Alcohol and Sleep - Book Review: Why We Sleep by Matthew Walker, PhD

When I was in my late twenties, I stopped drinking alcohol for two years. It was an illuminating and life changing experiment (more on that in another blog post). Many of my health coaching clients also experiment with reducing or eliminating alcohol. They usually remark on the increased mood and energy that booze-free living provides. I have historically chalked this benefit up to the fact that alcohol is categorized as a depressant, or the vague notion that alcohol affects sleep quality.

I had yet to encounter an in-depth and satisfactory explanation for the mechanism of some of the commonly reported benefits. Then I read Matthew Walker’s excellent book - Why We Sleep.

If you are a regular listener of the NPR radio circuit, you’ve likely heard interviews with Walker (known as the sleep diplomat). Walker is a sleep scientist at UC Berkeley, and one of the leading sleep researchers in the world. A section of his book completely changed my view on alcohol. I wanted to share my takeaways in case you find it similarly compelling.

First, I’m going to cut to the bad news. Walker essentially recommends that we all go dry. Not for any religious or moral sense of alcohol as an evil vice but because he understands the science on alcohol and sleep so well, he cannot in good faith advocate for alcohol at any amount. Yikes!

Alcohol negatively affects sleep in a couple ways. Paradoxically, many use alcohol as a sleep aid, as they perceive it helps them fall asleep. This may be true, but according to Walker, “alcohol sedates you out of wakefulness, but it does not induce natural sleep”. Rather than aiding in solid sleep it is more similar to a mild form of anesthesia. You may seem to fall asleep more quickly but the sleep you do get is littered with “mini-awakenings.” You may not remember waking up multiple times throughout the night, but you will likely not wake up feeling refreshed, even if you got a full night’s sleep.

Beyond the “mini-awakenings,” the second downside of alcohol is its impact on REM sleep, and, more specifically, its downstream effects on cognitive function, learning, and mental health. Walker lets us know that alcohol is one of the most powerful suppressors of REM sleep that scientists know of. According to Walker,  “People even consuming moderate amounts of alcohol in the afternoon and evening are depriving themselves of dream sleep”.

We likely all know that REM sleep is the phase of sleep when you dream. Dreams are undoubtedly fascinating, and often provide fodder for conversations with friends and therapists, but do they benefit us beyond their entertainment value?

Scientists are finding that when it comes to mental and physical health, the REM stage is vital. We are still learning why each sleep stage is important but here’s what we do know about REM sleep. First, REM sleep aids in memory integration and association. Without REM sleep, our ability to learn and remember is impaired. In his book, Walker cites several compelling studies related to alcohol, REM, and memory.

Another benefit is related to the fact that REM sleep is the only time in a 24-hour period, when your brain is completely devoid of norepinephrine (brain equivalent of adrenaline). In other words, REM is a unique moment when you don’t have stress-hormones affecting your brain. It appears your brain takes advantage of this by addressing emotionally relevant content from the day but through a stress-free lens. This allows the emotional brain to process and catalog the events and place them in a wiser, calmer context. If your brain has the opportunity to undertake this process, you will likely wake up feeling better about yesterday’s stresses and perhaps even have novel insights. Walker refers to this as the “REM-sleep overnight therapy mechanism”, and highlights that when we drink alcohol in the evening or even late afternoon we diminish or eliminate this opportunity.

Walker connects this to PTSD patients, a hallmark of the condition being sleep disruptions, particularly to the REM phase. Walker theorizes that this may be due to high levels of noradrenaline within the brains of PTSD patients that block normal REM and the “overnight therapy” effect it has. When stress is abnormally high post-trauma, the brain cannot do its overnight emotional healing. Relatedly, when researchers systematically deprived research subjects of REM sleep, REM-deprived subjects the next day interpreted neutral faces as fearful and menacing at rates much higher than their well-slept counterparts. The world literally looks like a less-friendly place when you are REM-deprived! It’s remarkable that alcohol also inhibits REM and has the same downstream effects.

In such tumultuous times, we could all use some extra emotional support and healing. Many of us seek this from therapy, meditation, exercise, and even Netflix. These are all wonderful resources to take advantage of, but it’s remarkable that we have an innate, biologically hardwired standing therapy appointment (free of charge) accessible to us each night when we sleep. The fact that alcohol diminishes this golden opportunity is something to be aware of when we are deciding how big of a role we want alcohol to play in our lives. Knowledge of the true effects alcohol has on sleep and mental health can empower us to choose how we want to relate to it.

If going totally dry sounds like an unacceptable buzzkill, another strategy is opting for an aperitif (before dinner drink) or a drink with dinner rather than an after-dinner cocktail. One tool for making this a habit would be setting an alcohol curfew -  a time in the evening where you stop drinking in order to protect your sleep. The earlier in the evening you stop drinking, the less alcohol will be present in your system while you sleep.

Many adults have a relationship with alcohol, and like any relationship, it can be useful to occasionally take stock of the quality of it. Is it providing more pleasure than harm? Is it enhancing the other areas of your life that you value? These are personal questions that do not have easy answers. And like any relationship, the answers can shift and change during different phases of life. I hope this article empowers you with information that helps you cultivate a relationship that works best for you!

How to Become a Salad Addict

Salads are perhaps our most virtuous foods. In a climate of food moralizing, the rebel in me wants to eschew them and focus this post on my true love - french fries. But I have to admit it, I am addicted to salads.

This is a recent development. It starts where many intriguing stories begin, when I met and moved in with my half-French boyfriend.

As a health coach, I am well aware of the merits of a salad, but was not in the habit of making them very often. Perhaps as a result of having hippies for parents, the salad making process struck me as a bit precious and overwhelming. We often assume a proper salad needs a dozen or more ingredients: multiple chopped veggies (carrots, broccoli, peppers, celery, beets, tomatoes...the list goes on!), herbs, and (although hotly contested) a big handful of some nuts and seeds sprinkled on top. Bonus points for fruit as well.

The problem with this approach to salad is that after preparing a whole meal at home, I wasn’t always in the mood for washing lettuce, gathering all of these ingredients, dicing, and coming up with the creative result.

Unlike me, my French boyfriend was a simple salad maker. Lettuce and dressing. At first, I was skeptical. It seemed a bit boring, lazy, and even lacking in nutritional density.

