Sleep, Satiety, and Keto Diet
Keto Diet, Sleep, and Satiety with Amber O’Hearn
Carole Freeman: We’re live everyone.
Have you ever noticed that your sleep changed after starting keto? Have you ever noticed how you’re hungrier after a night of inadequate sleep? How important is sleep for weight loss? Those questions and so many more we’re gonna answer today. This episode is for you, so stick around and learn about how a ketogenic diet impacts sleep and over overlaps. This is live you ever Once so I don’t have to do it perfectly.
How the ketogenic diet impacts sleep and the overlaps of sleep, obesity and satiety in so much more. My very special guest co-host today, Amber O’Hearn and everyone welcome, welcome, welcome to Keto Chat Live. I am your host, Carolee Freeman. I have a masters in nutrition and clinical health psychology. I’m a board certified keto nutrition specialist and I specialize in helping women 40 plus follow a keto diet for sustainable weight loss. And the thing that the lawyers like us to say this show is meant for educational and entertainment purposes only.
If, oh, it is not meant for medical advice nor intended to diagnose, treat, prevent, or cure any condition, not even including a wart on your thumb. If you have any questions or concerns related to your specific conditions, please contact a qualified healthcare professional. Everyone help me welcome Amber. All right, Amber I’m gonna talk a lot at the beginning, and then you get to talk a bunch after that. I met Amber at a health conference, one of the health conferences.
We met up at several of them, but I don’t remember if we met originally at a low carb USA conference or Ancestral Health Symposium or somewhere else. But immediately I was so impressed with her. She’s so intelligent and her depth of analysis. I met Amber and probably heard her talk and was so impressed. And just the depth of analysis and re research that she does in her talks.
And also she’s talking about things that nobody else is talking about and just something about the way that she thinks about things. She’s always looking for different angles and I just, so many of talks have always been like, oh my gosh, that’s really cool. I quote them all the time. But her official bio is she has an eclectic background with academic publications in several fields, including theoretical mathematics, cognitive psychology, computational linguistics, and more recently evolutionary nutrition and biology.
She has been studying in experimenting with low carb ketogenic diet since 1997 and is particularly interested in evolutionary constraints and inter species differences. EM’S been eating a nearly plant free diet since 2009, so there we go. Welcome, welcome Amber to the show. Thank you so much. It’s great to be here. Vir virtually. Yes. Virtually great . It’s great to hear Before we started the live button here, we were trying to figure out the last time we saw each other. It was probably like March of 2018, I think, in Bozeman, Montana at an ancestral health symposium. I think thats our best guess.
Amber O’Hearn: Incredibly too long ago. Too long. Too long.
Carole Freeman: Yeah. Yeah.
Just for our viewers that don’t know who you are, would you mind just starting out with how your diet has evolved over the years? And how it’s impacted your health. So way going back to 1997 or even before, wherever you wanna start. Sure.
Introduction Of Amber O’Hearn:
Amber O’Hearn: Yeah. I did start a low carb diet in 1997. Before that, I was brought up vegetarian.
I was born in 73. So basically I’ve been on a low carb diet of one form or another for half my life for two dozen years. And then the last half of it has been on a carnivore diet in particular. So it’s been a very strange evolution. My mother thinks I’m rebelling. I’m sure. Yeah, so I, I was on a vegetarian diet growing up.
It wasn’t super strict. Like we would occasionally have some chicken or fish. And I was allowed to have meat if I went out somewhere. But basically our household was largely vegetarian and so I grew up with that kind of Nor that was normal to me. And so when I first started having trouble with my weight, which is when I first went to university, I, my first thought was I should go back to eating vegetarian like I was brought up to.
And I read lots of books at the time that’s totally supported that like they were saying, if you’re having health problems or weight problems, you should cut the animal products and cut the fat and. So that didn’t work for me at all. But I tried it for a really long time and I even doubled down and became vegan for a while.
In fact, I lost some weight while traveling ,that made me think alright, obviously this isn’t the thing that’s preventing me from losing weight, so maybe I should go look into that crazy low carb thing that I heard about one time , that was the beginning of a really something has affected me for the rest of my life.
And I, when I first started a low carb diet if you’ve heard me speak before, I say this every time, but, the first book that I found was Mike and Mary Dan Eades’ book, Protein Power. And they had a lot of, science in it that. Blew my mind cuz it was completely opposite to anything I’d ever heard.
But they had references and so I went to the local medical library and looked them up and was like, wow, this is legit. And this sort of started a lifelong pursuit of looking at nutritional literature, which I, over time gut familiar with the different ways that people argue and how things aren’t always the way that they seem.
A recurring pattern that I see is that the authors will present data and will present their interpretation and I don’t always agree with their interpretation of their own data, which is a little bit maybe obnoxious of me since I didn’t do the experiment, but I get…
Carole Freeman: oh, so you started looking at nutrition research back when you had to go through a card catalog to find
Amber O’Hearn: Oh yeah, I used microfiche.
Carole Freeman: Oh yeah. I’m very old. Wow. So I you sent me the link to your talk which I’m gonna asked you what do you wanna talk about? Cuz there’s so much stuff that you could talk about.
And one of the things I remember most, and I don’t remember where this was, that you did this talk about how when you looked at research on Inuit populations at how they didn’t show ketones in their blood. That’s the ones I, one of the ones I talk about frequently to people about how we adapt to that state.
And you’re not gonna be able to, which blows my mind. That was, cuz that was back in what, in the thirties or something And they were actually even able to take blood samples back then. But anyways, there was a ton of topics that Amber could talk about, so I let her pick. There was a talk that she did in January in Boca Briton at Low Carb usa.
It’s about sleep and keto diet and satiety. And originally I saw that and I was like, these are three random words. How do they fit together? So I listen to the talk and so I, I’ve got some questions, based on that, for you to present the information to our to our viewers, our listeners, and anyone in the future.
