Tag Archives: sleep

Media’s Botched Coverage of Long Term Weight Loss | The Paleo DietIt sounds like a gimmick, doesn’t it?

Well, it would be if the top five tips focused on pills, powders, and packaged shake mixes that often have some side effects and frequently don’t even offer lasting results.

But what if we take a more natural, soundproof approach to turning our bodies into better fat burners instead?

How do we do this?

By changing what we eat.

Some may be surprised to learn that one of the most effective strategies for getting more efficient at using fat rather than carbohydrate as our fuel is to eat more of the very thing we have been told for years to avoid:  fat.

To clarify, this is not to suggest that we should simply add fat to the diet; rather, to shift the focus away from a high carb method of eating to one garnering more of its calories from an array of natural fat sources.

A study published by the Harvard T.H. Chan’s School of Public Heath showed that “a low-carbohydrate diet may help people lose weight more quickly than a low-fat diet and may help them maintain that weight loss.”  In addition, a low-carb diet was most beneficial for lowering triglycerides – the main fat-carrying particle in the bloodstream – and also delivered the biggest boost in protective HDL cholesterol.” (1)

Trust me, not only will you begin to see the pounds come off slowly and surely, you’ll quite likely begin to enjoy your meals much more, due to how satiating fat is.

Below are my top five tips to help make the shift to eating more fat and begin the transition into being a better fat burner.


1. Up the Water

No, I’m not suggesting you take a mind-over-matter approach to your hunger by drinking water instead.  Rather, simply check in to see it the next time you’re feeling hungry, you’re actually just thirsty.  Thirst can sometimes masquerade as hunger since the same part of your brain is responsible for interpreting hunger and thirst signals (resulting in mixed signals) (2), Before reaching for a snack, it’s worth a quick check by simply having a glass or two of alkaline water to make sure that doesn’t do the trick. How much water should you be taking in? There’s no one-size fits all approach, as there are many factors that would skew one’s need for water, such as age, activity level, gender, supplements, and medications. A safer bet is to simply make sure that your urine is light straw-color.   If you actually are thirsty, that’s a clear sign you’re dehydrated. Thirst indicates you’re already about 2-3% under where you should be.   Bottoms up!


2. Reduce the Carbs- That Includes Fruit

Eating white sugar has no part in a sound approach to weight loss, or a sound approach to health, for that matter, but it’s not just white sugar we need to be concerned about.   Many people eat far more fruit than veggies, no thanks to the categorization of the two together when we get the recommendation to ‘eat fruits and veggies.’ The results is more more sugar and less fiber compared to eating abundant veggies.   Begin to reduce the number of fruits you’re consuming each day.   You may be surprised to see the need to eat as often decreases, due to how much more satisfied you are after eating!


3. Audit your Veggie intake

Let’s be honest; are you really eating enough leafy greens?    Did you know only 1 in 10 Americans eat enough? (3)   With spring in the air, this is the perfect time to head to your local farmer’s market and start to develop a relationship with the vendors of some of the most amazing bounty you’ve likley ever seen.   Tip:  Ask them for ‘how to’s’ in terms of ways to prepare veggies that you’re learning about, perhaps for the first time!


4. Up the Fat

While it does require some thinking outside, the box, adding a variety of healthy fats to the diet is really not all that radical.   Simply use a bit more coconut oil to sauté your veggies and prepare your over-easy whole eggs, or top off the meal with some sliced avocado. Little things like this can do the trick to take what might have been a low calorie and low fat meal from ‘lite’ to ‘luscious’.    Plus, it will be all the more enjoyable and you’re not going to need a snack in two hours.


5. Check your sleep

Not getting enough sleep can spoil even the most prefect eating and exercise regimes.  The Mayo Clinic reported in a study that women who slept less than six hours a night or more than nine hours were more likely to gain 11 pounds (5 kilograms) compared with women who slept seven hours per night. (4)

 

If you’re feeling skeptical about upping the fat and going against what we’ve been told for years, ask yourself one question:  how has the low fat approach been working for you so far?

If you find yourself trying to achieve a different result while following the same approach, why not try something new, rather than banging your head against the wall, trying to figure out why it’s just not working (again)?