Yet after my first bite, I found myself begging for more. Could he make two heads of lettuce instead of one? In our meals together (sometimes extravagant) the simple salad kept stealing the show. Once, I found myself licking the plate hoping to get more of the dressing. This was a salad revelation.

These days, we have salad with almost every meal and while eating more leafy greens is a nice health outcome, it is in no way the primary motivation. Salad truly can be addictive. The key is mastering one delicious, simple, homemade salad dressing.

I’ll give credit where it’s due: Ryan’s grandfather, who still lives in France (and is coming into his 94th year!), eats a simple salad almost daily and the extremely addictive salad dressing is his family recipe. And as we know, when it comes to simple food, the French often know best.

Here’s a 4 Step Process for Becoming a Salad Addict:

Step #1 - Master one homemade, unbelievably delicious salad dressing recipe. If you think it’s kind of good but not amazing, keep trying. You should want to drink the salad dressing straight and be tempted to drive to the store for a head of lettuce, simply as an excuse to eat this dressing. Once you master one dressing, branch out and seek an equally addictive alternative that satisfies a different palette (perhaps creamy if the first is a vinaigrette).

Step #2 - Simplify your expectations for what needs to go into the salad. Try to make the dressing so good that you only need one ingredient. This increases your chances of you making it even when you are feeling lazy/busy.

Step #3 - Figure out how to wash lettuce without hating your life. In order to do this buy a good salad spinner and if you can’t stand washing and drying lettuce (dry lettuce is key if you want to coat the lettuce fully with dressing), buy the pre-washed salad mixes.

Step #4 - Don’t just pour dressing on your salad, pre-dress the salad and make sure to coat every leaf. You can do this by pouring on the salad dressing and tossing with some tongs (or if you’re like me, your hands) until thoroughly coated.

Here are my favorite addictive salad dressing recipes to get you started. If you have any you are currently loving please SHARE!

Ryan’s Grandpa’s Extremely Addictive French Salad Dressing  

1 part red wine vinegar

3 parts good olive oil

1 garlic clove per person - chopped or pounded (scale this back if you aren’t a garlic lover)

A small spoonful of mustard to emulsify everything

Salt and pepper to taste

Make it saltier and more acidic than you think it should be -- this will mellow a bit once it’s spread out on the salad.

To pound garlic, pour some salt on the peeled clove and pound it to a paste with a mortar and pestle or the side of a knife against a cutting board (feel free to just chop the garlic if you prefer).  

Here’s an article that describes Alice Waters making essentially this dressing if you want more thorough instructions: http://www.mariasfarmcountrykitchen.com/alice-waters-makes-salad-dressing-at-my-house/

Blue Cheese Dressing

Adapted from Salt Fat Acid Heat by Samin Nosrat

5 oz Roquefort (or another high quality blue cheese)

1 tbsp red wine vinegar

1/2 c olive oil

1/4 cup heavy cream (or creme fraiche)

1 garlic chopped / or pounded

Asian-Style Salad Dressing

1 part rice wine vinegar

3 parts olive oil

1-2 tbsp soy sauce

1-2 cloves of diced or pounded garlic

Dash of maple syrup or honey

*All of these recipes are approximate. Adjust the acid, salt, and garlic to your preference.

Additional salad-related inspiration:

• I find this video of Jamie Oliver talking about salad-making basics inspiring (and charming).

• For the ultimate salad inspiration visit the blog of fellow salad lover, Julia Sherman, called Salad For President.

Light is the New Coffee

In a wellness market flooded by the latest gurus promoting expensive programs and products, I’m increasingly interested in focusing my blog on highlighting the freely available, nature-based elements that impact human health.

One of the most obvious and underrated of which is our relationship with light.

A while back I wrote a post extolling the power of spending adequate time in darkness (aka avoiding screens at night). I’ll recap the basics here but for a deeper look at the dark side of the light equation and its importance for human health, start with my first article.  

Since I wrote it, screen addiction has been discussed ad nauseam in the media and we’ve likely all been saturated with messages regarding the hazards of blue light at night, so I won’t focus as much there. In this follow-up piece, I’d like to discuss the underrated power of exposing yourself to adequate natural light during the day. Despite its reputation in the media, blue light is not the problem. It’s the timing of blue light exposure that determines whether it is poison or medicine: bright, blue light is beneficial during the day and detrimental at night.

I’ll begin with a brief background on circadian biology, which explains why light matters.

How does our body keep time?

We evolved being exposed to predictable and alternating periods of light-dark every 24 hours. Our brains and cells evolved sensors to attune its physiology to the natural light-dark cycles in order to determine biological time.

More specifically, our master clock (the suprachiasmatic nucleus nucleus) in the brain entrains with light-dark cycles, as our optical nerve is constantly scanning the intensity and spectrum of light. The body is most sensitive to short wavelength light (blue light) and least sensitive to long wavelength light (like red light). In addition every cell in the body has clock cells which make up the peripheral clock. Our peripheral clock cells are most sensitive to metabolism (or in other words meal timing).

Timing physiological functions with light-dark cycles in nature led to more biological success. Historically, it made sense to be alert and active during daytime hours when food acquisition, preparation, and the majority of feeding most successfully occur. It made sense to sleep and focus on tissue repair and regeneration at night.

The field of chronobiology is helping us understand that optimal health occurs when the master clock (light is strongest cue) and the peripheral clock (meal timing is strongest cue) are in sync with each other and both are in sync with natural cycles of light and dark.

In other words, optimum health occurs when our sleep, meals, and light exposure inputs align with the natural cycles of light and dark.

THE POWER OF DARKNESS FOR HEALTH

Here’s a quick recap of why darkness matters. Bright, blue light at night signals to your biology that it is daytime. One of the way it signals this to your body is by blocking the release of melatonin in your brain. Melatonin, known as the “hormone of darkness,” relies on light intensity to know if it should be produced or blocked. If your eyes are sensing blue light at night, melatonin release doesn’t occur. We are all likely familiar with melatonin as a hormone (and supplement) that helps initiate sleep.

Perhaps more compelling is that melatonin appears to be a POWERFUL antioxidant, anti-inflammatory, and oncostatic (cancer-fighting) hormone that helps your body repair and heal at night. If you are deficient in DARKNESS, and thus deficient in melatonin, you won’t sleep as well but you are also lacking a powerful repair mechanism you evolved to expect in adequate quantities each day. Rather than spending your money on expensive antioxidant supplements (that likely don’t work), prioritize your daily dose of darkness instead.