Amber O’Hearn: Yeah, so there, there are a lot of different ways that we could talk about what sleep is and sleep stages are something that happened.
It’s something that you can’t see, right? So you go to sleep and it just all basically looks the same. The person is inert , but there’s more going on if you measure actual brain waves. And it turns out that there are patterns happening and that we can identify and the patterns they alternate.
So the main two stages that we identify would be REM sleep, which stands for rapid eye movement because during that stage of sleep, there’s a characteristic kind of back and forth eye movement that’s happening. And REM. It’s actually physiologically a lot like being awake. So your mind is very active.
Your brain is very active in a way that is paradoxical. And sometimes it’s actually called paradoxical sleep in the older literature, although REM is the more modern term and and the other main kind of sleep stage is slow wave sleep. And what’s happening during slow wave sleep is really amazing.
All your neurons turn off at the same time. It’s called coordinated neuron silencing. And actually even when you’re awake, it turns out that there’s actually a very small percentage of neurons that are firing at the same time. Something like 3%, or it’s definitely less than 10%. It’s very surprising that, but what’s happening while you’re in slow wave sleep is that they’re all going off at the same time.
In this pulsing thing that creates this delta wave that shows up on your electrodes. So slow wave sleep can be, it can be lighter or deeper, and it depends. We just have these arbitrary cutoffs of how big that the wave is. And what happens is the stages alternate throughout the night.
So it’s usually, slow wave sleep and REM and slow of sleep and REM with little, there might be wakings in between that are very brief. You might, you’re probably not even aware of them. But one thing that happens is that the slow wave sleep is, takes up more proportion of the time during the first half of the night.
And REM takes up more proportion of the time during the second half of the night, and they have different functions. We’re not necessarily clear on what the functions of the different parts of sleep are, what sleep does at all. There, there are lots of good theories, and I’m not saying that we don’t know anything or have good ideas about it, but it’s really a developing field and it’s been a misery for a really long time.
An analogy I made in the talk was if we talk about food and how we need food we know what we need food for. We have a pretty good idea about how the different nutrients are used as enzymes or used as building blocks or used as energy. We don’t have to guess as much.
Whereas when you talk about sleep, we don’t, we can talk about these things that sleep does, but most of what we know about that comes from depriving animals of sleep and seeing what, what breaks. And we can correlate that to the different stages too. So that’s your basic rundown of sleep stages.
Carole Freeman: Oh, it’s, it was so fascinating when you said that in your talk about how there, there’s mostly, we don’t know what sleep even does. It’s just mind boggling to think about the fact that we don’t know. We know we need it. And a lot of pe all animals need it. I don’t know, we’re getting off topic there, but so one of the next points you had too was there’s a lot of scientific articles on the web, on ketogenic diets that and sleep.
Let’s see. The sleep stages, drama is taken, conclusions what really happens to deep or slow? Labors slow. I can’t even like slow wave sleep and REM on a keto diet. So what’s the truth? Basically there’s myths out there, so if you wanna tell us like what is, what are the articles saying and then what the truth is.
Amber O’Hearn: Yeah. It’s really interesting whenever somebody who doesn’t really have a very big background in ketogenic diets, tries to write an article about what a ketogenic diet might do related to something that they do have expertise on. There a couple of pitfalls that they might make, and one of them is to talk about what is, what happens if you have high fat, right?
And there may be some things. Where that makes sense to, we all know that a high fat diet, that’s a high carb diet has a completely different effect on metabolism than a high fat diet in the context of very low carb. Some people will look at say, what’s the effect of having high fat on sleep stages or sleep duration or sleep quality in some way?
And it may actually have no correspondence to what happens in the ketogenic conditions. So we can dismiss those right away. Another problem that often comes up with, go ahead.
Also Read: Is Body Positivity Bad?
Carole Freeman: Oh, I was gonna say to, to clarify, that’s often the phrase, high fat diet is used in nutrition research, but it really is referring to also what we call like the standard American diet, high fat, high carb, but they’ll just see high fat.
And so then like you’re explaining, people will mistakenly apply that. Article to then a keto high fat diet. So in research, they’re gonna specify either a ketogenic diet or a low carb, high fat, or a carb restricted diet. They’re gonna specifically mention the carb part of that. I was looking through that on a lot of different stuff as well, where they’re saying things about gut health.
Well, a high fat diet is shown to do this, but you have to go in and look at that. So anyway, so the clarity is on, when it’s called the high fat diet that generally equates to high fat, high carb, not a high fat, low carb diet. Yes.
Amber O’Hearn: And it’s a completely different metabolic state. And then a second kind of pitfall that can happen when people are looking at ketogenic diets is to not take the adaptation phase into account.
So it takes three or four days sometimes depending. What exactly you do to switch your metabolism to ketogenic metabolism. Not for sleep. I haven’t really seen this so much for sleep, but I’ve seen things on cognition and other things where, you know they put someone on a ketogenic diet and it, at day two they say, oh look, their brain isn’t working as well.
And it’s yeah , they haven’t keto adapted and they’re not getting enough glucose. So that’s a bad time to be measuring. But a third way is a lot of the studies that are done on ketogenic diets are specifically looking at people who have some kind of medical problem, like obesity or like epilepsy in particular, or some other thing that requires intervention.
And so if you just look at. What people, what happens to people when they go on a ketogenic diet in the context of having some metabolic or some medical issue, it might not give the same result as if you just put a basically healthy person on a ketogenic diet. So that’s something to watch out for.
And that is something that I did see in some of the literature, or at least in some of the summaries or reviews that I saw on the web when people are looking at what does a ketogenic diet do to sleep stages in particular. So it happens that there are some evidence that in people with epilepsy, and I think there was another case with obesity where REM sleep was increased and so the conclusion was, oh, a ketogenic di increases REM.
