New recipes

Why Can't the Experts Agree on Which Diets Work?

Why Can't the Experts Agree on Which Diets Work?


We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

This is one in a series of articles. For more on this subject visit The Daily Meal Special Report: Is Our Food Killing Us? Diet, Nutrition, and Health in 21st Century America.

When Howard Helmer retired as the senior national representative for the American Egg Council in 2010, at the age of 72, after 42 years doing what he called “hustling eggs,” it was the end of the era. As a hungry young food writer in the early 1990s, the single best thing that could happen was lunch with Helmer: He had an extravagant expense account and excellent taste in restaurants, and was fabulous company; from his encyclopedic knowledge of Broadway musicals to his status as a two-time Guinness World Record holder (the world’s fastest omelette, in 39 seconds, and the most omelets ever made in 30 minutes: 427, which he admitted were “moist”) no topic was off limits. There was only one thing he wouldn’t discuss: “the cholesterol debacle,” as he called it, that dogged eggs. Helmer was referring to the fact that in the 1980s America’s leading nutritionists cited health studies that warned the country off eggs, associating them with tremendously increased risk of high blood pressure and heart disease. Although the idea had been debunked by the time I encountered Helmer, there were still some stubborn Americans — both clinicians and consumers — clinging to it.

And that’s what happens when doctors and scientists tell us what to eat and then, down the line, change their minds. Meanwhile, the crisis of obesity in America gets bigger, literally. In February, the bestselling nutrition, science, and health author Gary Taubes reported in The New York Times that obesity and its related diseases, especially Type 2 diabetes, cost the U.S. health care system more than $1 billion per day. So if, say, an egg is bad for you or not is detrimental: “It’s not hyperbolic to suggest that the health of the nation may depend on which is the correct answer” to these dilemmas of what to eat, Taubes asserted.

Along with the obesity rate in this country, the suggestions for overcoming it have also ballooned: In 1960, fewer than 13 percent of the American public was obese and fewer than 1,100 articles on the subject had been published; last year, more than 36 percent of the American public could be considered obese, and more than 44,000 articles were published on the topic. So the more and longer we hypothesize, the fatter we get.

While we’re contemplating our collective fatness, we wander the aisles of our local Piggly Wiggly in hopes of figuring out a plan for dinner. These are a few of the trendy dietary choices you have as an American head of household concerned about her or his weight:

You could go Paleo and follow the so-called “cave man” diet based on the eating patterns of our Paleolithic ancestors as popularized by the folks who do Cross Fit and post selfies of pulling tractor tires across gym parking lots. This diet advocates eating lots of lean protein, “alternative fats” like coconut and macadamia nut oil, and all the vegetables you can manage — but no dairy, wheat, or sugar (including the natural kind found in most fruits).

You could go low-fat as the U.S. Department of Agriculture suggests with its carb-heavy food pyramid in a plan that rode a considerable wave of popularity throughout the 1990s and is still touted by groups including the National Heart Lung and Blood Institute. Do this and you'd buy foods like light mayonnaise, diet soda, fat-free yogurt, low-fat microwave popcorn, and skim milk.

You could go vegan and observe an animal-product-free diet (no meat, no dairy). Initially touted by hippies and yogis and now embraced by celebrities from Alec Baldwin to Ozzy Osbourne (we’ll give Ozzy credit even though he barely lasted “more than a week or two”), this diet is big on foods like brown rice, black beans, lentil soup, and veggie burgers topped with vegan tofu-based cheese (no eggs, though).

You could go straight-up low-calorie and buy a full complement of Lean Cuisine entrées (Lean Cuisine is owned by Nestlé, the self-described “World’s Leading Nutrition, Health, and Wellness company”) for three meals a day, including a Canadian bacon English muffin for breakfast (180 calories, 650 milligrams of sodium, 27 grams of carbohydrates), a chicken club panini for lunch (360 calories, 675 milligrams of sodium, 45 grams of carbohydrates), and an enchilada rojo with Mexican-style rice for dinner (310 calories, 670 milligrams of sodium, 46 grams of carbohydrates).