How to actually make it happen!

• Avoid looking at bright screens beginning ideally two hours before bed. Decide on a screen curfew time (at least one hour before ideal bedtime) and do your best to stick with it. Set a digital sunset alarm on your phone as a reminder. FUN FACT: TV screens (likely due to their distance from your eye) were shown to not decrease melatonin levels in the same way that personal devices do. Good news for us nighttime Netflix bingers :) Study linked here.

• If you work a night shift or simply need to use a lot of electronic devices at night, consider wearing blue-blocking glasses. I like the Uvex brand, which you can buy on amazon. Additionally, download the f.lux program on your computer which blocks blue light as it gets dark: https://justgetflux.com/.  Nightshift is the equivalent for Iphone http://www.apple.com/ios/preview/.

• Use dim red-spectrum lights for night lights. Red light has the least power to shift circadian rhythm and suppress melatonin.

LIGHT IS THE NEW COFFEE

Morning light is the original coffee. Bright light in the morning gives our bodies a signal it’s daytime (known as daytime anchoring), which elicits a cascade of alerting hormones that make us energized and ready for the day.

Today, humans spend 90% of time indoors. This is problematic as many of us are not receiving adequate light cues to signal to our circadian rhythms that it’s daytime. It’s easy to assume that that indoor lighting is brighter than outdoor light, especially on a cloudy day. This isn’t true. The brightest lit office spaces are only around 500 lux, while being outside on a cloudy day exposes you to about 10,000 lux (and as much as 30,000 on a sunny day).

The impact of low light exposure on mood is illustrated in the modern understanding of Seasonal Affective Disorder (SAD) and the connection between low mood and lack of exposure to light in the winter. Too much time spent indoors is making it so that we are living in a chronic, low-light, “winter-like” environment. Studies have now found that exposure to bright light during the day positively impacts cognition, memory, energy, mood, and alertness (study here). Additionally, exposure to bright light during the day leads to better sleep at night and is protective against the harmful effects of blue light at night.

This means that most of us are exposed to inadequate, dim lighting environments during the day and too much light at night. In this environment, our bodies never receive a robust message as to whether it is biological day or night, which leads to circadian misalignment.

You can use light boxes or other high tech solutions but none are as elegantly designed for your physiology as simple sunlight. In the words of renowned light scientist Mariana Figueiro during her awesome Ted Talk on Light and Health, “Daylight is the ideal light source for the circadian system - it goes on and off at the right time, and is the right color and right intensity”.

Below are my top tips for harnessing the power of bright light during the day for optimal health.

How to actually make it happen!

• The #1 practical way to get enough bright light during the day is by creating a morning walk habit. Go for at least a 10-30 minute walk each morning (ideally before 10:30am) and you will ensure you are getting adequate daylight anchoring each day. The most potent results happen within the first 30 minutes of exposure, so set this as a daily minimum for total time outdoors.

• Get outside as much as possible during daylight hours. Particularly if you get groggy in the mid-afternoon, swap your coffee for a brisk walk outside.

• If it is not possible to get outside during the day, consider using a light box of at least 10,000 lux in the morning. I haven’t used one myself but this looks like a good product.

*It’s important to mention that wearing sunglasses can reduce your bright light exposure by 7-15 fold, so don’t wear them on your walks where light exposure is the priority.

Like many topics, there are a lot of high tech, expensive ways to optimize sleep, energy, and moods. I argue that none are as potent and effective as intelligently using light-dark cycles to optimize your circadian rhythm. Light is an ally we co-evolved with. If we use the right spectrum and brightness at the right time, it has positive benefits on every system of the body. The best part is that it is free and democratically available as long as you have access to the outdoors!

As always, I’d love to hear about your own creative ways to optimize your circadian rhythm - feel free to post below!

If you need help improving your sleep and circadian cycle and are ready to transform your personal habits, I’d love to support you as your health coach. Click here to schedule a free consultation call.

How To Exercise For Free, Anywhere, Anytime.

Exercise clearly matters. We all know the benefits on our physical health but perhaps, more importantly, movement is key for cognitive and mental well-being. The mood boost from even small bouts of movement make it one of the most powerful brain altering tools we have.

Yet, most of us struggle to prioritize it in our daily lives. I argue that it’s not for a lack of effort but that a few common obstacles get in the way. There are many barriers (sedentary culture, busyness, etc.) but today, I’m focusing on one of the most common pitfalls: having an unrealistic exercise plan. When I work with health coaching clients, many have lofty and aspirational exercise goals that they are not actually doing with any regularity. When I encourage people to shrink down the goal, many feel it wouldn’t be worthwhile to pursue the smaller, more realistic exercise plan. So, they continue to not exercise.

There are a few myths at play. One, that exercise isn’t effective unless it is intense and sustained for a long period of time (or takes place in a gym). Let me bust this myth right now. Even moving for 5 minutes has been proven to have benefits. Any movement breaks up sedentarism, which has its own benefits. And, all movement counts (read my article on that topic here).

Second, the fitness industry would have you believe that you need to buy something in order to be in shape. Whether this is a yoga studio membership, joining a CrossFit gym, or an online class series. These are all fantastic resources but the reality is that they are luxury items that aren’t necessary if you’re on a budget. I also think the gym model can lead to a lack of consistency because the barrier to getting there (both effort, money, and time) is large.

This article is going to focus on resources that can help combat these roadblocks. Most people have exercise goals that are too large, sometimes expensive, and often not very portable. In order to be consistent with movement, I’m going to share some of my favorite free, portable ways to move. Get familiar with a few of these resources and you’ll always be able to move, no matter what life throws at you. The following resources include options that are under 10 minutes, in order to limit the busyness barrier.

Here are some of my favorite resources. All free, all portable.

Bodyweight-based workouts.

Try at-home bodyweight circuits for a portable way to add in strength training. As a good starting goal, aim to do 1-2 bodyweight circuits a week.

Bodyweight workouts are the best! They build strength in an accessible way and many also have a cardio aspect. Perhaps the best part is that they can be done anywhere. To begin, learn a bodyweight circuit or two and you’ll never be without a way to move your body no matter where you are. If you get bored with that routine, there are infinite to choose from and you can always learn another.

Here are my favorite resources to get you started.