But in those particular cases It seemed to me that REM was disrupted and what was happening is that REM was being brought back to a normal level. And the reason that I’m so confident about that is that I looked at other studies where the context was fasting. So one way of trying to look at what would happen on an ketogenic diet that I think is a bad way, is to say, oh, what happens when you look are on a high fat diet that’s also high carb.
And another way that’s not quite looking at a ketogenic diet, but and so is not exact either is fasting, but at least fasting does put you in a ketogenic state, right? . So I’m gonna trust something that I read about fasting more than I trust something that’s a high carb. Diet. And the fasting studies in humans have shown an increase in slow wave sleep and a decrease in REM not a drastic decrease, but like from 25% to say 20% of your night’s sleep.
And so I’m fairly confident that’s representative of ketogenic diets, whereas the increase in REM that you see in patients in epilepsy who had compromised REM sleep is more of a normalization effect.
Carole Freeman: One of the things you mentioned too in your talk was how a lot of people with obesity tend to be also oversleep.
Amber O’Hearn: Yes. Yeah. And so that, that’s a really complicated thing. There, there is, where am I gonna start with this? So there. There can be oversleeping in obesity. And there can be unders sleeping in obesity, . In fact if you’re looking just observationally at people who are at different, if you’re just comparing weight with sleep duration, you get this U curve.
So people who are overweight sleep too much and people who are. Overweight or , people who sleep too much are overweight, and people who sleep too little are overweight and the like, best weight corresponds to like this, six or seven to eight hours of sleep, which is part of why that’s the recommendation because it’s like a correlation, causation kind of idea.
This is where that people are the healthiest, so we’re gonna recommend you get that amount of sleep. And, there’s some logic to that. It’s not completely crazy. But I think that the reason that sometimes people oversleep when they’re over when they’re overweight has to do with their, it could have to do with a couple different things.
One, one is this kind of phenotype of a very depressed, overweight person that sleeps too much. And those things often go together. And. The other thing is the whole connection between energy and sleep duration, which will hopefully get into a lot more. On the other side of it though, with not sleeping enough, it’s more of a mystery because you would think if they’re if they’re getting so much energy that they’re getting weight, then why wouldn’t they be sleeping longer?
And that puzzle to unravel it, I think we have to talk about the difference between short sleep in an acute sense and short sleep in the sort of chronic long term sense. So if. If you just get a short night of sleep, say you only get five or six hours of sleep that’s gonna have effects on like immediate effects on your cognitive ability and on your metabolism.
And if you do it for several days in a row, those are gonna accumulate and get worse and worse or more acute, let’s say to be less judgmental about it. I guess I’m fairly comfortable with saying that cognitive deficits are worse, but the other thing that happens is that metabolically your fat tissue becomes more insulin resistant, and that is generally medically in the mainstream medical world held to be a bad thing.
I don’t think it’s necessarily a bad thing because for your fat tissue to be insulin sensitive, that means that it stores fat easily. And that’s not necessarily what you want if you’re trying to lose weight. But it’s very confusing because insulin resistance is a broad term and associated with having high levels of insulin. Your tissue’s becoming insulin resistant as a sort of consequence of this chronic situation where you have so much insulin going around that your tissues just can’t take anymore.
But if you’re, if you just have an acute responsive insulin resistance that doesn’t necessarily correspond to that diabetic insulin resistance state. But nonetheless, if we have we have this one set of data that’s showing us that if. Sleep deprives someone in the acute sense, they’ll get insulin resistance.
And then we also have this long-term observational data that people who have short sleep are also tend to be obese. Then it’s e it’s tempting to draw this picture to say the, what’s happening is that as you continue to be chronically sleep deprived, this causes insulin resistance, which then causes obesity.
And I don’t actually think that’s true. And one of the reasons that I don’t think it’s true is because of what happens to animals when you completely sleep deprive them. So you wanna talk about that?
Acute Insulin Resistance:
Carole Freeman: Yeah. Yeah. And I’m, I just had a thought too about that acute insulin resistance that happens at the cellular level.
Is that it would make sense that short term, that it’s gonna keep more that glucose in the blood rather than storing it so that you have energy supply readily available when you haven’t had adequate sleep. There’s probably something there. I’m thinking that, physiologically your body’s doing that.
Amber O’Hearn: Yeah. And the interesting thing about that I don’t know if you’ve been following Peter Dubinsky’s work on the proton theory and it’s also been talked about by Brad Marshall and by Mike Eades about this idea that
how do I make this simple , it’s complex but satiety is related to insulin resistance. So when your fat cells are full, If they stop taking in glucose, they become insulin resistant. And that’s a good thing because you don’t want them to keep growing. And if your cells were more insulin sensitive, then they would just suck up that glucose and then you’d be hungry again because you don’t have all this energy in your bloodstream.
So what, so a ketogenic guy actually induces. Insulin resistance in a positive wave, it’s completely reversible. If you go off, like if you un keto adapt for a couple of days by eating high levels of glucose, your insulin sensitivity will immediately return. So that’s a physiological difference.
And this is something that shows up. For example, in pregnant women who have to take a glucose tolerance test, or anybody who has to take a glucose tolerance test you might notice if you’re on a ketogenic diet, you will fail that glucose tolerance test because you’re in a cellularly insulin resistant state.
Your cells are taking up fat. They’re not taking up glucose. They’re they’re actually glucose intolerant. So what people are advised to do is if they have to take this glucose tolerance test to go off a ketogenic diet for at least three days, eat 300 grams of carbs a day and get your body back into glucose mode so that you can pass that test if that’s what you need to do but obviously a ketogenic diet isn’t causing diabetes. Some people might have that bizarre idea, but because it’s reversible, it’s not, that’s not what’s happening and you’re, it’s not causing obesity. It’s actually causing me to lose weight. So the whole insulin resistance piece becomes very tricky because it’s so contextually dependent.