 

References

1. “Low-Carbohydrate Diets.” The Nutrition Source. Harvard’s HT Chan School of Public Health, 12 Apr. 2016. Web. 07 May 2017.
2. Bruso, Jessica. “Difference Between Being Hungry and Thirsty.” LIVESTRONG.COM. Leaf Group, 13 May 2011. Web. 07 May 2017.
3. Thompson, Dennis. “Only 1 in 10 Americans Eats Enough Fruits and Veggies: CDC.” Consumer HealthDay. N.p., 09 July 2015. Web. 07 May 2017.
4. Hensrud, M.D. Donald. “Sleep and Weight Gain: What’s the Connection?” Mayo Clinic. Mayo Foundation for Medical Education and Research, 16 Apr. 2015. Web. 07 May 2017.

 

 

Sleep | The Paleo Diet
As we move into the colder, darker and shorter days of fall and winter it becomes more difficult to maintain your energy levels, productivity and fight off nasty colds and flu. These common complaints become the norm as the seasons change and people are constantly looking for that “magic bullet” supplement or medication to keep them running on all cylinders. Interestingly, a new study on the daily patterns of modern hunter-gatherer tribes across the globe might hold a few clues in how we can keep ourselves healthy, fit and productive through the winter season.

How Much Sleep Did Our Paleo Ancestors Really Get?

There is a romantic notion that our “hunter-gatherer” ancestors rested their heads with the setting sun in the evening, slept blissfully through the night for 8-10 hours and woke up with the rising sun. They certainly didn’t have cellphones, laptops or external light sources to keep them up. Was it partly down to this that they were so fit, strong, and free of chronic degenerative diseases? Not quite.

An interesting new study on modern day hunter-gatherer tribes – the San of southern Africa, the Tsimane in Bolivia, and the Hadza in Tanzania – found they only sleep an average of 5.7-7.1 hours per night.1 This is very surprising because sleep research today suggests most westerners are sleep deprived, averaging about 6.5 hours of sleep per night, which is approximately 1.0-1.5 hours less sleep than our grandparents got two generations ago. Experts believe we should be aiming for 7.5-8.0 hours per night for better health.

This new research suggests there is much more at play than simply the amount of hours of sleep you get (although, I believe this is also important). Let’s take a closer look at some key factors that could help you improve your sleep and upgrade your energy levels this winter and help fight off colds and flu.

The Tribes Go To Bed Earlier in the Winter

As the year comes to an end, most people are busier than ever at work and home as the holidays approach, rather than winding down to recharge their batteries. If we look to our ancestral roots to find answers to the “best” sleep practices, we find the tribes in the aforementioned study went to bed earlier during the darker days of winter/rainy season and later in the summer/dry season. Their average bedtime was just after 9:00 pm in the winter months, compared to 10:45 pm in the summer (still, not exactly “night owls” by today’s modern standard).
A lot people struggle to get bed before midnight (laptops, cellphones and TVs don’t help) and usually don’t get to bed earlier in the colder, darker, winter months. As we approach the darkest days of the year, we should be getting more sleep (not less), but holiday parties, travel, and work commitments usually ramp up at this time of year. This lack of sleep is shown in the research to suppress your immune system function, putting you at significantly increased risk of catching a cold or flu.2

The Tribes Wake Up Consistently With Morning Light

Hitting snooze is a morning ritual for a lot of people, as they struggle to find the energy to get out of bed and start their day. While I am sure we can all agree that sleeping in feels pretty good, is it what your body really needs? The tribal groups in this study woke up at virtually the same time throughout the entire year with the morning sun (not surprising if you’re an avid camper!).

Many of your key hormones are produced on a natural daily pattern or circadian rhythm that new research shows gets disrupted if you constantly change your sleeping and waking time. Disrupted circadian patterns have been shown to leave you more prone to fatigue (sound familiar?), inflammation, and even change the balance of “good” to “bad” bacteria in your gut.3

If you struggle with fatigue, insomnia or frequent colds and flus, aim to have a consistent bedtime and waking time this winter. Go to bed earlier (don’t sleep in longer in the mornings) to help kick your snooze button habit in the morning. If you really struggle to wake up, try some gentle stretching/mobility/yoga on the floor to ease your way into the day. (Not only that, research shows the later you get to bed the greater your likelihood for weight gain.4 If weight loss is also a goal, get ahead of your new year’s resolution by tucking in earlier at night).

The Tribes Are Exposed To Lots of Morning Light

It’s difficult to wake in the morning and get outside during the cold days of winter. Fatigue, lack of time and general desire to stay warm keep you huddled up in your house, car, and office. However, not exposing yourself to natural light may be having a significant negative impact on your health.