5 Reasons You Can't Lose Weight Anymore, According to Experts

Move over, baseball—weight loss might just be America's true pastime. According to a 2020 report from the Centers for Disease Control and Prevention (CDC), between 2015 and 2018, 17.1% of U.S. adults were on a diet at any given time, with the vast majority of those individuals dieting as a means of achieving weight loss. However, for most people, those weight loss efforts don't last long—a 2020 meta-analysis published in the BMJ found that among 21,942 individuals on diets, while many had "modest weight loss" at the six-month mark, their weight loss had largely stalled or stopped after 12 months.

That said, it's more than just willpower keeping you from achieving the results you want. Read on to discover why you can't lose weight even though you're dieting, according to experts. And if you're eager to slim down for good, check out these 15 Underrated Weight Loss Tips That Actually Work.


What we know

People vary — a lot — in how they respond to dieting.

Some people thrive on low-fat diets, others do best on low-carb diets. Still others succeed with gluten-free diets or Paleo diets or periodic fasts or ketogenic diets or other options on the seemingly endless menu of weight-loss plans.

Most studies comparing diets have produced results like Dr. Gardner’s: no difference in weight loss between study groups as long as the calorie intake was kept equal. But within each group, there always have been a few individuals who lost a lot of weight, a few who did not lose any weight, and a few who actually gained.

Dr. George Bray, an obesity researcher who is emeritus professor at the Pennington Biomedical Research Center in Baton Rouge, La., sums it up this way: “Eat the diet you like and stay with it.”

There is nothing new in the diet universe.

Many of the diets people swear by today have been around in various incarnations for decades. More than a century ago, a best-selling book, “How to Live,” told Americans that the only way to lose weight was to count calories.

Low-carbohydrate diets were introduced by a London undertaker, William Banting, in 1863 and became so popular that one word for dieting was “banting.”

Diet studies are insanely difficult.

Most are short-term, and often it is hard to know if subjects really adhere to the plans they were given. Few studies follow participants for a year or more to see if they kept the weight off. Little of this research is ever definitive, and most of it leaves plenty of room for skepticism, argument and debate.

Dieting for better health is not necessarily the same as dieting to lose weight.

Any diet that restricts calories will result in weight loss, but some diets simply are not healthy even if you are shedding pounds.

It is hard to find definitive evidence that particular diets protect against disease, but many public health experts agree that unprocessed or minimally processed foods, along with abundant fruits and vegetables, can promote health.

They also agree that people with diabetes or high blood sugar levels often benefit from a diet low in carbohydrates.


What can you eat on the DASH diet?

Those following the program aren't given a particular meal plan, but follow general guidelines. Here's everything you'll be able to enjoy on the DASH diet:

  • Fruits: Apples, oranges, unripe bananas, apricots, and berries, or any variety that is low in sugar.
  • Vegetables: Anything that falls under this category, and the more the better including frozen and canned products, as long as they don't contain added sodium.
  • Whole grains: Whole-grain breads, brown rice, and rich, ancient grains like bulgur, quinoa, and oatmeal.
  • Healthy dairy: Fat-free cheese, milk, and yogurt.
  • Lean meats: Skinless chicken, white fish, turkey, and the occasional serving of red meat or pork.
  • Nuts, seeds, and legumes: unsalted raw almonds, sunflower seeds, kidney beans.
  • Healthy vegetable-based oils, including olive oil

Sassos says this diet plan is most in-line with what a regular, healthy lifestyle should look for most &mdash a dietary routine that consists of 2,000 calories each day (or a higher or lower caloric intake recommended by your healthcare provider) consisting of wholesome ingredients. She says the diet recommends an adequate intake of non-fat and low-fat dairy products, two to three servings a day, as well as the appropriate servings of whole grains each day.