And so when I see, oh, a sleep deprivation causes or sleep restriction causes insulin resistance in the fat tissues, my immediate thought is, wait a minute. Maybe that’s adaptive. Maybe that’s not a bad thing, but if you’re on a high carb diet, then maybe you’ve got two discordant things going on. So another thing that does happen with people and nobody ever studies ketogenic people generally, so we’re just talking about people on regular high carb diets, and you’re looking at this, these sleep restriction studies, what happens is they have glu more glucose intolerance.
You give them a meal and their glucose and their insulin will shoot up way more than normal for them, and they will typically eat more and, have metabolism. That’s leading to weight gain. But my immediate question is, What would happen if you had that same study, but they were on a ketogenic diet so that insulin resistance is actually important with the metabolic state that you’re in, and it’s going in the same direction rather than going in the opposite direction.
So if you just gave them very high fat and some protein rather than some carbs, would that actually enhance weight loss? I don’t know. I, that would be very interesting to look into.
Carole Freeman: Maybe we need to have different terms then, right? So the glucose intolerance versus insulin resistant define the what, the context of each thing that’s going on.
Amber O’Hearn: Yeah. I like that suggestion.
Carole Freeman: May maybe in a thousand years we’ll have all this nutritions go figured out. . Now you had something you wanted to go to next, and now I’ve been so in the moment I’m like, I forgot what point you wanted to go to next. So do you remember what that was?
Amber O’Hearn: Oh yeah, I was gonna talk about different species given Oh yeah.
Carole Freeman: Yeah. Yeah, that was fascinating. If in, yeah, go ahead. I’ll let you go ahead, .
Amber O’Hearn: Okay. But stop me at any point. Okay. So in humans, we know that if you give them, if you sleep, restrict them, they’ll have glucose intolerance, they’ll get hungry, they’ll actually eat a lot more, and they’ll have other markers of hunger and they’ll gain weight.
But if you take other animals and you completely sleep, deprive them, so total sleep deprivation what happens to all of them eventually is that they die. And that’s why we don’t do that experiment in humans. At least not for very long because we don’t wanna take it to that point. But it’s been done a lot in other animals.
Specifically some old studies, a lot of studies in rats. And what happens when you completely sleep deprive rats is it takes about two to three weeks for them to die. But what happens to them as like before they die, is that first of all, their fir their body temperature decreases and their cells start burning a lot of energy because they’ll start having mitochondrial uncoupling, which is this phenomenon where the cell is burning energy without creating atp.
It’s just wasting it basically, and it makes heat. And It could be functionally, partly that they’re trying to make heat to make up for the lower body temperature, but I’m not actually sure what the lower body temperature is from. So I don’t wanna state causality when I’m not sure. But those two things happen.
But the, they’re burning so much energy that they are basically ravenous and they’re eating so much, they’re eating as much as they possibly can, but they can’t keep up with the energy deficit that this is creating. And They burn but before they get to the point where they die, they’re burning like twice much calories as normal and still dropping weight.
Carole Freeman: You’ve got people right now going, sign me up. I’d love to have that problem. No, you wouldn’t.
Amber O’Hearn: Actually there’s this thing called dnp. It’s was a weight loss drug. It’s now you can’t get it because it kills you.
Carole Freeman: Imagine that,
Amber O’Hearn: And it works through causing uncoupling.
It’s, and it’s it’s like the holy grail. Like you cannot eat enough to make it not work, but the effective dose is too close to the toxic dose. And. People like bodybuilders and people have died, and I can just imagine like them thinking I’ll just keep it, right at the level and I’m just gonna do just enough and it’s really tragic. Yeah. But it’s the same kind of effect. And people are working now trying to find a better uncer that will do the same thing, but not be so dangerous. And I don’t know where progress is on that right now, but like any day now, someone might have something like that on the market.
I know it’s being worked on. Or it might be that anything that’s effective has that same problem. I don’t know.
Carole Freeman: Yeah. And I wonder if it’s irreversible too. If you do it too long, the cell adapt to that state and it might be too late to reverse it.
Amber O’Hearn: Yeah. I don’t know. It could kill the cell if you push it too far, but I don’t know.
But so we’ve got this contrasting effect, right? We’ve got these lab animals who you sleep deprive them and it causes weight loss and, ravenous hunger. And in humans it seems to cause the ravenous hunger but not the weight loss. So that’s a bummer, right? . And one wonders if it has to do with just the fact that it’s that humans are only getting partial sleep deprivation and maybe you need much more sleep deprivation.
But I think There, there may be possibly a way to get around it. And to talk about that, I wanna talk about the uncoupling just a little bit more without getting too technical. There are proteins involved called uncoupling proteins, and they get activated and they do diff slightly different things.
And there are three main ones that we study and the most famous one is called uncoupling protein one, UCP one named Cuz it was the first one I guess, but it’s probably not the, it seems like evolutionarily, it’s a more recent one and it’s the one that really drives up uncoupled in brown fat tissue, which brown fat tissue is also holy grail.
We know that a ketogenic state causes fat tissue to become more brown, but humans don’t seem to have as much brown fat. As say rats do at all. And some people think that’s completely a species difference, and it may well be. So one hypothesis about why rats would have this weight loss effect and humans don’t is that U C P one is just much lower in humans than in, in rats.
And so they may not have, we may not have as much uncoupling ability. I don’t think that’s probably strictly true because ketogenic diets and other things that we do cold exposure and stuff can ramp up uncoupling proteins in fat and in muscle. And and because, uncoupling works,
Brown Fat and White and Fat:
Carole Freeman: So can you, Amber, can you explain a little bit about brown fat and white and fat?
Amber O’Hearn: Yeah. It basically, it has to do with the density of mi mitochondria in the fat tissue. And the more mitochondria there are the more the uncoupling can waste extra energy and create heat.