Nerdfitness is a great resource for bodyweight workouts.  Try their Beginner’s version here (this is the strength workout I do most often). For an added challenge, you can always use the Advanced version here.

Darebee: Darebee is an incredible, free database of HIIT and bodyweight workouts. If you choose no-equipment in the search filter you’ll find  workouts that are completely bodyweight-based. Find a few workouts you enjoy and stick to those, or do one of their strength programs, which gives you a workout plan for the month. This is a good program to start with. They also have an exercise library which demonstrates each of the exercises so you can make sure you have the correct form.

Fitness Blender: They have a fantastic library of free exercise videos (both HIIT and bodyweight ). They allow you to add filters to help you find a personalized workout based on your preferences. For my lifestyle, I like the filters: 10 min or less, no equipment, total body, and then either HIIT or bodyweight for a quick workout.

High intensity interval workouts (HIIT).

The Venn diagram between HIIT and bodyweight circuits has a lot of overlap. The way I think of it is that with HIIT the emphasis is on getting your heart rate elevated in addition to any strength building component (exercise physiologist readers please feel free to amend my understanding!). I love HIIT workouts for when you want to feel the benefits of a hard workout (endorphin rush, sweat, elevated heart rate) but are time limited. In my opinion, of any form of exercise, these burst workouts seem to contribute most to elevated mood, focus, and resolving feelings of acute stress.

HIIT Resources

The 7 minute workout. Here is the viral New York Times article about it here and a link to an app that guides you through it on your phone.

Tabata training: Tabata is a 4 minute workout where you do 8 sets of 20 seconds of hard effort, with 10 seconds of rest. For a simple Tabata workout you can do burpees (how to do burpees here). This app provides you with a tabata timer.

Darebee also has a great library of HIIT workouts here.

Fitness Blender: In addition to their bodyweight and weight lifting videos, they have wonderful HIIT resources as well. Link here.

YOGA.

Yoga is one of my favorite forms of movement. Unfortunately, it can be prohibitively expensive in a studio setting. It’s getting better but historically, yoga studios have not always been the most welcoming places for all types of people with all types of bodies ( this is changing!). These past few years I’ve moved around a lot, so I haven’t had a yoga studio home. I’ve maintained a yoga practice solely with free, online yoga classes.

Yoga Resources

My go-to free yoga resource is Yoga with Adriene channel on Youtube. She has infinite free videos for all types of yoga practitioners and skill levels.

I also really enjoy Lizette Pompa’s yoga channel as well: she focuses on vinyasa flow and functional strength.

Yogaglo is also wonderful but isn’t technically free ( cost $18/month).

Other ideas (no app needed).

• WALK: Walking is underrated. Go outside, and take a 5-30 minute walk for an instant mood boost. This is extremely portable and one of the best things to do while traveling.  The daylight, fresh air and movement combination are nothing short of miraculous for a mental reset.

• MINI MOVEMENT GOALS: Decide on a baseline mini movement goal for your day. Maybe it’s doing 20 squats or 10 push-ups. This minimum daily commitment makes you feel like a regular exerciser and is easy habit to add on to on days when you have more time.

Do you have any low-friction, free, accessible ways you like to keep moving? Please post below!

If you need help developing your own exercise habit,  I’d love to support you as your health coach. Click here to schedule a free consultation call.

Wellness Book Review: The Good Gut by Erica and Justin Sonnenburg

It’s hard to escape the emerging media excitement about the gut microbiomes impact on human health. While there is much excitement, it can be difficult to sort through what is pre-speculative hype and what is substantial science. Enter, the Sonnenburgs and their recent book, The Good Gut.

Justin Sonnenburg and Erica Sonnenburg are the preeminent scientists researching the gut microbiota. Together, they run the Sonnenburg Lab out of Stanford’s Department of Microbiology and Immunology. As a direct result of their scientific discoveries on the gut microbiota, The Sonnenburgs found themselves making profound dietary and lifestyle changes. Yet, they realized that their friends and the general public were not yet aware of the importance of this “new organ” and its implications for human health.

To help the rest of us out, they wrote The Good Gut: Taking Control Of Your Weight, Your Mood, And Your Long-term Health. The Good Gut summarizes the current scientific understanding of the gut microbiota and the practical recommendations for cultivating healthy gut ecology. As someone who has been excitedly following the microbiome research for years, I can honestly say this is *THE BEST* book I’ve read on the topic to date.

But in case you don’t get around to reading it, here are some key takeaways:

FIRST, WHAT IS THE GUT MICROBIOTA?

The gut microbiota refers to the community of bacteria and other microorganisms living in the GI tract. The gut microbiome refers to the genetic material these microorganisms possess. This “second genome”, unlike our own genetic material, is rapidly malleable and altered by our lifestyle and dietary changes. For this reason, the community of gut flora serve as an extension of our own genome and have profound implications to our health.

HOW DOES IT IMPACT HEALTH?

In the book, the Sonnenburgs refer to the microbiota as our own internal drug factory. When the gut bacteria feed on dietary fiber, a fermentation process occurs, which produces an assortment of molecules that are released and absorbed into the circulatory system. It appears these molecules communicate with our brains and bodies to produce profound health effects.

Another way it impacts our health, is through the connection between the gut’s impact on the brain via the brain-gut axis. The brain-gut axis is a vast connection between the brain and the gut through neuronal and hormonal communication. In fact, there are so many neurons in the gut, that it has been referred to as the “the second brain”. Studies also show that stress and mood disorders can change the population of the microbiota. This is likely modulated by our autonomic nervous system (stress and relaxation responses) which control things like gut motility and mucus secretion. Thus, stressful states change the environment of the gut, which changes which populations of microbes are likely to thrive there. Inversely, bacteria in the gut also appear to impact mood, perception and potentially even behavior. In mouse models, scientists have shown that they can change mood disorder and personality states by transplanting microbes between mice. With more research, the mechanisms for exactly how the gut flora so profoundly impact mental and physical health will continue to get clearer.

WHAT’S WRONG WITH OUR MODERN GUTS?