She believes that the best DASH diets are those that restrict sodium, as high-sodium diets can cause issues for otherwise-healthy patients. "When you go out to a restaurant, so many of us are drowning in salt, but this approach fixes that," she says.

Here's what you should avoid and limit as much as possible:

  • Sugary products: Candy, cookies, sodas, and canned or sugar-added fruit juices and other treats should be eliminated.
  • Full fat dairy and cheese
  • Enriched Grains: White bread, pasta, plus things like packaged potato snacks.
  • Anything containing elevated sodium levels. Think: frozen meals, convenience store snacks, fast food.
  • Alcohol: In excess, it can be quite the stress on blood pressure, and added stress on liver.

These items shouldn't come as too much of a shock: they're all high in fat, sodium, and calories. Not to mention, they're often highly calorically dense, but not in actual nutrients. "The DASH plan is rich in potassium, calcium, magnesium, fiber, and limits saturated fat, total fat, and cholesterol," Meyer explains.


Why can’t mainstream medicine admit low-carb works?

A leading American low-carb physician (who personally lost 150 pounds on the ketogenic diet) expressed his anger and frustration over the closed minds of mainstream physicians who won’t acknowledge the mounting medical evidence in favor of low-carb eating.

Dr. Tro Kalayjian, a board-certified internal medicine and obesity medicine physician, just published a heartfelt, almost despairing blog post about spending a week listening to speakers at the recent Obesity Week Conference in Las Vegas, Nov 3-7. The conference brought together more than 4,000 obesity professionals from around the world. This year, the annual conference focused on diabetes.

Kalayjian, who goes by the name “Dr. Tro” on his blog and social media, lamented: “I don’t quite know how to express my feelings and thoughts about this event, but the words ‘anger’ and ‘hopelessness’ immediately come to mind.”

That’s because speaker after speaker at the event, while touting “there is no one best diet”, still then defaulted to promoting a low-fat diet, with multiple small meals featuring plenty of “healthy” grains, fruits and vegetables. This, writes Dr. Tro, is “legacy” messaging that ignores the mounting evidence in favor of low-carbohydrate diets for diabetes management and reversal.

“My anger and hopelessness are best exemplified by the first keynote speech, delivered by Dr. William Cefalu, who is chief scientific and medical officer of the American Diabetes Association,” writes Dr. Tro, adding that Dr. Cefalu stressed, “The best diet is one that a patient can adhere to.”

If adherence is the main issue in the diet wars, then low-carbohydrate and time-restriction (both ketogenic) approaches should be considered the BEST diets…… The statements that harp on dietary adherence are a half-hearted attempt to recognize the growing data of approaches like low carb and time restriction that pay little attention to the failed messaging of multiple small meals, lean meats, and whole grains.

Dr. Tro is the medical director and founder of Dr. Tro’s Medical Weight Loss and Direct Primary Care, in Tappan, New York. He is a member of Diet Doctor’s new Low Carb Expert Panel. This panel is made up of a select group of nine talented and experienced low-carb clinicians who are helping set the standard of care for therapeutic use of low-carb and keto diets. Dr.Tro supports patients in low-carb and ketogenic eating for weight loss and diabetes management.

At the conference, Dr. Tro was struck by the fact that physicians refuse to see the big picture.

These puzzle pieces seem to be hiding in plain sight. Several lectures mentioned the harms of sugar and sugar-sweetened beverages. And yet low-carbohydrate approaches are glossed over in favor of low-calorie and low-fat diets, medications, and surgery. Why can’t these physicians put the puzzle pieces together?

As we said in our Facebook post about his blog: It is time for more obesity and diabetes doctors to admit failure. Let’s stop the fake open-mindedness, claiming “there is no best diet” while then continuing to promote only a high-carb, low-fat, eat-often message. We know it is less effective than a low-carb, ketogenic diet for diabetes management and better blood sugar control.