And so with the UCP one, it’s thought to be actually that’s the purpose of it, is to create heat. So in cold temperatures, that’s why cold exposure will upregulate it. So rats, babies have more than adults do. And so it’s thought to have this thermo thermogenic function. But there are other uncoupling proteins that do other things they uncouple, but to a lesser extent than U CCP one.
So U C P two causes glucose intolerance at the level of the cell by preventing py vate from getting into the Creb cycle. So that’s interesting because now we have another thing where uncoupling is related to glucose intolerance.
All of those things are going together to this picture of burning more fat and generating more heat and wasting more energy. And all of those things seem to be upregulated. In the human case with sleep deprivation, we don’t see an upregulation of mitochondrial and cut pilling.
And so this is part of the mystery. And what I am guessing is that because we’re eating high carb diets, and this is a hypothesis of mine, and it may turn out to be false, I would really love to see it tested. But I’m guessing that when you have sleep deprivation, but you’re coupling it with a high carb diet, Which is not really very concordant with human evolutionary history.
We didn’t have a lot of access to carbohydrate. And probably in a case where you have sleep deprivation, it might be going along with food or glucose deprivation as well. But one could imagine that in the low carb context, maybe sleep deprivation, even partial sleep deprivation would encourage mitochondrial encoupling more than sleep deprivation plus glucose, which kind of puts the breaks on the mitochondrial coupling.
So my hypothesis is that the reason that humans are having are gaining weight when they have. Sleep deprivation that causes glucose intolerance is that they’re eating glucose . And that if you’re in a ketogenic state, maybe sleep deprivation would actually enhance weight loss. And I don’t know if that’s true or not, but now everyone’s, oh my gonna try it and tell me,
Carole Freeman: that’s gonna be the next weight loss wave. Sleep deprivation.
Amber O’Hearn: Oh, I’m gonna get in so much trouble. I’m encouraging people to lose sleep. ,
Carole Freeman: somebody’s gonna write that book right now. . Oh the Sleepy Keto, the, yeah. I’m so tired. And diet. Yeah. People didn’t feel deprived enough on a keto diet now they can’t even have sleep.
Amber O’Hearn: Yeah. I’m gonna be lambasted for this one. Cause sleep deprivation is not really very good for you. And the reason it’s not very good for you. Again, we don’t really know, but one, one theory. One theory about. What causes a need for sleep has to do with reactive oxygen species. So oxidative stress oxidative stress builds up in the body in response to making energy.
Byproduct of Making Energy:
It’s a byproduct of making energy and it turns out that it accumulates over time and sleep lowers it. So there is, there are some groups of scientists who think that this is the primary or a primary regulator in sleep. And one of the main functions of sleep is just to deal with that ongoing oxidative stress.
And one really cool study from a couple years ago that confirms that, or supports that theory is they took I think it was fruit flies. I think they also looked at rats, but I think it was fruit flies that were the ones where they gave some antioxidants to the animals and it cut, it extended their survival time under total sleep deprivation by a factor of two, which is really like huge.
So that really supports the idea that the need for sleep is being driven, at least in part by this buildup of oxidation. So
if you can address that oxidation if you don’t address that oxidation that’s one of the things that’s gonna be a problem with sleep deprivation. So sleep deprivation does have Other benefits. Actually, one of the benefits of sleep deprivation is that it is an antidepressant a very strong antidepressant.
You take people and who are depressed and give them four hours of sleep a night, and for many of them it will treat their depression, but it’s completely unsustainable. ? Yeah. Because one really bad thing that it does is it puts your cognition in the toilet, your reaction time, you’re like a drunk person, basically.
It’s very bad. It’s the cause of accidents. So we’re in this conundrum where there’s, there are some definite benefits to sleep deprivation, some tantalizing potential hypothetical benefits to sleep deprivation, and yet really bad problems with sleep deprivation. And so how do you How do you manage that?
One thing that is really interesting about ketogenic diets is that they increase sleep. I mentioned that they increase slow wave sleep, but I, what I think is true is that they increase the intensity of slow wave sleep. So remember we were talking about how the first half of the night you get more slow wave sleep in the second half of the night you get more rim.
That’s because your sleep drive is driven. It’s driven by this need to get slow wave sleep for whatever reason, for a variety of reasons. It does all kinds of things. All kinds of things happen. You clear, you get a clearance of metabolites and oxidative metabolites in the brain. It’s good for cognition.
There’s, there are correlations between you, if you have a. Diseases, like Alzheimer’s or something there, there’s at least a correlation between better sleep and better cognitive, like less cognitive deficit. Anything that increases energy in rain, energy use in the brain during the day will then increase the intensity of sil wave sleep.
So that means the waves are that we were talking about are higher amplitude or there’s more of them in a shorter period of time. It makes your sleep more efficient. And one thing that might be happening with a ketogenic diet is that because of that increase in sleep intensity and slow wave sleep you’re getting more bang for your buck , like you’re getting more of the benefits of slow wave sleep crunched into the same amount of time, or you might even decrease the amount of time needed by a bit.
Carole Freeman: Yeah, that’s definitely what I’ve noticed for my clients. They report that they sleep less hours and they just feel so much more refreshed when they do wake up and more energy. And some of them actually are very concerned cuz they’re like, I. They, they think something’s wrong because, oh, I just, I can’t fall asleep for a couple hours.
And I said how do you feel when you wake up? Like you’re, I’m only sleeping six hours a night. And they’re very worried. I’m like how do you feel when you wake up? I feel great. I’m like you get two more hours in your day now, I guess so .
Amber O’Hearn: Yeah. Yeah, exactly. Sleep quality and sleep duration are different things and and it, the time, the amount of time you spend in bed doesn’t, you can, one person can have seven hours in bed and getting really high quality sleep and another person could just be having a lot of wakings or not getting very deep or so yeah, if it, insofar as a ketogenic diet improves sleep quality, which I think it does you’re likely to need less
Another thing that is related to that, that we didn’t talk about at all, but I went into the talk is these two neurotransmitter neuropeptide chemicals. Without getting too technical about it there’s a wakefulness one called rein and a sleepiness one called Adenine.