For most of our evolutionary history , we subsisted as hunter and gatherers, consuming mostly wild plants and lean meats. The advent of Agriculture 12,000 years ago drastically changed how we eat and live. Another radical change to our diets happened 400 years ago with the industrial revolution, which resulted in our current model of highly accessible, mass produced, highly sweetened, low-fiber processed foods. To investigate the climate in which our physiology (and our relationship with our internal population of microorganisms) evolved in, scientists have studied the last remaining full-time hunter and gatherer tribe, The Hadza people of Tanzania.In stark contrast to modern Americans who consume 10-15g fiber a day, the Hadza consume on average 100-150g a fiber/day. As a result of this dietary fiber diversity and outdoor lifestyle, their gut microbiota has much more diversity than the average American. Our modern lifestyle appears to have stripped our modern microbiotas of their rich diversity, which is thought to explain much of Western disease states. Currently, lack of dietary fiber and the subsequent lack of microbial diversity, is linked to weight gain, increased inflammation and risk of chronic illness.

WHAT TO DO?

Just like we focus on feeding ourselves, we’d be wise to also consider how to best feed our internal flora. The Sonnenburgs make it clear that the key to optimizing our microbiota is all about dietary fiber from complex carbohydrates. Complex carbs (unlike simple starches and sugars), survive the transit from mouth to colon, where they are accessible to the microorganisms living in the large intestine. The Sonnenburgs call these foods, Microbiota Accessible Carbs (MACs). Examples of of MACs include beans, whole grains, fruits and vegetables. If we do not consume enough dietary fiber (MACs) our gut bacteria resort to feeding on the mucosal lining of the gut, which serves as a backup carbohydrate source. Normally, the mucosal lining provides a barrier which protects our intestinal and immune cells from contacting the microbiota. When this barrier is compromised, our immune system is exposed to bacteria, which triggers a systemic inflammatory response. In summary, if you are not regularly consuming foods that feed your internal bacteria, they will resort to feeding on your gut wall. This diminishes the quality of your gut barrier, and leads to increased systemic inflammation.

If you’ve made it this far, I’m sure you’re wondering how to cultivate the health of your internal flora. Luckily, the Sonnenburg’s book focuses as much on illustrating the practical lifestyle recommendations as summarizing the research findings.

Below are some of the top action steps recommended for cultivating a healthy gut microbiota:

• Eat a wide diversity of dietary fiber from complex carbs ( MACs ) like beans, whole grains, vegetables and fruits.

• Reduce consumption of meat and saturated fats, which appear to favor a microbial population which is more inflammatory.

• Increase probiotic rich foods such as fermented dairy products, kimchi, kefir, sauerkraut etc.

• Avoid unnecessary antibiotics

• Spend more time outside, on farms, and in the garden

• Have pet(s).

For more fascinating science and in-depth recommendations, check out the book!

What are you currently reading? Any health books you'd recommend for a future review? 

Wellness is Free

The wellness world seems confused about something. If I scroll through my Instagram account, I get the impression that to be healthy, I need to buy lots of things. In a world of brand ambassadors, luxe wellness events, and expensive functional medicine consults it appears that wellness is inaccessible to all but the ultra-rich.

Meanwhile, on the opposite end of the spectrum, there are still far too many folks struggling to meet their basic needs (access to food, shelter, healthcare, etc), the stress of which obviously does not allow for wellness to thrive. The gap between these two extremes seems increasingly large. Clearly, most of the world will never be able to participate in any of the wellness trends that abound. Does that mean that the masses simply cannot be well because they won’t ever be able to buy a $15 herbal adaptogenic smoothie? (That is a rhetorical question but I’ll answer it anyway...NO). After going through my own period of reduced income, I came to understand more experientially how “out of touch” a lot of wellness recommendations seem.

It’s seductive to look towards the latest supplement, workout fad, or expensive cream as the solution to what ails us. It’s an iteration of a pill for every ill. The desire to fix ourselves by purchasing something is alluring. It deepens our cultural narrative that something quick and external is the solution. Relatedly, I’ve become increasingly uncomfortable with the confluence of fashion, wellness, and consumerism. These elements are converging at a time when it seems vitally important to rethink our rampant consumerism in order to combat climate change and environmental degradation, especially since a thriving planet is our ultimate “wellness” resource.

On this note, I recently came across a refreshingly different framework for approaching wellness. This new roadmap is laid out in a scientific paper that posits that modern society is experiencing “paleo deficiency”, or a lack of essential inputs derived from engaging with nature and as a result experiencing high levels of modern chronic disease. The authors offer solutions based on increasing nature-based inputs that create ecosystems leading to human well-being. This article is not discussing the shaky definition of paleo that is being touted as the latest diet trend, but rather the common natural elements that our physiology and genes expect to be in contact with because of years of coevolution. Things like appropriate exposure to cycles of light-dark that sets our internal circadian rhythms, natural sounds and environments (which appear to have a restorative effect on our brains and immune systems), exposure to a wide diversity of microbes which sets the stage for a healthy microbiota, etc. When we are removed from these inputs, due to modernization, urbanization, and increased technology-use, there are both mental and physical health consequences.

The paper provides an incredibly useful figure that illustrates the essential wellness ingredients that modernization reduces our exposure to. Surprisingly, (or not), not one thing listed needs to be purchased over Amazon. These missing elements were all nature-based and free.

In case you’re not up for reading an academic paper, here’s a recap of some of the factors that can lead to poor physical and psychological health:  

• Too much time indoors, not enough time outdoors ( Why it matters? negative ions, attention restoration effects, phytoncides -- aromatic chemicals secreted from trees, increased microbial diversity, light cues, more activity)

• Lack of movement

• Too much processed foods ( ie. not enough fiber and a lack of phytonutrients)

• Mismatched light cues (too much blue light at night, not enough bright natural light during the day)

• Not enough nourishing time in solitude (appropriately balanced by time in interconnected community and nourishing relationships).

Using this framework, there are indisputable, common ingredients that facilitate well-being but the individual expressions of how to build a lifestyle that includes these things is a creative act. This is a creative task wrought with much challenge and tension, particularly given that much of what’s built into modern society is in direct opposition to these things. The expression of what it means to create a life well-lived is never going to be able to be condensed into a one-size-fits all protocol or a product you can purchase. And contrary to what the wellness zeitgeist on the internet is telling you, rather than buying more stuff, it actually involves stripping away barriers that prevent you from accessing the essential, nature-based inputs.

Inspired by this paper and my increasing discomfort with a capitalistic approach to wellness, I brainstormed a list of ways to increase these vital “paleo inputs”. I made sure all my suggestions are low or no-cost and don’t require buying more stuff.