Modern hunter-gatherer communities get up daily with the morning sun and engage in the vast majority of their physical labor in the morning hours exposed to natural light. In contrast, most people are indoors all morning throughout the winter – commuting in cars and working in buildings – not getting nearly enough exposure to natural light. Even on a cloudy day, the natural light outside provides a whopping 100,000-lux (a measure of light intensity), compared to only 5,000-lux in your office or home.

New research shows that this light exposure is crucial for circadian hormone production and thus your energy levels, health and resiliency.5 It’s easy to find yourself stuck in your car, office or house all winter. Instead, get outside to grab your morning coffee, walk a few blocks to your next meeting, or go outdoors in the morning for a light run/jog to start your day. You’ll feel much better for it!

Often we’re drawn to the “shiny new toy” or exotic and complex solutions to our problems, however the real lasting solutions are typically always found in how you eat, move and lifestyle factors. While a Paleo diet will go a long way to keeping you energized and fighting off colds and flu this winter (check out my article on how to Paleo boost your immunity this fall), looking at your daily patterns of sleeping and waking from an ancestral perspective will likely help you dramatically upgrade your energy and vitality this winter.

 

References

  1. Yetish G et al. Natural Sleep and Its Seasonal Variations in Three Pre-industrial Societies. Current Biology. Vol 25, Iss. 21, 2 November 2015, Pages 2862–2868.
  2. Prather A et al. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep Journal. Vol. 38, Issue 09.
  3. Voigt R et al. Circadian disorganization alters intestinal microbiota. Plos One. 2014 May 21;9(5):e97500.
  4. Asarnow L et al. Possible link between bedtime and change in body mass index. Sleep Journal. Vol. 38, Issue 10.
  5. Czeisler C, Klerman E. Circadian and sleep-dependent regulation of hormone release in humans. Recent Prog Horm Res. 1999;54:97-130; discussion 130-2.

Is the 40 Hour Work Week a Thing of the Past? | The Paleo Diet

America is somewhat (in)famous for its “work hard, play hard’ motto,1 whereas Europeans typically work less and relax more.2 As America’s health rapidly declines, many Americans are starting to wake up and realize all those extra hours aren’t really worth it.3, 4, 5 One recent example of this is a Portland-based company Treehouse, who have started a 32 hour work week trend for their employees without slashing their benefits.6 Interestingly, they have found that employees are more productive on this schedule.7 We have to ask: is this feasible for everyone?

Then there is the story of Ultra Romance – a 35 year old man who only works six months out of the year, spending the other six months riding his bicycle around the world, and living off of a mere $10.00 per day.8 While certainly not a mainstream idea, part of me thinks that he just might be on to something. He claims modern life is just too stressful, and often I’m inclined to agree with him. Scientific literature supports his claims, as well.9, 10, 11 Though there are other parts of his story that are even more fringe-like (he’s never owned a car, and he only got a bank account to buy and sell bicycle parts on eBay), at heart he may be more in tune with our Paleo ancestors, than we are.

But believe it or not, capitalism used to be even more demanding on the human psyche, with a 48 hour work week being a thing of the not-too-distant past.12 That clearly seems like too much to expect of human beings. It cannot be good for us to work that much…right? Correct.13 To put it simply, all that constant work is not great for our brain or body.14, 15, 16 And as life outside of the workplace becomes increasingly demanding it is a healthy question to ask: “how much is enough?” One alarming trend that has occurred only over the last 40-50 years is a completely diminished sleep quantity, across the board, for all genders and age groups.17 Not getting enough sleep can have long term negative consequences, on a variety of biomarkers of wellbeing.18, 19

Interestingly, before capitalism, most people did not work very long hours at all.20 Capitalism may have raised income levels, but precious time (the one thing you can never get back) was lost. Was this a good trade? As we reach the apex of technology and with the potential for nearly everything to be automated, we must reexamine our lifestyles.21

If you don’t believe me, believe the data. Never before have we seen such a widespread obesity pandemic.22 Never before has healthcare and diabetes been costing us so much.23 Happiness indexes are highest in the Nordic countries – countries which have vastly different work and leisure habits than we do.24

Hopefully I’ve given you some food for thought. We are undoubtedly in tough times. There is vast economic disparity, great economic instability, rapid advancements in technology, and hyper-stimulation of our senses. But our basic biology has not changed. We are still humans who require relaxation, 8-9 hours of sleep, high quality food, and smart amounts of physical activity. Our Paleo ancestors may have been right all along – and they certainly did not work a 40 hour week.