They both go up on a ketogenic diet and which is really fascinating because they have opposite effects. So one of the things that I was speculating in my paper and in my talk is that because they’re both going up, what happens is that, adenine in the sleepiness one, like sleep deprivation.
In fact it’s believed that the reason that sleep deprivation gives these antidepressant effects is because of the increase in adenine, but adenine makes you sleepy. But it and a ketogenic diet, it doesn’t seem to make you more sleepy. And maybe that’s because the erection is balancing it out.
They they mutually inhibit each other. So
I tend to think, and of course, I’m a little bit biased toward ketogenic diets because of all the wonderful things that they do. But I think that maybe what a ketogenic diet is allowing to happen is that you’re getting more of adenine the sleepiness without getting the normal sleepiness that would accompany it.
And therefore you’re able to get those benefits without the detriments. And insofar as that is true, we may be able to at least slightly reduce our sleep deliberately on a ketogenic diet and still maintain benefits. But it’s empirical question.
Carole Freeman: So fascinating. Ah let’s talk about the satiety part then.
How does this all, how does this all take, tie together with the satiety? We covered it a little bit where Sleep de deprivation makes you hungrier. Is that the summary ?
Amber O’Hearn: There’s a lot. So satiety should be directly related to your energy availability, which some people have shown to be tied to metabolic rate.
So if you’re making a lot of energy, your metabolic rate is high, you’re turning a lot of material into energy and then using it
Metabolic rate also seems to be directly tied to probably, I believe, causely to hunger, which would make sense, right? Because you should be hungry exactly. When you feel like you’re not getting enough energy. So if your metabolic rate is low, your energy output is low, and if your brain senses that somehow, then that should tell you to eat.
Whereas if your metabolic rate is high, you’re producing all kinds of energy. There should be energy in the blood and the metabolic kind of metabolites or byproducts of making energy should be in the blood, which your brain can pick up on. And then, so your body your organism yourself should say, okay, I’ve got lots of energy.
I’m not hungry. That would make perfect sense, right? But the interesting thing is that the. High rates of energy use also correlate to sleepiness and sleep duration. So if you have a lot of, if it’s like when you’re using a lot of energy in the brain and it causes a lot of good intense sleep.
Similarly, when you have a lot of energy your sleep duration is more and you actually get more REM sleep. Whereas if you are if you’re energy deprived, for example, in anorexia, you will often not be able to sleep in the second half of the night, which is when most of your rim is happening. So sleep duration seems to be quite tied to energy availability in a similar way to The way appetite is.
And it also ties into the reactive oxygen species, the ox stress that we were talking about because we’re already talked about how high levels of Ross are instigating sleep. And high levels of Ross are also tied into satiety, which is part of the theory that I mentioned from Peter Dubinski about how cell will recognize that it’s had enough because reactive oxygen species that are created by generating atp tell the cell, oh, we’ve got lots of energy.
Now we can become more insulin resistant. Now we can demonstrate satiety at the cellular level. And so That’s concordant with the need for sleep and getting lots of sleep. And then on the opposite end of that I mentioned orexin as one of these things that causes wakefulness.
It also causes hunger. So like the word anorexia means not hungry. Anorexia is this thing that drives wakefulness and hunger. So we, there are actually a lot of common pathways in both in the periphery and the brain for for detecting having enough energy and. Sleeping. And so often I see people who are on a ketogenic diet if they’re not getting enough to eat such that the ideal case right when you’re fasting, say, is that you’re your cell, your fat cells will give up.
And you’ll just use that for energy. That’s the that’s what’s supposed to happen you faster when you’re on some, any kind of a diet is that whatever deficit you deliberately create by not eating your fat cells will just make up. And if that worked, then we probably wouldn’t be here. , for a lot of people it doesn’t work.
And even in the ketogenic case, sometimes if you cut calories too much or if you fast, yes, you might be able to get some fat flowing out of your fat cells, but it might still not be enough to make your body feel like it’s got enough energy and that can cause wakefulness. Whereas if you add some fat back through intake it’s really not gonna disrupt the fat coming off your body because if you’re in this situation where supposedly just compare fasting and you’ve got a certain amount of fat that’s coming off your body at a certain rate, But it’s not enough to meet all your energy needs.
Then adding some fat intake can’t possibly make you not lose weight as fast, right? Because you’re already maximally giving as much fat as your body is willing to give. So now add some fat to give your body and your brain energy that it needs and you will feel better and you’ll sleep better and you’re not losing any less weight, cuz your body wasn’t gonna give up more anyway.
Carole Freeman: If that makes sense. Oh it, yeah, it, I’ve seen it just anecdotally where, people that hell have gastric bypass surgery, right? And they’re, they, because of that restriction, they end up eating very little per day, maybe six or 800 calories. And I’ve seen though that the rate of weight loss for them is very similar to what my clients experience when they’re eating You.
Whatever they want to eat, which ends up being, somewhere between 1500, 1800 calories a day. And like the calories in, calories out model is that doesn’t make any sense. It can’t be possible. But what you’re talking about could be part of the explanation of what’s going on there.
And the body is, there’s way more complicated than a math equation . So Mallory’s saying that anecdotally I also find it easier to adhere to a ketogenic diet when I’ve gotten enough sleep. Oh,
Amber O’Hearn: ah, yeah. So maybe yeah. So there is this idea that when you’re sleep deprived, not only are you hungry, but you can be hungry specifically for carbs because carbs are a fast energy.
My suggestion in that case to try is if you end up in a position where you’ve had less sleep, either deliberately or or accidentally, and you’re feeling those car cravings, give yourself more fat and see if that energy will put, toss the cravings because that was what they were for, is for energy.
