The old children’s song that contained the phrase, “the arm bone is connected to the wrist bone” had it right. Everything we do to our bodies (how we sleep, eat and exercise) has a consequence; and these consequences hook up in ways we couldn’t predict, but which we need to know to protect our precious health.
Many people know that working late hours and getting less than five hours sleep a night creates a “sleep debt,” which causes fatigue and mild impairments of cognition, coordination and reaction time. But how many people know that sleeping less than five hours a night triggers the accumulation of fat inside your abdominal cavity around your visceral organs, that this kind of fat triggers metabolic syndrome (apple shaped belly, hypertension, high blood sugar, low HDL cholesterol and high triglycerides), or that metabolic syndrome is potentially very harmful because it increases the risk of insulin resistance, Type II diabetes, heart attacks and strokes?
In March 2010 Kristen G. Hairston, M.D., M.P.H., and colleagues at the Wake Forest University School of Medicine published a study which looked at fat deposition in adults over age 40 who sacrificed sleep to work long hours. They found that sleeping less than five hours per night led to deposition of harmful fat around visceral organs. They recommend that adults over age 40 get 6-8 hours of sleep per night to avoid this potentially dangerous metabolic consequence of insomnia.
Many people know that Type II diabetes can cause blood vessel occlusion, blindness and nerve damage with numbness, tingling or burning in the hands, fingers, feet or toes. But how many people know that diabetes increases their risk of dementia? Type II diabetes can cause vascular dementia (the second most common form of dementia in the U.S. after Alzheimer’s disease) by clogging up cerebral arteries. It can also cause dementia by harming brain cells through hyper- or hypo-glycemia. Too much or too little sugar in the blood can damage or kill brain cells. Diabetics suffer harmful drops in blood sugar when they don’t eat enough or when they take too much insulin. The part of the brain most sensitive to damage from low blood sugar is the hippocampus which is involved in converting short term to long term memories and in learning new information.
A third link between diabetes and dementia has been discovered. For reasons not yet understood adults who have both diabetes and major depression are 2.7 times more likely to develop dementia as adults with diabetes only. This was the finding of a study published in the Journal of General Internal Medicine in March 2010 led by psychiatrist Wayne Keaton, M.D. of the University of Washington who teamed up with the Group Health Research Institute in Seattle and the VA Puget Sound Health Care System.
This finding was not entirely unexpected by medical researchers because diabetes alone and depression alone can both cause dementia. Depression can cause dementia through a number of mechanisms. Depression raises the level of the stress hormone cortisol and too much cortisol can damage and even shrink the hippocampus. Excess cortisol suppresses the human immune system which can allow inflammation of the central nervous system to occur. Depressed people are less likely to exercise, eat healthy or take medication (such as blood pressure or diabetes drugs). They may also increase smoking or drinking of alcoholic beverages.
Lawyers employed by law firms feel pressured to work inhuman hours to make partner or just to protect their job security. Solos and small firm lawyers in charge of their own schedules may work as many or even more hours in order to establish a law practice. Even when a lawyer has “made it,” in the sense that he is a respected, valued member of a practice whose job is safe, it’s rare to see him decrease his work hours to increase his family and leisure time. More often such lawyers continue to work long hours to fund an affluent lifestyle that includes a large house, new cars, dinner out at fancy restaurants, exotic vacations, private schools for the kids, a collection of fine art or fine wine, etc.
In the end each lawyer has to choose what matters more, extra dollars on the one side or his healthspan (the years during which he is in good health with good quality of life) and lifespan. If you stay up late and sacrifice sleep night after night to do legal work or you’re so anxious and wired from working all the time you can’t sleep, you are putting yourself at risk of obesity and metabolic syndrome. Sleep deprivation and an apple shaped belly are connected. Have you developed an apple shaped belly already? Then it’s really time to take notice and start doing something.
What can you do? Clearly you need to start cutting back on the night-time work and increasing your hours of sleep to 6-8 per night. You also need to start exercising. If you’re already overweight it’s easy to say “why bother, it’s too late.” But it really is never too late. A study published in April 2010 in the Journal of Applied Physiology showed that exercise in overweight people counters the effects of weight gain, increases metabolic health and reduces the risk of disease. Tom R. Thomas, professor in the Department of Nutrition and Exercise Physiology in the College of Human Environmental Sciences found that overweight people with metabolic syndrome often regain weight after dieting, but as long as they kept exercising they were able to keep their blood pressure, blood fats and blood sugar in a much healthier zone than peers who stopped exercising when they regained weight.
Alzheimer’s disease and other forms of dementia are marked by the loss of neuronal connections (synapses). The brain has the capacity to secrete a growth substance that helps create new synapses called BDNF (brain-derived neurotrophic factor). It is well known that physical exercise stimulates the fresh release of BDNF. In March 2010 UC Irvine neurobiologists Lulu Chen and Christine Gall published a paper in the Proceedings of the National Academy of Sciences stating that learning triggers the release of BDNF which facilitates the growth of new synapses in the hippocampus which to memory consolidation of new information. This is consistent with the fact that people who pursue lifelong learning retain their mental sharpness and mental health.
So sleep more, exercise more, eat healthier, keep learning, and keep exercising even if you’ve regained weight after dieting. I have a whole chapter on healthy eating in my book The Upward Spiral: Getting Lawyers From Daily Misery To Lifetime Wellbeing. The chapter includes discussion the nutrients and supplements you need to keep your brain healthy as you age.
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