 

REFERENCES

[1] Available at: http://www.stanforddaily.com/2012/04/30/editorial-work-hard-play-hard-not-healthy/. Accessed July 29, 2015.

[2] Okulicz-Kozaryn A (2011) Europeans work to live and Americans live to work (Who is happy to work more: Americans or Europeans?). J Happiness Stud 12:225–243

[3] Roth J, Qiang X, Marbán SL, Redelt H, Lowell BC. The obesity pandemic: where have we been and where are we going?. Obes Res. 2004;12 Suppl 2:88S-101S.

[4] James PT, Leach R, Kalamara E, Shayeghi M. The worldwide obesity epidemic. Obes Res. 2001;9 Suppl 4:228S-233S.

[5] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[6] Available at: http://www.usatoday.com/story/tech/2015/07/10/portland-company-32-hour-work-week/29950755/. Accessed July 29, 2015.

[7] Available at: http://www.washingtonpost.com/local/at-some-start-ups-fridays-are-so-casual-everyone-can-stay-home/2015/02/06/31e8407e-9d1c-11e4-96cc-e858eba91ced_story.html. Accessed July 29, 2015.

[8] Available at: http://www.businessinsider.com/ultraromance-bike-camping-free-spirit-does-not-like-work-2015-7. Accessed July 29, 2015.

[9] Benson H, Allen RL. How much stress is too much?. Harv Bus Rev. 1980;58(5):86-92.

[10] Arnsten AF. Stress signalling pathways that impair prefrontal cortex structure and function. Nat Rev Neurosci. 2009;10(6):410-22.

[11] Babazono A, Mino Y, Nagano J, Tsuda T, Araki T. A prospective study on the influences of workplace stress on mental health. J Occup Health. 2005;47(6):490-5.

[12] Available at: http://www.nbcnews.com/news/us-news/where-did-40-hour-workweek-come-n192276. Accessed July 29, 2015.

[13] Available at: http://www.inc.com/jessica-stillman/why-working-more-than-40-hours-a-week-is-useless.html. Accessed July 29, 2015.

[14] Babazono A, Mino Y, Nagano J, Tsuda T, Araki T. A prospective study on the influences of workplace stress on mental health. J Occup Health. 2005;47(6):490-5.

[15] Sapolsky RM. Why stress is bad for your brain. Science. 1996;273(5276):749-50.

[16] Mcewen BS. Stressed or stressed out: what is the difference?. J Psychiatry Neurosci. 2005;30(5):315-8.

[17] Available at: https://www.advisory.com/daily-briefing/2015/07/10/were-sleeping-less-than-ever. Accessed July 29, 2015.

[18] Greer SM, Goldstein AN, Walker MP. The impact of sleep deprivation on food desire in the human brain. Nat Commun. 2013;4:2259.

[19] Irwin M. Effects of sleep and sleep loss on immunity and cytokines. Brain Behav Immun. 2002;16(5):503-12.

[20] Schor, Juliet. The overworked American : the unexpected decline of leisure. New York, N.Y: Basic Books, 1991.

[21] Available at: http://www.wired.com/2015/02/ai-wont-end-world-might-take-job/. Accessed July 29, 2015.

[22] Malecka-tendera E, Mazur A. Childhood obesity: a pandemic of the twenty-first century. Int J Obes (Lond). 2006;30 Suppl 2:S1-3.

[23] Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-46.

[24] Available at: http://www.newyorker.com/magazine/2015/02/16/northern-lights-4. Accessed July 29, 2015.

Easy With That Salt Shaker: The Effect of Dietary Salt On Sleep | The Paleo Diet

INTRODUCTION

Got sleep? Fact is many of us have a problem sleeping. You probably fall into one category, either being unable to sleep, or not getting enough sleep. In actuality, “counting sheep” and staring at the clock may be the favorite pastimes of many adults. Poor sleep quality, and associated sleep disorders like insomnia remain at the foremost of global health issues. For many, a common solution to tiredness entails having a daily fix of caffeine. Yet, the negative effects of caffeine on the heart, as well as the importance of sleep in regulating chemical imbalances within the brain, cannot be overstated.1

Sleep disorders have long-term consequences. They increase the risk of chronic diseases such as cardiovascular conditions and diabetes, resulting in a dismal quality of life. In addition, this leads to a big hole in your wallet and great financial burden to the economy.2 Given the increasing prevalence of reduced sleep quality and its costs, finding hidden factors that affect sleep is required to improve public health. Many are aware of risk factors like alcohol and sugar consumption, but a possible risk factor that normally goes unmentioned may lie in the individual’s dietary salt intake.3

While devoted Paleo followers are conscious of reducing dietary salt, after reading Dr. Loren Cordain’s books, it is important to understand the scientific basis behind this premise. Let’s put together results from past research to connect the dots.