Guides

Posts

Weight-loss videos

20 comments

When I was diagnosed with my hba1c at 7, which came as a complete surprise to me because I had been eating the American Diabetes Association diet guidelines for more than 30 years in an attempt to prevent diabetes because I had seen my cousins lose their lower legs and feet - so when my dad at age 70 was diagnosed with diabetes I chose"prevention," my doctor said it was time for medication. I was already taking drugs for hypertension, arthritis inflammation, fibromyalgia, and depression and I did not want more drugs. So I told him I was going to get online and find out if there is a better way to get this under control with my diet. His reply was, "okay, but come back in 3 months to have another test run and we can discuss the situation again then."

I came home and googled "diet to reverse diabetes" and the dietdoctor.com website came up and I spent 3 days reading everything on it, I bought Dr. Fung's books on Amazon for next day delivery, cleaned out my pantry, went shopping for food and a glucose meter and started eating Keto by the end of the week and I did before and after testing of every individual food I ate in an attempt to learn how my body was responding to what I ate. As I noticed changes in blood pressure which I had been tracking daily for years I slowly cut back on how often I was taking the hypertension medicine (I called my doctor to discuss it first), then one day I noticed I wasn't having pain that needed medication any more so I never took any more of it, and I tapered off the anti-depressant (I had been on it and off of it for 12 years so I was well versed in this) and then a day came about 8 weeks in that I noticed for the first time in more than a decade that I felt really amazing, I felt like I had before all the illnesses had set in - I cried tears of pure joy my heart was bursting with gratitude for Dietdoctor.com. When I went back to the doctor for my 3 month check up my HbA1C was 5.3, and I had lost 80 lbs in that 3 months without exercise because I am disabled. My doctor was shocked, which is putting it mildly. His eyes welled with tears for me. For that appointment I prepared a print out of what I was eating, links to the websites I was using, and information about Dr. Fung's books and I gave it to him, and I said, "Doc, please read this because it is saving my life and I know it will save many other lives." When I went back for follow-up at 6 months I was down a total of 110 lbs, my HbA1c was still 5.3 but this time all my other blood markers were remarkably healthy as well - great Cholesterol and Triglycerides, no more inflammatory markers, my Vitamin D level which had been critically low and for which I took prescription Vitamin D of 50,000 units 3 times a week for 3 years and it had not gone up to a normal range was now in a normal range without the pills, my B12 went into the high normal range and it had been deficient, and many other things improved as well. This way of living began in April 2016 for me and it has changed and saved my life. It hasn't always been easy because there have been long plateaus, and I would like to drop 100 pounds more so I keep testing and changing things up but the fear that doctors have about people not being able to sustain this way of eating are unfounded. After all, our ancestors did it for thousands of years - and if a doctor simply tells patients the truth about the fact that the whole of their physical well being can be greatly improved upon, medications abandoned, and great joy returned to living + an increased possibility of staving off many modern diseases such as Alzheimers, depression, other forms of dementia, hypertension, PCOS, etc - patients will be much more willing to learn about it and make it happen.

One note about my doctor - He used the information I gave him. He made information sheets to give to patients, and because he is a teaching doctor at the clinic and hospital in my town - he talked with the other doctors about it and set up a "keto support group."

The best doctor is one that can admit they don't have all the answers, and will listen to what their patients tell them and ask questions to fully understand their life and their circumstances.


How would calling the virus airborne change the pandemic?

FWIW: The WHO has lagged behind in its COVID-19 recommendations before. The organization only endorsed face coverings for the general public after most of its member nations did the same. A member of the WHO also controversially stated that transmission of the virus by people without symptoms is rare&mdashand then walked back on that statement. The CDC and other major health organizations do warn that the virus can be passed on by people without symptoms.

Of course, the WHO&rsquos stance on whether or not the virus is airborne could eventually change due to scientific evidence and pressure from the community, and that would require big changes on how to control the spread of the virus.