And they just appeared to be for glucose.
Carole Freeman: Especially if you’re already keto to adapted, your body should be able to easily take that fat and create energy from it. Yeah. If
Amber O’Hearn: you’re not keto adapted, all bets are off
Carole Freeman: Oh, that’s, oh, that’s really cool. The other thing I thought was really interesting, one of the. After your top questions that was in that recording you were talking about cortisol and how it’s called a stress hormone, but, and so it, it gets labeled as the bad hormone. That’s, doing bad stuff during stress.
But you talked about how it’s actually a really good thing. So can you talk a talk about that? Cuz we’re always like, oh, minimize your cortisol, you gotta get rid of it just like everything else. That’s good or bad. There’s a reason our body’s making it obviously, so it’s doing something.
Amber O’Hearn: Yeah.
Cortisol, the Stress Hormone:
There’s one sense in which it’s two sides of the same coin, right? So if you, cortisol is the, it’s called the stress hormone because it’s a response. It can be a response to stress and it actually but what it actually does in its response, the reason it’s a response is because it reduces stress.
Cortisol goes up, for example, if you look at animals who are, that are studied in the context of dietary restriction for longevity. So you do this like caloric restriction to try to induce longevity in different animals, and sometimes in some animals it works. So they live longer and they also have mildly elevated cortisol.
And if you look at the many different papers where they discuss this, what they say is, oh yeah this mildly increased cortisol. It’s probably probably part of what’s giving them longevity because it’s a, it’s an anti-inflammatory. It’s a, it’s an anti-stress hormone. And then, but then
Researchers. You turn around and look at the literature on ketogenic diets where they’re in some cases, in some experiments, a similar thing is shown where there’s this mild increase in cortisol and everyone says, oh, that’s bad. That shows stress. And we don’t get to see if the person lived longer like we did, cuz they can’t say that in the rats, right?
If you can’t say, oh, their cortisol went up and they lived longer, so the cortisol had to be bad. No, everything that happened, now you have to say that might have been good. Or at least it wasn’t so bad that it prevented the good thing. But when, when you’re looking at a ketogenic diet and everybody wants to hate on them, they’ll just pick on anything.
But yet cortisol it could be in certain situations, if you just see it being raised all the time, you could say that indicates that something underlying. Going on is bad because why would you need so much anti-inflammation all the time? So that’s another way of looking at it in which someone might wanna say, yeah, you need to lower your cortisol, not because cortisol itself is bad, but because whatever it is that’s causing you to need that cortisol, you need to fix.
And that’s maybe a more valid way to think about it, although I don’t think that the, it depends on the levels that we’re talking about. And then cortisol has different effects in different situations. So if you have a high insulin and high cortisol, the net effect of both of those is fat gain because of the way that they interact at the cell in terms of fat uptake and fat release.
But if you have low insulin and high cortisol, it should result in a fat loss. So it’s really highly contextually dependent.
Carole Freeman: Yeah. Oh, I’m just like thinking of all the, gotta lower your cortisol. So then what do you think of then herbs that people take? Cortisol is high. What are those doing? Are those just addressing the inflammation? Are they actually just suppressing cortisol? Do you know much about herbs that reduce cortisol?
Amber O’Hearn: I don’t know. I can imagine there might be both types. Yeah. Yeah.
Carole Freeman: What else? And those of you listening, watching, please give us some questions and then comments. We’ll hang out and answer some questions if you have any here. Was there anything else that you were hoping I would ask about or along these lines that you feel like is important to share or,
Amber O’Hearn: I don’t think so.
We covered a lot.
Carole Freeman: Yes. Yes. I know there’s a bit of a delay for people. So go ahead and put your questions in the comment box there too. If you have any questions about sleep about satiety, about obesity and a ketogenic diet.
Or anything else really? Yeah. Or anything just, we’ll pick and choose whether we answer it or not, yeah. It just really has me thinking a lot about the fat intake and how you can leverage that too, because we’ve gone from, the early days of a ketogenic diet for weight loss specifically was lots and lots of fat.
We’ve moved through a period of time of oh no, no protein don’t eat so much fat , the more fat you eat, the less is gonna come off your body. I have found with my clients that moving toward a more protein pot, protein centric approach where they’re getting adequate protein, which is a lot more than what originally. I’d have them doing does seem to facilitate more rapid weight loss. Even though, higher energy intake too. But I know that the experiments that I done if it’s experiment, but the approach that Chevon has found for herself a much higher fat intake actually has been a way at releasing more fat.
Are you, would you like to share a little bit about that?
Ketogenic Diet High Protein vs Low Protein:
Amber O’Hearn: Yeah, let’s talk about that at least briefly. So there, there have been some pendulum swings over the course of time that I’ve been hanging around ketogenic diet forms and stuff with high protein versus low protein. And there, going too low in protein is gonna be detrimental.
And a lot of people, especially if they’re not on a carnivore diet, where they might eat a whole lot of plants which aren’t a very high source of protein, they could end up having protein that’s actually so low that it’s not meeting your needs and it could be causing it. If your body needs to be in repair and it can’t do that can actually cause your insulin to go up as insulin is part of the inflammatory and repair response.
So getting too low protein chronically can have, can cause all kinds of problems. And then the consensus on what is enough protein, I think has been too low for a really long time. So there’s this 0.8 gram per kilogram of ideal weight, which I think is way too low. I think people actually need like 1.4 to 1.6 at least grams per kilogram of ideal weight of protein.
So when you say higher protein, if you’re moving from something that’s more like 0.8 to something that’s more like 1.5, then that could really be like a game changer for someone to get healthier. Once you get healthier, it’s easier to lose weight. And then If your fat is willing you’re not too metabolically unhealthy, your insulin is fairly low and you don’t have certain types of say, tissue damage problems that you might see in, say, lipedema or autoimmune disorders.