DIETARY SALT AND THE BIG WHAMMY CORTISOL

Research studies have shown possible evidence between high dietary salt consumption and increased levels of the stress hormone cortisol.4 Furthermore, there appeared to be indication of metabolic syndrome. This group of conditions are characterized by risk factors including truncal obesity (where fat deposits around the waist line), low HDL cholesterol levels (which helps eliminate bad cholesterol from the body), hypertension and insulin resistance (which leads to hyperglycemia-high blood sugar)5.

This sounds like a lot, but let us put this in perspective. An individual diagnosed with metabolic syndrome doubles the risk of cardiovascular (heart) disease, while also quintupling the risk of diabetes. This should have set some alarms going off.

What exactly is cortisol, and how does it affect the body physiologically and psychologically? That answer will help you really understand where this is headed. Cortisol is a glucocorticoid hormone made in the adrenal cortex, near your kidneys.6 Aldosterone, which regulates sodium, is also made in the same area. Known as the key stress hormone in the body, the highest levels of cortisol are seen in the early part of the morning. A term coined as the “awakening response.” That feeling when you wake up excited and ready to start the day, yes thanks should go to cortisol. Cortisol helps your body in maintaining homeostasis. It keeps everything “A-okay” during and after exposure to stress.7 Regulation of cortisol takes place via the hypothalamic–pituitary–adrenal (HPA axis).

Cortisol acts on many parts of the body. In your immune system, cortisol exhibits weakening effects, while inhibiting the inflammatory process. It leaves you prone to developing infections.8 Cortisol encourages gluconeogenesis, basically it increases glucose/sugar production within the body.9 Makes sense right? In a stressful situation, your body needs energy.

In the brain, the memory zone, known as the hippocampus, has numerous cortisol receptors. Excess cortisol during stress has been shown to affect the hippocampus, through atrophy or wasting, resulting in severe memory loss.10 Evidence shows that cortisol affects the limbic system in the brain, which is responsible for mood and emotion.11

Cortisol prepares the body for a fight or flight response to stress, which explains the link between cortisol and insomnia. High levels of cortisol have been linked with a dysfunctional HPA axis, which helps regulate the sleep-wake circadian cycle. This affects sleep quality, and decreases slow-wave sleep aka deep sleep, and sleep time.12 Well the problem is that we need deep sleep. This is where human growth hormone is released, and where the body undergoes healing and repairs.13

Some evidence has shown the likelihood that cortisol also inhibits the production and release of melatonin, the sleep hormone, from the pineal gland.14 Adequate melatonin hormone is needed to induce good sleep. Melatonin and cortisol work inversely, think of it like a see-saw. Melatonin levels are naturally higher at night, but high cortisol levels at night leave melatonin unable to regulate this process.15

TIME TO CONNECT THE DOTS

Enough said. You may be thinking cortisol is pretty bad, but what does that have to do with dietary salt and sleep again. Well, it is a simple linear relationship. Dietary salt leads to increased cortisol levels, and these excess levels affect sleep. This means you can deduce dietary salt may affect sleep. Sounds simple right? Well in science, a hypothesis can be proposed, but a study must be carried out to provide answers.

A research study using a sample size of 20 individuals validated this hypothesis.16 In the study, significantly affected sleep quality, decreased deep sleep, resulting in frequent awakenings, alongside increased thirst. Given the small sample size of this study, further work is needed. Another study also confirmed the hypothesis that salt affects sleep.17

Yet another study shows that dietary salt increased the severity of the sleep disorder known as obstructive sleep apnea.18 With this condition, your airway narrows, decreasing oxygen availability, and leaving you with the inability to breathe for periods at a time.19

So now you have some science to back up your knowledge, when asked the real reason behind your decreased salt intake. Also remember that increased salt intake will make you wake up frequently to use the bathroom. As the body tries to get rid of the sodium, water goes out with it, leaving you thirsty and feeling dehydrated. As you place the almost empty salt shaker next to the empty wine glass, remember there is indeed a science behind this supposed madness.