&ldquoIf airborne, then COVID-19 is much more transmissible,&rdquo says Dr. Watkins. &ldquoThen social distancing is a lot less effective. This has a lot of implications for society, such as whether it is safe for kids to go back to school in the fall.&rdquo

&ldquoThe question of &lsquoCan the virus aerosolize?&rsquo is separate from &lsquoAre people getting it that way?&rsquo&rdquo

Other possible effects: People may be advised to always wear a mask in public, even when they&rsquore spread out beyond six feet. Ventilation systems in public spaces would need to have high-powered new filters.

But until we have more direct evidence or new guidelines, Dr. Schaffner says the general public should keep practicing known prevention measures. &ldquoThe vast amount of transmission occurs within families, bars, and when people get together for long periods of time without any facial protection and without observing social distancing,&rdquo he says. Continue to spread out, wear a mask, and wash your hands regularly.

Ultimately, the entire debate may come down to semantics, Dr. Adalja says: &ldquoThe question of &lsquoCan the virus aerosolize?&rsquo is separate from &lsquoAre people getting it that way?&rsquo&rdquo

Support from readers like you helps us do our best work. Go here to subscribe to Prevention and get 12 FREE gifts. And sign up for our FREE newsletter here for daily health, nutrition, and fitness advice.


1. What is low carb?

A low-carb diet means that you eat fewer carbohydrates and a higher proportion of fat (with adequate amounts of protein as well). This can also be called a low-carb, high-fat diet (LCHF) or a keto diet. 4 However, not all low-carb diets result in ketosis.

For decades we’ve been told that fat is detrimental to our health. Meanwhile, low-fat “diet” products, often full of sugar, have flooded supermarket shelves. This has likely been a major mistake, that coincided with the start of the obesity epidemic. While this doesn’t prove causation, it’s clear the low-fat message didn’t prevent the obesity increase, and it is possible it contributed. 5

Studies now show that there’s no reason to fear natural fats. 6 Instead, on a low-carb diet fat is your friend. Simply minimize your intake of sugar and starches, make sure you are getting adequate protein, and you can eat all the fat you need to feel satisfied. 7

When you avoid sugar and starches, your blood sugar tends to stabilize and the levels of the fat-storing hormone insulin drop. 8 This helps increase fat burning and may make you feel more satiated, thereby naturally reducing food intake and promoting weight loss. 9

Studies show that a low-carb diet can make it easier to lose weight and to control your blood sugar, among other benefits. 10

The basics

  • Eat: Meat, fish, eggs, vegetables growing above ground and natural fats (like butter).
  • Avoid: Sugar and starchy foods (like bread, pasta, rice, beans and potatoes).

Eat when you’re hungry and stop when you’re satisfied. It can be that simple. You do not need to count calories or weigh your food. 11 You don’t need low-fat products. 12

Below are examples of what you could eat, alternatively check out our 1000+ low-carb recipes.


What Is the HCG Diet, and How Does the Fad Diet Work?

The diet requires that you eat only 500 calories a day, supposedly as part of an effort to help reset your metabolism and change your abnormal eating patterns, as the FDA explains in its warning against the diet. (1) The HCG diet also requires you to take a daily dose of the hormone human chorionic gonadotropin (HCG). Available in injections, pellets, sprays, oral drops, and pills, HCG is the hormone produced by the placenta during pregnancy.

In 1954, British physician A.T.W. Simeons theorized that HCG allows mothers-to-be to access fat reserves to feed their fetuses. He published a book, Pounds and Inches: A New Approach to Obesity, in which he suggested that HCG could help people access their fat reserves and achieve weight loss.

The idea might have been that, if a woman had morning sickness or some other condition that prevented her from taking in ample nutrition at a certain point in her pregnancy, her baby would still have a reserve of energy to draw on, and the hormone HCG could help facilitate access to that supply, Weinandy says. But, she notes, this really oversimplifies the numerous systems at work in pregnancy: A number of hormones are active, and the way they interact can sometimes even promote fat gain for the mother.

In fact, Weinandy says, this kind of speculation about HCG’s role in weight loss can be “really dangerous, and it’s sending a bad message to people because we don’t know for certain how HCG works.” Another worry? Many chronic diseases, including breast cancer and prostate cancer, have been linked to an imbalance of hormones, so we can’t predict what effects manipulating our hormones might have, Weinandy cautions.


