9.9.2019: A Blue Light Special

A Blue Light Special: Larry Leibowitz, MD

To my Patients and Friends,

Here are some of the latest interesting health news highlights… enjoy!

too much of a good thing: Larry Leibowitz, MDToo much of a good thing

A study recently published in JAMA has found that daily intake of high-dose vitamin D (4,000 IU or greater) is associated with bone density loss as contrasted with a more standard dose of 400-600 IU per day. Given the uncertainties regarding the risks and benefits of vitamin D supplementation, for those who choose to take vitamin D on a daily basis, it would be prudent to stick with a moderate dose. For the record, brief episodes (10 to 15 minutes) of daily sun exposure (no sunscreen) provides us with all the vitamin D we need without significantly increasing our risk of developing skin cancer.

On a related note, check out this article for an interesting take on the potential benefits of sun exposure.

Sleep Myths: Larry Leibowitz, MDSleep myths

An informative article recently published in the journal Sleep Health dispels some common myths regarding healthy sleep:

Myth #1: Being able to fall asleep anywhere or at any time suggests a healthy sleep pattern. 
Wrong. This tendency suggests the presence of excessive daytime sleepiness, which generally occurs in the setting of chronic sleep deprivation or an aberrant sleep cycle.

Myth #2: Many adults can get along well with 5 or fewer hours of sleep per night.
Nope. Habitual insufficient sleep can result in chronic health conditions such as heart disease, cognitive or mood difficulties, altered metabolism and immune dysfunction. We should aim for 7-8 hours per night.

Myth #3: The mind and body can adapt to less sleep.
Sorry. In such cases (for example in shift-workers), we see increases in daytime sleepiness, poor daytime performance, breast cancer and mortality from any cause!

Myth #4: Adults need less sleep as we get older.
Sadly, it just isn’t the case. Although many older folks struggle with sleep, it doesn’t mean they need it any less than everyone else.

Myth #5: More sleep is always better.
There’s no evidence to support this notion, and excessive sleep can result in fragmentation of our normal sleep cycle.

Myth #6: It doesn’t matter what time of day we sleep.
If it were only true. As noted above, shift-workers run into more health problems than those of us who sleep consistently during the night.

Myth #7: Resting in bed is almost as good as sleeping.
Not the case. Critical shifts in endocrine, cardiovascular, metabolic and cognitive function occur during sleep. These shifts are important for the maintenance of optimal physical and mental functioning, and they just don’t occur during wakeful rest.

Myth #8: If you’re having a hard time dozing off, it’s best to stay in bed and try to fall asleep.
Not so. It’s best to get up, avoid blue light (i.e., screens) and go back to bed when you feel sleepy.

Myth #9: Loud snoring is annoying but mostly harmless.
It ain’t so. A large study showed that over one-half of loud snorers experience adverse health effects. Additionally, loud snoring is a cardinal symptom of sleep apnea, which is very problematic in its own right and should be explored.

Myth #10: Sound sleepers rarely move in bed.
No worries. Movement during sleep changes over the course of our lifetimes but doesn’t generally indicate disrupted sleep.

Myth #11: It’s OK to hit the snooze button.
Nah…although it’s tempting to hit the snooze, it’s really best to resist the urge and just get up. Ironically, those extra little fragments of sleep can be associated with increased moodiness and poorer cognitive function.

Myth #12: “Catch-up” daytime naps can compensate for inadequate nighttime sleep.
Napping may not be so bad on an occasional basis, but habitual daytime napping as a means of compensating for chronically insufficient nocturnal sleep can lead to health consequences and further disruptions to our normal sleep cycle.

Myth #13: An evening cocktail can help with sleep.
Regrettably, although a nightcap may enable us to fall asleep more quickly, it ultimately causes sleep disturbances, inadequate restorative sleep and worsening sleep apnea in those who are so predisposed.

Myth #14: A warm environment facilitates good sleep.
Simmer down, folks…cooler temperatures (65-70 degrees Fahrenheit) have proven to be best.

Myth #15: Watching TV in bed can help facilitate sleep.
Unplug it! Studies suggest the opposite is true (see myth #8, above). Stick with other rituals such as a warm bath or shower, sitting quietly in prayer or meditation, or reading under dim light.

Myth #16: Remembering your dreams means you had a good sleep.
Dreams are great, but consistently remembering them can mean that sleep is being disrupted during our critically-important REM sleep cycles…but be aware that the jury is still out on this one.

Pernicious produce: Larry Leibowitz, MDPernicious produce

Researchers at the University of California, Berkeley recently published a study in Proceedings of the National Academy of Sciences that found a link between prenatal exposure to the ubiquitous yet highly-toxic organophosphate pesticides and cognitive dysfunction during teen years. Using a technology known as functional MRI imaging, which monitors brain activity during particular activities, the researchers found that teens with a history of higher organophosphate exposures while in the womb had decreased blood flow to the frontal cortex of the brain during the performance of certain cognitive activities involving executive function, focus and attention, social cognition and language comprehension.

Organophosphates are so toxic to humans that the EPA has limited their availability to the public. Unfortunately, these chemicals are still commonly used in agriculture. In my mind, these findings indicate another good reason to consider consuming organic foods when possible in order to limit our exposure to pesticides and other toxins.

Plant-based proteins associated with greater longevity

A large study of over 70,000 subjects just published in JAMA found that those with a higher intake of plant-based (vs. animal-based) proteins live longer and have lower rates of cardiovascular and cancer-related mortality. So eat those (pesticide-free) veggies!

screen it out: Larry Leibowitz, MDScreen it out

A study recently published in the journal Pediatrics has demonstrated once again that more sleep and less screen time is associated with a reduction in impulsive behaviors in kids. Given that impulsivity underlies a number of impactful conditions including ADHD (Attention-Deficit/Hyperactivity Disorder), substance abuse, behavioral and eating disorders and self-harm (including suicide), and given what we already know about the negative impacts of screen time on cognitive and emotional health, it seems prudent to continue making efforts to enable our kids to get adequate sleep and to impose reasonable limits on screen time exposure, especially during these critical formative years.

And a reminder:

Get your flu shots this fall!

That’s all for this installment…I hope the kids and grandkids got off to school OK. Sleep well and enjoy these final weeks of warm weather!

Larry Leibowitz, MD
Matrix Personalized Medicine LLC
45 Grove Street
New Canaan, CT 06840
(203) 920-1772