• Cultivate hobbies that connect you with the natural world and get you outside. Examples: gardening, foraging, hiking, camping, outdoor cooking.

• Walk or bike more for your transportation.

• Develop a habit of taking a morning walk first thing in the morning (this has the added benefit of aligning your circadian rhythm by signaling to your system that it’s daytime and thus to be alert).

• Learn a yoga sequence or a bodyweight sequence that you can do at home (here’s a link to a sun salutation demo and a beginner’s bodyweight circuit to get you started).

• Start to work for your food in some way -- walk to the farmers market or grocery store, forage, grow some of your own food and cook it! Bad things happen when we completely uncouple the need to move for our food--(I’m looking at you Seamless!)

• Eat more plants (aka increase disease-fighting phytonutrients). Come up with a list of your favorite plant-based recipes and include in your weekly rotation. For inspiration check out this post.

• Spend more time in silence. Seek out quiet (whether it’s a place in nature or your home, a meditation practice, or simply turning off the music and podcasts during parts of your day) and learn to disconnect from constant noise.  The Headspace app is a wonderful way to get started with a home meditation practice.

• Conversely, spend intentional time in community. Offer and seek support from your community. Plan weekly communal meals and join supportive networks. Feeling a sense of belonging is one of the best ways to reduce stress.

• Create an environment of total darkness at night to sleep in. Strip away the technologies that keep you seeing blue light into the night. Make your bedroom totally dark and create a habit of disconnecting from all screens and devices at least a half hour before bedtime. More on the importance of light cues for health here.

I’m very curious about creative, non-consumerist ways people have found to bring more of these elements into their daily lives. What does your unique, ecosystem of wellness look like?

*DISCLAIMER: I am not trying to make anyone feel guilty about existing in a consumerist society. I’m as complicit as anyone! I’m just offering what I hope will be an empowering alternative perspective on wellness that reminds us we don’t need anything extra to access our innate sense of well-being.

References: 

Logan AC et al. Natural environments, ancestral diets, and microbial ecology: is there a modern "paleo-deficit disorder"? Part I. J Physiol Anthropol. 2015; 34(1): 9. 

Logan AC et al. Natural environments, ancestral diets, and microbial ecology: is there a modern “paleo-deficit disorder”? Part II. J Physiol Anthropol. 2015; 34(1): 9.

Why You Need A Health Coach

You can imagine my surprise when a prominent New York City physician told me that doctors don’t know a thing about health. He argued that yes, they were extensively trained to diagnose symptom patterns into disease names and to treat the symptoms through pharmacology, but that these disease-management skills are not the same skill set needed to cultivate health. This innovative doctor saw an obvious gap in healthcare and was calling for a new profession-- a profession that was similar to a primary care doctor but instead a generalist expert in health. Long story short, I asked him if he’d heard of health coaching and landed myself a job as a resident wellness expert at his healthcare company. But that’s another blog post. At that time, I had already spent a lot of time in clinical settings, trying to figure out if I wanted to pursue my passion for health by going to medical school. I had reached a similar conclusion as my doc friend. Even the more holistically-minded clinicians I had worked with faced frustrating limitations in their capacity to elicit health-behavior change due to time and insurance constraints. 

I now find myself in the unique but awesome position of working in a clinic where the doctors actually do know a heck of a lot about health. My doctor colleagues are naturopathic physicians, trained in primary care medicine from a natural-perspective. Unlike conventional doctors, their training focuses on food as medicine, botanicals, psychosocial wellness and root-cause resolution of disease. 

The obvious question in a setting like Wellness Minneapolis is why would someone see a health coach rather than a naturopathic physician? 

Here are some reasons it may make sense to begin your health journey with health coaching.

In most cases, the keys to creating health are shockingly simple and don’t require a medical degree to understand. They are so simple in fact, that you’d think everyone would be vibrantly well. But unfortunately, KNOWING what you should do, does not usually translate into doing it. I deeply wanted to become a daily meditator about 2 years before I actually did it. I currently know I’d be 10X happier if I spent less time each day on my phone and I have yet to solidify this behavior change. So many of my clients are focused on debating the tiniest minutiae of health (ex. which brand of supplement is best) and have yet to master the basics that would have the biggest impact (like consistent sleep and daily movement). What’s needed to create health behavior change is usually not more complex health knowledge and information. It’s usually two-fold approach: accountability and strategic support to create different daily habits +  breaking down psychological barriers and cultivating health supportive mindsets. This is where coaches excel. 

Alternatively, naturopaths are able to hone in on the root cause of chronic symptoms and disorders and creating a holistic treatment plan, accordingly. A naturopath’s treatment plan usually includes lifestyle changes, botanicals, and supplements. With some variation for specific issues, any plan your naturopathic doctor recommends will involve consistently getting quality nutrition, sleep, movement and managing the stress in your life. These are the four areas you need to build consistency in and a health coach is an expert at making that a reality. If you’ve already worked with a health coach, you’re likely a superstar at rocking the foundational habits of health. With these foundations in place, any targeted solutions offered in your clinical plan will yield faster, more efficacious results. Additionally, a coach can help you actually implement the lifestyle changes suggested by your naturopath.

Here’s why a health coach may be your most powerful tool for finally getting healthy:

Health Coaches Understand That The Key To Health Is Daily Habits: 
Health is created by your daily choices over time. In other words, health is simply a sum total of your habits. Often we have psychological barriers that limit our ability to create lasting change. For example, I bet you already know the basic things you need to do to be healthy. But unfortunately, knowledge does not necessarily lead to consistent action. We are not rational creatures but instead influenced by myriad factors including psychological barriers (limiting beliefs), and cues in our environment. This is why it’s so important to create systems and structures that automate your health behaviors rather than relying exclusively on willpower and good intention. 

Health Coaches Have A Truly Holistic Definition Of Health: 
A good health coach possesses a truly holistic model of wellness, understanding that often what’s needed to create vibrancy isn’t just kale smoothies but may involve things like expanding social supports or tapping into a sense of purpose beyond the humdrum of the mundane. A good coach has strong intuition and is able to break out of any cookie cutter treatment protocol and instead taps into their clients deeper needs and unique vision for what true wellness means for them. Signing up for a coaching program also gives you the time to address multiple layers that impact health beyond just the obvious physical ones. 