What can you eat?

In a word: fat. Lots and lots of fat.

The desired ratio in the ketogenic diet is consuming 3 or 4 grams of fat for every 1 gram of carbohydrate and protein, which amounts to getting about 75-80 percent of your daily calories from fat.

You can eat foods like butter, heavy whipping cream, mayonnaise, and oils, the Epilepsy Foundation notes.

“It’s putting butter on your butter,” Taub-Dix said. A sample daily menu might include eggs with olive oil and avocado on the side for breakfast leafy greens, salmon, nuts and olive oil for lunch and steak, greens, vegetables and oil for dinner, Glassman added.

It’s all about that fat to carbs/protein ratio, so even though you’re not really counting calories, the meals have to be planned very carefully to adhere to the strict formula.


The top 13 reasons why you can’t fall asleep

1. You’re doing too much before bed.

When a patient can’t fall asleep, Dr. Pizzino first asks about what they’re doing in the hours leading up to bedtime. “Sometimes, people are staying up and answering emails and things like that because they know they don’t fall asleep, so they know they need to occupy themselves until they get tired.”

Especially for parents with young children, people sometimes stay up to get important tasks done before bed. Then, they find themselves having trouble going to sleep when they’ve finished, “So teasing out how much of staying up is voluntary and how much of it is something physiologic going on can be important,” Dr. Pizzino adds.

If after reflection, you discover this is your problem, finding another time to do these tasks and/or developing a nighttime routine can help.

2. Your sleep schedule isn’t consistent.

You probably know that you’re supposed to go to bed and wake up around the same time every day. This isn’t always easy to achieve, but the more regular you can get, the better, Dr. Pizzino says. If you’re consistent enough with your bedtime, your body will eventually learn when it’s supposed to fall asleep.

For those trying to adjust their sleep schedules to be more regular, it’s important to do it gradually, Dr. Pizzino says. So if you normally fall asleep at 1 am, but you’re looking to change to 10 pm, start by adjusting your bedtime to 12:30 am. Then, gradually push your bedtime 30 minutes earlier every one or two weeks.

Naps can also have an impact on your ability to fall asleep. Some people may find power naps (ones lasting less than 30 minutes) to be helpful, but anything longer than that is likely to make it difficult for you to fall asleep at night, Dr. Pizzino says, so for most people, long naps should be avoided. If you find naps are necessary because you’re tired all the time, there may be something deeper going on.

3. You’re dealing with cortisol dysregulation.

If you feel exhausted but can’t sleep, this might be the issue you’re dealing with. “We call it wired and tired,” Dr. Pizzino says. “This is probably the most common thing I see with patients who can’t fall asleep.”

We already covered how stress affects the autonomic nervous system. “Part of that is what’s called the hypothalamic pituitary adrenal axis, or HPA-axis,” Dr. Pizzino explains. The hypothalamus, a part of your brain, and the pituitary gland control the adrenals, which produce cortisol, our stress hormone. “Cortisol goes up in response to physical, mental, and emotional stress,” Dr. Pizzino explains. Increased cortisol makes it even harder to get into that “rest and digest” state, making it difficult to fall asleep.

If your doctor suspects this may be your issue, they can test your levels with a 4-point cortisol test that measures your cortisol levels throughout the day. For optimal sleep, your levels should be lowest when it’s time for bed. If that’s not the case, Parsley Health’s doctors and health coaches work with members to naturally lower your cortisol levels.

4. Inflammation is leading to a hormonal imbalance.

“Chronic inflammation is probably the biggest health issue in the modern world,” Dr. Pizzino says. ”When we’re inflamed, the body sees that as an alarm system.”

If you think back to the example earlier, we mentioned that the gazelle doesn’t make a baby while running away from the lion. “Our sex hormones and thyroid hormones are among of the first things that are impacted in a sympathetic state, Dr. Pizzino says. This can cause hormone imbalances, which can play into energy levels and circadian rhythm, potentially wreaking havoc on our ability to fall asleep.