Then there is a, there seems to be a, or, and you don’t have a history of type two diabetes. Then there seems to be quite actually a large range of protein. That you can eat and still stay healthy. Access your fat and lose weight fairly effectively. So for a lot of people as long as they’re meeting that minimum. You could go you could go up to.
Maybe 150, 200 grams of protein and still lose weight. But then for other people for whom the fat is not as accessible for any of a variety of reasons. Lowering protein so that it’s much closer to that adequate level and not very much higher. And then adding a lot of fat for energy is, can actually be a lot more effective.
So it depends. Both approaches can work . But I think in both approaches you have to make sure , you really are getting enough protein. It’s not so low that it’s a detriment.
Carole Freeman: Oh, fascinating. Oh, so there’s not one size fits all way of eating for every single person on this planet
Amber O’Hearn: if they’re all healthy, it’s like that to story, right? That tol story quote. All fam, all happy families are happy in the same way. And all unhappy families are unhappy in their own individual.
Carole Freeman: Here’s a good question, but we are not gonna have time to cover this. So we’ve got kay STAs ask, asking how to heal the gut. And you know what, that’s, I should have that as a future future topic. And anything you wanna say real quick on that? Amber?
Amber O’Hearn: Yeah, I used to think that antibiotics were neutral and not a big deal. I had a bad experience with antibiotics that I think. I believe made me prone to infection and gave me a lot of gut trouble.
I’m still in the process of fixing it and I don’t know the answer, but I don’t know. That was a side note,
Carole Freeman: And I think we’ve got Dr. Ellen Schaeffer here. So many folks who are overweight will have sleep apnea, which will fragment their sleep, continue contributing to insulin resistance. Usually my patients see me for sleep. Oh yeah.
Amber O’Hearn: It’s a big vicious circle because the sleep apnea will wake you. Then you’re getting like inherently bad sleep quality cuz it’s disrupting all of the processes in including the duration.
And then you’ve got insulin resistance. If you’re not on a ketogenic diet, that’s gonna worsen glucose tolerance and affect your ability to eat food well. That can cause obesity and can contribute to sleep apnea , because it can like physically make the passages less free.
So yeah, it’s a terrible endemic problem.
Carole Freeman: Yeah. Here’s a question from Jennifer. How important is it to adhere to a sleep schedule? Is it helpful to get my seven to eight hours of sleep at approximately the same time each night?
Amber O’Hearn: Yes. You will sleep better if you sleep at the same time . I think waking time more than going to sleep time.
And I don’t remember why I think that , so maybe I’m wrong. I’ll have to get back to you. But yeah, if you’re, if you have sleep consistency, that tends to contribute to better sleep quality.
Carole Freeman: Thank you for the question, Jennifer. And then, Dr. Shaffer follow up. I treat their apnea first, then work on carb restriction, weight loss, diabetes reversal, et cetera. So I think sleep apnea needs to be discussed even if they aren’t particularly symptomatic. I’m assuming it means treats it with probably a C P A P machine or some kind of airflow, right?
Amber O’Hearn: So I think what you’re saying Alan if you have an patient presents with diabetes or overweight. Then even if they don’t think that they’re having apnea. It should be looked into because you can address that right away. That should start to have a positive feedback loop.
Maybe that’s what you’re saying
Carole Freeman: and yes is the answer,
I know the history of me getting into a ketogenic personally after a car accident and undiagnosed traumatic brain injury. Every symptom that I had from that developed post-traumatic hypo pituitary. Which basically my whole body was just like, oh, a wreck. Everything that was going wrong got fixed by going on a ketogenic diet.
All the symptoms went away, except for I ended up having this residual essential sleep apnea. So I was still experiencing that a couple years afterwards. And I couldn’t find anybody that could explain to me what was really going on. Why that was happening, except for my brain had been injured.
And the therapy that I finally found that worked for that was, it was really frustrating going. The sleep clinic diagnosis and all that kind of stuff because. I’d already lost 60 pounds at that point and their answer was, you should lose some weight. And I’m like, how much more should I lose. And so they didn’t have, they didn’t have any treatment for the central sleep apnea basically. Because the C pap machine wouldn’t, override that set central? . Yeah, where the brain just stops remembering to tell your body to breathe. So it’s not obstructive like the sleep apnea that Dr.
Shaver’s talking about. So what I ended up doing that, that seemed to work, was doing some hyperbaric oxygen therapy treatments. And so I seem to be normal now. I don’t know. Normal , I
Amber O’Hearn: won’t grant you that. Carole right?
Carole Freeman: She knows me well enough. So Alan saying especially after they have trouble losing weight and so that’s Say more.
Are you getting that? And I think it, addressing the sleep apnea and finding. If that’s an issue first, can then help with the weight loss. I’m suspecting. All right, great discussion here everyone. Thank you all for being here today. Give it up for Amber for being here. Everyone too.
Amber O’Hearn: Thank you so much. Thank you so much for having me on.
Carole Freeman: Great so much to think about here. And yeah, so next week, join me next week I’m gonna have Randy Webb here. We’re gonna be doing some easy techniques to release stress and trauma from the body.
He’s my former supervisor during my grade school degree in psychology. We did the episode a few months back, but there were some audio issues. So we’re gonna redo that episode. So come back next week. And so today we talked about keto diet. And satiety and obesity with Amber O’Hearn. Thank you again for being here, everyone.
If you like what you heard today, support this show. Leave us some more comments share this episode with a friend. Leave us a review. If you’re listening on one of your podcast platforms, would appreciate you leaving us a review. It really would mean a lot. It helps more people find out about the show. And we can get more people this information that could also change their health and their life.
So everyone, thank you again for being here. Thanks to Amber and remember, help us grow the show and we’ll help you shrink . Bye for now, everyone. We’ll see you next time.
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