Health Coaches Know Health Is Simply A Series Of Learnable Skills: 
A coach is an educator who can help you fill in any skill gaps that may be limiting your success. Often times health is touted as a fixed state (for example a fixed body ideal or something gifted to you only if you’ve won the genetic lottery) that some people have and some people don’t. A more empowering view is that deep self-care and health consists of consistent habits and learned skills. There are a few essential skills that make healthy living accessible and easeful. For example, some essential skills of a healthy person include basic cooking techniques, knowing how to create routines and rituals the automate behavior change without relying on willpower and learning some basic breathing and mindfulness techniques that put you in control of the state of your nervous system. 

Health Coaches Help You Shift Your Mindset and Beliefs:
A coach doesn’t just focus on the externals but evokes paradigm altering mindset shifts that can change not just your behavior but how you view your sense of reality. A few key health mindsets involve adopting a growth mindset, a stress-is-enhancing mindset, and a self-compassionate mindset. A coach can also help you re-frame your limiting beliefs, expanding your sense of agency and possibility for your life. Often times these beliefs operate below our subconscious mind. A coach can help bring them into the light of awareness, where they can be questioned and changed. An example of this may be an old belief that you don’t have the right body type to attend a yoga class or that food equals love. 

Health Coaches Emphasize That You Are The Expert, and focus on helping you tap into YOUR intuition and body wisdom. A coaches magic involves consistently directing you towards your own deep wisdom and desires. In a world filled with health experts, many of whom disagree with each other, it’s easy to feel confused, overwhelmed and paralyzed about where to even begin. Our current medical paradigm often exacerbates this by asking us to hand our personal power over to clinicians. A good coach teaches you tools to consistently access your own inner wisdom to find out what would be most nourishing for your body and soul. This cuts through information overwhelm and the feeling that there are a million things you SHOULD be doing. Instead, you learn to write your own prescription for what’s going to lead you to your best life. 

Health Coaches Offer Accountability and Individualized Support: 
A coach is an accountability partner and having accountability towards a trusted other is often one of the missing keys to changing behavior. Since a coach gets to know you deeply and works with you over time, they can uncover your unique barriers that have prevented you from achieving your health goals in the past, and hold you accountable to intelligently crafted goals uniquely suited to you. This is how you finally get the outcomes you’re desiring. 

The essential ingredients that lead to health are not rocket science. In fact, the suggestions that can create profound changes in energy levels, vitality, and wellness are usually shockingly basic and simple. The reality is that most people don’t consistently do the things that lead to health. Yes, we all know getting sleep is vital for everything from weight management to optimal brain function but the tricky part is how YOU, with your unique psychology, lifestyle, and values are going to create a sleep habit that is realistic and effortless given the context of your daily life. It is at this juncture, between what you know you WANT to be doing and the REALITY of what you are doing, where a coach can be incredibly valuable in closing the gap. By working with a coach you’ll develop the key skills and habits needed to create a lifetime of health. 

If you’re intrigued and would like to see if coaching is right for you, you can get started by scheduling a free 20 minute intro coaching call.

We all know we should be eating more vegetables...Here’s how to actually do it.

There still remains a lot of debate in the nutrition world. Paleo or vegan? What ratio of macronutrients is optimal?  Couple this with the powerful lobby influence the food and agricultural industries have on government regulatory bodies like the USDA, and it’s no wonder we live in a society of confused eaters. Yet, there is one indisputable recommendation that ALL nutrition experts agree on, and that is the power of increasing vegetable intake. Despite this being the most unequivocal piece of nutrition advice out there, most of us consistently fail to meet the recommended daily dose.

There are many compelling reasons to eat your vegetables. For example, the gut microbiome ( the microbial population that lives in our GI tract) and its impact on human health is THE hot topic in the scientific and medical community. Every day there seems to be a new study linking the health of your microbiome to everything from mood disorders to obesity to cardiovascular disease. And what is the key to a healthy microbiome? Eating a diversity of plants. Plants provide the indigestible fiber which feeds the beneficial bacteria in your lower intestine, which leads to a healthy intestinal lining and encourages beneficial strains of bacteria. Additionally, plants offer a variety of polyphenols, vitamins and minerals, and antioxidants which have innumerable disease fighting properties.

While we all know we should be eating more vegetables, getting the recommended 6-10 servings a day often remains an elusive target. I’ve tried many different techniques to inspire myself and my clients to turn this recommendation into a daily habit and the following are the best methods I’ve encountered.

my top secrets For finally eating enough veggies.

1. Batch cook your vegetables. My vegetable guru and solver of veggie angst is the food writer, Tamar Adler. My favorite thing about Tamar Adler is that she is not motivated by health. Her writing rarely, if ever, talks about health benefits. Her eating and cooking philosophy is motivated by flavor, pleasure, frugality, and food traditions. A bi-product of this is that she cooks primarily with local, whole foods and lots of plants. She shows us that there are much more elegant ways to “eat your veggies” than a sad-looking salad next to your grilled chicken, which can quickly make you feel like you’re on a 1980s-style deprivation diet. Instead, while you prep your veggies, you can feel like you are Alice Water’s in your Berkeley kitchen or at least a vibrant Sicilian grandmother. She recommends batch cooking your vegetables all at once and eating them throughout the week in various dishes. It’s common in other cultures to eat cooked, room temperature, leftover vegetables but Americans don’t have this food tradition. The result is good intentions and a plethora of limp, rotting vegetables in crisper drawers. For full instructions on the batch cooking ritual, watch this enviable video series of Adler prepping her farmer’s market bounty. Written instructions here. The basic idea is to roast a few trays of veggies in your oven at once (try broccoli, cauliflower, beets, sweet potatoes, etc). While these cook, sautee some greens on the stove. Store everything in glass containers in your fridge and eat your way through the veggies throughout the week.

2. Eat a super salad once a day. My brilliant nutritionist colleague, Jesse Haas, has a salad formula that takes care of most of your veggie requirements in one sitting. Try to eat this once a day and you’re golden. Here’s the basic recipe (customize to your liking and to what veggies are in season) :  2-3 cups greens + 1-2 cups cut veggies + 3 oz. protein + 2 Tbsp dressing (here’s a nice basic salad dressing recipe) + 1/2 c cooked whole grains (optional) = 4-7 servings of vegetables and limitless possibilities.