One hormonal imbalance that especially affects the ability to fall asleep is low progesterone in menstruating women (which can happen alongside higher-than-normal estrogen levels). “Progesterone, which is a calming hormone, is the direct precursor to cortisol. So when we’re under a lot of physical, mental, or emotional stress, we often don’t have enough progesterone,” Dr. Pizzino says.

If you notice sleep issues that coincide with your menstrual cycle, that’s a red flag that this may be an issue for you. And if you’re beyond cycling and you’re into menopause, hormone deficiencies may also be at the root of sleep issues.

Your doctor can help you get your hormone levels checked. They’ll also advise you on changes like diet and exercise modifications that can help get hormones back to their normal levels.

5. You have a hidden infection.

The HPA-axis can also get out of whack due to physical stress, and one physical stressor that people often miss is hidden infections and viruses. Everything from parasitic infections to tick-borne diseases, viruses in the herpes family such as Epstein-Barr virus, cytomegalovirus, and the herpes zoster virus can cause undue stress on the body, Dr. Pizzino says.

These are referred to as “hidden” because they’re really good at avoiding the immune system, which makes diagnosis and treatment tricky. Aside from having trouble falling asleep due to revved-up cortisol, the most common sign this could be an issue, according to Dr. Pizzino, is not feeling rested even when you do get enough sleep. Other signs include flu-like symptoms in the absence of a fever, brain fog, and musculoskeletal pain (which may also make it difficult to fall asleep).

6. Eating too close to bedtime.

“Digestive issues contribute immensely to problems falling asleep,” Dr. Pizzino says. In particular, eating too much too close to bedtime is problematic. Because of our circadian rhythm, we’re really not supposed to be digesting after about 8 p.m at the latest, according to Dr. Pizzino. Of course, feeling uncomfortably full could be contributing to why you can’t fall asleep. But there’s another reason it’s best to have an earlier dinner: “When we eat late at night, it literally pulls blood away from the brain and other places that are supposed to be working while we sleep.” That might make it difficult to fall asleep and stay asleep.

One way to improve your ability to fall asleep is to try out a 12-hour overnight fasting window. So for example, that would mean finishing up dinner by 7pm and eating breakfast at 7am.

7. Your gut health needs help.

Gut health gets a lot of attention, for good reason. A lot of important neurotransmitters—chemical messengers in your nervous system—such as serotonin and GABA, are made in your gut. “GABA is particularly important for sleep because it’s the only calming chemical in the brain,” Dr. Pizzino explains. “When we don’t have enough GABA, that’s when we get anxiety and have trouble sleeping.”

When your microbiome is out of balance, with more “unfriendly” flora than “friendly” flora, your body literally sees that as a threat, Dr. Pizzino says. “Are you going to be able to fall asleep if you think that there’s something dangerous out there? Probably not.”

The good news is that there’s a lot you can do to improve your gut health, from dietary modifications to taking a proven probiotic, both of which can be done with support from your health care team.

8. Alcohol is messing with your brain waves.

“Alcohol tends to be one of the big slip-ups with sleep because people often use it to help them turn off that sympathetic nervous system and calm down,” Dr. Pizzino says. Because alcohol is an anesthetic, it takes your brain waves down into a more relaxed state. But when that effect wears off, the brain waves start getting overactive again, causing you to become alert. Depending on how you time your alcohol intake, this could either cause you to have a hard time falling asleep, or wake up in the middle of the night.

For this reason, it can help to take a break from alcohol until your sleep issues are worked out.

9. Your afternoon (or morning!) coffee is still affecting you.

“A lot of people don’t appreciate how much the coffee they drink in the morning is still affecting their body at night,” Dr. Pizzino says. How your body processes caffeine is partially genetic, she explains. Some people are less efficient at it, which means their 10 am latte could really leave them with caffeine lingering in their system well into the evening.

