nurse was on vacation or called in sick. 

Response from the nurses was quick, within less than a month every weekend and deep-night shift position was filled. Nurses said it wasn’t the money that motivated them, it was having a predictable schedule they could count on that they loved. (2062) 

This program made it possible for families with young children to avoid putting their children in daycare. Dad could work weekdays while Mom cared for the kids at home, then Mom could work 12 hour shifts on Saturday and Sunday and bring home a full 40-hour paycheck with benefits while Dad took care of the kids at home on the weekends. The hospital already was considered one of the best places to work, but now it was considered the premium place; soon a long waiting list developed to work at the hospital. Believe me the pharmacists and other groups still assigned to rotating shifts without differential pay for weekends, deep nights, and evenings were jealous of the nurses’ guaranteed work schedule. 

The truly amazing thing was when the nurses decided to thank the hospital in return by volunteering to contribute to the hospital permanent foundation fund. They did this by automatic paycheck deductions that purchased term life insurance policies on themselves, and they assigned the benefits to the hospital foundation permanent fund. Their donation was $70 million. The hospital has honored them by placing each nurse’s name on a permanent memorial wall that everyone walking to the newborn nursery sees. The name of each nurse is on one-inch-tall brass plaque and there are so many they run the entire length of the hall from floor to ceiling. The value of the loyalty, dedication, cohesive teams, and camaraderies the nurses developed were beyond measure. 

 

Shift workers unite and fight for your circadian rights! 

 

Nursing errors and automobile accidents double for nurses that rotate shifts. 

In comparison to hospital nurses in Massachusetts who worked all fixed day or all fixed evening shifts, nurses who rotated between day and evening shifts had more sleep/wake cycle disruption and nodded off more at work. Rotator nurses made 2 times as many errors that were reported at work. Nurses that rotated shifts had more sleep problems. They fell asleep more at work (nodded off). They had twice the odds of nodding off while driving to or from work. Nurses that rotated shifts were twice as likely to be involved in a reported vehicle accident while driving to and from work. (2057) Many studies validate a circadian relationship in car accidents. A very prominent circadian related peak in auto accidents occurs in the middle of the night at 3 AM or 0300 military time. (2, 294, 1591, 2059) Longer duration of total shift work in nurses was associated with increased BMI (Body Mass Index), waist circumference, and body fat percentage (p<0.0001) (2064) and diabetes risk. (2072) 

 

Occupational errors, auto accidents, and sleep disorders in rotating shift workers. 

 

Working rotating shifts chronically disturbs circadian rhythm. A study of 1,473 professionals found those who worked rotating shifts had over twice as many occupational accidents, car accidents, and sleep disturbances compared to those who worked daytime only shifts. Permanent night shift workers had slightly less accidents and sleep disturbances than rotators. (2063) 

 

The heart of shift workers. 

 

Firefighters and other shift workers who live with chronic circadian disruption suffer from increased risk of heart disease, diabetes, obesity, insomnia, and cancer. (2072-2081) Wildland firefighters suffer high fatality rates due to accidents and are enrolled in studies. (1767) Firefighters in San Diego work 24 hour shifts and 137 San Diego firefighters participated in a study. (2291) They continued to work their usual 24 hour shifts. 

Half of the San Diego firefighters in the study ate at their usual times for 14.13 hours per day and adopted a Mediterranean Diet. The other half of the firefighters limited their food eating times to a 10 hour window during daylight hours and adopted a Mediterranean Diet. (2291) 

Eating in a 10 hour window was found to be feasible and improved heart health measures, especially for the firefighters who were at increased risk of heart disease (cardiovascular disease). There were no adverse effects for firefighters eating in a 10 hour window during the 12 week study. At the start of the study both groups of firefighters were well matched and had approximately the same age ranges, health conditions, and took similar medications. (2291) 

Compared to the firefighters who ate at their usual times, the firefighters who ate in a 10 hour window decreased their “bad cholesterol” (VLDL or Very Low Density Lipoprotein) particle size. Their blood sugar control was better as indicated by their improved glycated hemoglobin A1C and they experienced reduced diastolic blood pressure. These tests indicated improved cardiometabolic health. (2291) 

 

Eating to support circadian rhythm highlights 

 

Our brain master clock is networked to our body clocks. 

Over half the genes identified in the human genome are clock rhythm genes. 

Our circadian rhythm is genetically encoded and of crucial importance for cellular, physiological, and behavioral functions of the brain and body. 

Every cell in our body has biological clocks and in health our body clocks operate in sync with the master circadian clock in our brain. Our human master clock has a circadian rhythm of about 24 hours. 

Light and food are the two most important inputs that control our circadian rhythm. 

Modifiable environment and lifestyle factors impact and regulate the circadian system. 

Disruption of circadian rhythm results in increased accidents, injuries, and disease. Circadian rhythm impacts individual, community, and work safety. 

Travel across time zones, daylight savings time, and being woken up by an alarm clock are examples of circadian disruption. 

Shift work is harmful to health, but much can be done to assist shift workers. 

When we eat matters as much as what we eat. 

Eating food at the right time supports body systems, restores circadian rhythm, and promotes health. Health benefits can occur rapidly in a few weeks of time. Conversely, eating food at the wrong time can disturb circadian organization, just like light at the wrong time. 

Long duration eating is common in our modern culture. 

Nine (9) out of 10 people eat for more than 12 hours per day. 

One (1) of 2 people eats 15 or more hours per day. 

One size does not fit all – individuals vary in their circadian clock rhythm by as much as 4 hours. 

People voluntarily ate to support their circadian rhythm after studies were

completed. 

They ranked improved sleep and increased energy as their prime motivation. 

Once we step out of our home, we have little or no control over the quality of our food, but we always have control of our time. The beauty of circadian eating is that it is time centered. Eating to support circadian rhythm is free, and easy. 

Circadian time centered eating is now being proposed as part of healthy and safe lifestyle. Worldwide nutrition guidelines should include when to eat. 

Eating right for your circadian type is Nutrition Principle 1 of the BATON Diet.

BUT BATON Diet is about more than just eating at the right time. BATON Diet is about eating the right stuff at the right time.

Next, BATON Diet introduces 6 additional new principles of nutrition about eating the right stuff. Finally, we tie all 7 new principles of nutrition together and package them in a time honored pleasurable eating experience backed by sound medical studies in millions of people.

 

 

 

 

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