Best wishes,

Obianuju Helen Okoye, M.D, M.B.A, M.S.-Epi

 

REFERENCES

[1] Harvard Medical School Division of Sleep Medicine. (2007, December 18). Under The Brain’s Control. Retrieved May 19, 2015, from http://healthysleep.med.harvard.edu/healthy/science/how/neurophysiology

[2]<Grandner, M., Jackson, N., Gerstner, J., & Knutson, K. (2014). Sleep Symptoms Associated with Intake of Specific Dietary Nutrients. J Sleep Res, 23(1), 22–34. Retrieved June 22, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3866235/

[3] Ibid.

[4] Baudrand, R., Campino, C., Carvajal, C. A., Olivieri, O., Guidi, G., Faccini, G., . . . Cerda, J. (2014). High sodium intake is associated with increased glucocorticoid production, insulin resistance and metabolic syndrome. Clin Endocrinol, 677–684. doi:10.1111/cen.12225

[5] National Health, Lung and Blood Institute. (2011, November 3). What Is Metabolic Syndrome? Retrieved June 23, 2015, from Metabolic Syndrome: http://www.nhlbi.nih.gov/health/health-topics/topics/ms

[6]  Johns Hopkins Medicine. (2015). The Adrenal Glands. Retrieved June 23, 2015, from Health Library: http://www.hopkinsmedicine.org/healthlibrary/conditions/endocrinology/adrenal_glands_85,P00399/

[7] Randall, M. (2011, February 3). The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis. Dartmouth Undergraduate Journal of Science. Retrieved June 24, 2015

[8] Ibid.

[9] Ibid.

[10] Ibid.

[11] Kandhalu, P. (2013, November 4). Berkley Scientific Journal, 18(1), 13-16. Retrieved June 22, 2015, from http://bsj.berkeley.edu/wp-content/uploads/2013/11/04-FeaturesEffects-of-Cortisol_Preethi-KandhaluKim.pdf

[12] Kandhalu, P. (2013, November 4). Berkley Scientific Journal, 18(1), 13-16. Retrieved June 22, 2015, from http://bsj.berkeley.edu/wp-content/uploads/2013/11/04-FeaturesEffects-of-Cortisol_Preethi-KandhaluKim.pdf

[13] National Sleep Foundation. (2006). Sleep-Wake Cycle: Its Physiology and Impact on Health. Washington DC. Retrieved May 15, 2015, from http://sleepfoundation.org/sites/default/files/SleepWakeCycle.pdf

[14] Nikaidoa, Y., Aluru, N., McGuire, A., Park, Y., Vijayan, M., & Takemura, A. (2010, Jan). Effect of cortisol on melatonin production by the pineal organ of tilapia, Oreochromis mossambicus. Comp Biochem Physiol A Mol Integr Physiol, 155(1), 84-90. doi:10.1016/j.cbpa.2009.10.006

[15] Roden, M., Koller, M., Pirich, K., Vierhapper, H., & Waldhauser, F. (1993). The circadian melatonin and cortisol secretion pattern in permanent night shift workers. Am J Physiol, 265(1), R261-7. Retrieved June 24, 2015, from http://ajpregu.physiology.org/content/265/1/R261

[16] Baudrand, R., Campino, C., Carvajal, C. A., Olivieri, O., Guidi, G., Faccini, G., . . . Cerda, J. (2014). High sodium intake is associated with increased glucocorticoid production, insulin resistance and metabolic syndrome. Clin Endocrinol, 677–684. doi:10.1111/cen.12225

[17] Grandner, M., Jackson, N., Gerstner, J., & Knutson, K. (2014). Sleep Symptoms Associated with Intake of Specific Dietary Nutrients. J Sleep Res, 23(1), 22–34. Retrieved June 22, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3866235/

[18] Pimenta, E., Stowasser, M., Gordon, R., Harding, S., Batlouni, M., Zhang, B., . . . Calhoun, D. (2013). Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism. Chest, 143(4), 978-83. Retrieved June 21, 2015, from 10.1378/chest.12-0802

[19] Pimenta, E., Stowasser, M., Gordon, R., Harding, S., Batlouni, M., Zhang, B., . . . Calhoun, D. (2013). Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism. Chest, 143(4), 978-83. Retrieved June 21, 2015, from 10.1378/chest.12-0802

 

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