Even for those who do process caffeine well genetically, relying too much on the stuff causes another vicious cycle when it comes to sleep. At 3 or 4pm, you still have some work to do, but you’re tired because you didn’t sleep the night before, so you have some coffee, which then lingers and makes it harder for you to fall asleep that night.

If you frequently consume caffeine and can’t fall asleep, Dr. Pizzino recommends experimenting with what happens when you greatly reduce it or completely remove it from your diet. This can be hard to execute, though, because she finds a lot of people don’t give it enough of a chance. That’s because if you’re dependent on caffeine at all, removing it will cause your sympathetic nervous system to go into overdrive temporarily, which might make sleep issues worse at first.

But rest assured, if you stick with it for a week, you’ll be able to decipher whether removing caffeine is helpful for you or not. Parsley’s health coaches often work with people to reduce their caffeine intake gradually and monitor symptoms.

10. You’re anxious about falling asleep.

Worrying about not being able to fall asleep is also pretty common, and can exacerbate the primary issue. “People who have trouble falling asleep can get into clock watching and tossing and turning, wondering why they haven’t fallen asleep yet,” Dr. Pizzino says. “Now they’ve added that fear on top of whatever was keeping them from falling asleep.”

This is where basic sleep hygiene comes into play: having a dark, quiet, cool room is key, Dr. Pizzino says. These might seem a bit obvious, but they can make a big difference, she adds.

11. You’re sleeping with your phone in your room.

Another core element of sleep hygiene is avoiding blue light before bed, which can block melatonin production, making it tough to fall asleep. “You really need to turn your screens off one to two hours prior to bed,” Dr. Pizzino says.

If you use your phone as your alarm clock, avoid the temptation to scroll right before bed or go old-school with a traditional alarm clock.

There’s also the idea that electromagnetic fields (EMF) emitted by electronics—such as cell phones and wifi routers—may interfere with sleep by impacting brain waves and therefore messing with our ability to fall and stay asleep. This has the potential to interact with our own electrical system, says Dr. Pizzino. Still, the World Health Organization has stated, “current evidence does not confirm the existence of any health consequences from exposure to low level electromagnetic fields,” so more research is needed.

For both of these reasons, Dr. Pizzino recommends leaving your phone charging in another room when you sleep—not on your nightstand.

12. You’re exercising too close to bedtime.

“As far as your body knows, you just ran away from a tiger,” Dr. Pizzino says. “Are you going to be feeling like going to sleep?” Again, the answer is probably not. That’s why she recommends ideally working out earlier in the day, but definitely not within two hours of bedtime.

13. You’re deficient in magnesium.

“Magnesium is probably the number one nutrient deficiency we see,” Dr. Pizzino says. That’s because it’s not found in the soil much anymore, so it’s hard to get from food. “A lot of people really need magnesium supplementation, so it’s one of the best things to try if you’re having trouble falling asleep.” That’s because it supports brain function, and can help support restful sleep.

Just make sure you’re getting an absorbable form: magnesium glycinate, glucarate, aspartate, or threonate. Avoid magnesium citrate and oxide, Dr. Pizzino says. “Those are good for evacuating your bowels, but they’re not so good for helping you sleep.”

If you find that you frequently can’t fall asleep, consider talking to a healthcare provider. Parsley Health helps members with sleep issues get to the underlying cause and improve their sleep long term.

Julia Malacoff is an Amsterdam-based freelance writer, editor, and certified personal trainer. She covers a wide range of wellness topics including nutrition, fitness, specific health conditions, and the latest scientific research in these field. Julia graduated from Wellesley College and she works with brands like Shape, Cosmopolitan, Fast Company, Precision Nutrition, Equinox, and Aveeno. Outside of work, you can find her walking her dog, trying out a new recipe, or learning Dutch.

Share

Parsley Guides

Free Guide: Simple Sleep Strategies

Learn the science of sleep from our doctors and how to have your best night of rest—every night.