3. Drink a Micronutrient Smoothie. This tip is from one of my favorite scientists, Dr. Rhonda Patrick. She is a cancer and aging researcher who has done extensive health studies on micronutrient deficiencies as one of the key factors in disease prevention. The secret to getting adequate micronutrients? Again, dietary plant quantity and diversity. Her health hack is a daily smoothie where you get your fiber + plant intake in one (slightly intense but worth it) veggie-smoothie. Here are two videos (smoothie recipe 1 and recipe 2) with the ingredients and overview of the benefits. If you’re not ready to go all-in you can start adding a handful of greens to your fruit smoothie and call it good!

4. Aim to fill half your plate with vegetables, especially at lunch and dinner. One Medical's blog offers a great infographic to demonstrate the distribution of a healthy plate. 

Pick one new veggie habit to try and notice how it affects your energy and overall health. As always, I would love to hear how it goes!  

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Emotions 101: The Healthiest Ways to Relate To Your Feelings May Surprise You

There is a persistent meme in our culture that we should feel happy all the time. Particularly in the spiritual world where the latest spin on the Law of Attraction meme can give the impression that if only you felt good all the time and just maintained “higher vibes” you’d attract everything you desire (gotta love when consumerism and pop spirituality converge). This can fuel the belief that feeling the whole range of emotions is somehow bad, unevolved, or unhealthy. The science of mindfulness and emotional regulation is showing that the opposite is true. A recent study showed that believing that certain emotions are “unacceptable” was associated with an increased risk of depression, anxiety, and fatigue. The key to becoming an optimistic, happy person does NOT, in fact, lie in never experiencing unpleasant emotions, but rather becoming skilled in relating to the full spectrum of emotions that will inevitably arise. Since there seems to be a lot of conflicting ideas about the how to best manage emotions, I sought the most useful, well-researched techniques on how to best relate to  “all the feels”.

Before I dive into techniques though, you may be wondering how this relates to your physical health. The connection is through the stress response. For many of us in the Western world, our biggest stressors are no longer external threats such as wild animals, or imminent starvation but rather internal stressors, ie. our emotions and thoughts. When these “internal threats” are poorly managed our stress response is activated chronically. Chronic stress is implicated in nearly every disease and mood disorder, so in many ways learning how to healthily relate to your emotions is one of the most important healthy living skills to cultivate. What determines whether our emotions elicit unnecessary stress is how we relate to our emotional states as they arise. Here are the most practical, science-backed ways to develop a compassionate, healthy relationship with your emotional landscape.

 4 Ways To Befriend Your Emotions and Drastically Reduce Your Stress:

1. Don’t try to THINK your way out of emotions. Instead, change your breathing to create true emotional shifts. Rather than trying to force shifts in your thinking, your breath is the key to regulating your emotional state. In research studies, they’ve shown that there are distinct breathing patterns associated with different emotional states. The fascinating part is that this relationship is bidirectional, meaning state shifts can be created in two ways. When you feel a certain emotion you breathe in a specific, predictable way AND if you breathe in a specific way, you will change your emotional state. Slow, deep breathing is associated with more “positive” emotions like happiness. Shallow, rapid breathing was associated with emotions like fear, sadness and anger.  The next time you’re experiencing a distressing emotion, consciously take slow, deep breaths until you feel better.

2. Self-compassion is your best friend in emotional regulation. A common reaction to a distressing emotion is to beat yourself up for feeling bad, which makes you feel even worse. Kicking yourself while you’re down isn’t helpful and leads to rumination, depression, and re-triggers the initial unpleasant emotion. Use your unpleasant emotions as an opportunity to give yourself love and support, just as you would to a good friend who is suffering. Make a pledge to pile self-compassion on top of any emotion, particularly the “negative ones”.  A practical way to evoke self-compassion is mindfulness + kindness. This looks like bringing your awareness to the reality of what you’re feeling and if you recognize it as a moment of suffering use it as a cue to be kind and gentle towards yourself. You can solidify this kindness through a mantra, touching your hand to your heart, or anything else that feels compassionate in the moment.

3. Stay focused on the body sensations associated with the emotion, not your thoughts about what the emotion means. Emotions are inherently an embodied experience as the feelings are a result of a cascade of hormones and neurochemicals. This actual physiologic emotional reaction does not last long unless re-triggered by the mind replaying the story around the emotion. A simple practice is to drop the story (even if it’s really compelling--you can always come back to it) and non-judgmentally observe your body sensations as you experience the emotion. Feel free to label the sensations you’re feeling in your body and watch as they shift and change. This allows the physiological emotional response to dissipate without re-triggering the emotional reaction with our thoughts and narratives about what it means. Meditation teacher, Tara Brach, offers a mindfulness practice that encompasses this technique here.

4. Label the emotion you’re experiencing. There have been some studies showing that simply labeling your emotional experience (ex. I’m feeling sad/mad/anxious ect.) reduces the physiological signs of distress associated with the emotion. This may be due to the recruitment of the higher brain centers  (prefrontal cortex) required to label the emotion, which helps shift out of the more reactive, lower brain centers. Additionally, acknowledging the presence of an emotion brings mindfulness to your experience. Also, labeling offers some distance between you and the experience of the emotion allowing for more space to notice its transience and mindfully choose your response.

Feeling the entire range of human emotions is normal, and necessary. What determines whether our emotions elicit unnecessary stress is our relationship with our emotions as they arise. Embrace the whole range of human emotions and relate to them skillfully using labeling, self-compassion, breathing and awareness of body sensations. As always, I would love to hear about your experience using these techniques!

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Don't be afraid of the dark: It may be our most potent medicine!

If there were such a thing as a panacea in the wellness world, I’d place my bet on optimizing circadian rhythms by getting appropriate exposure to light and dark. In ancient forms of medicine (such as Greco-Roman Medicine and Traditional Chinese Medicine), there was a heavy emphasis on Nature as healer and physicians recommended aligning with nature as a disease cure. Within modern biomedicine, extolling the healing powers of nature has largely fallen out of fashion. But recently, this theme is beginning to crop up again in medical literature. This isn’t some outdated, sentimental notion after all, but rather an entire field of science known as chronobiology. Chronobiology is a branch of biology that studies how our body's natural cycles—mental, physical and emotional—are affected by solar and lunar rhythms. Our physiology has evolved to function optimally when aligned with natural rhythms of light-dark. Disrupted circadian rhythms are being correlated with a myriad of illnesses such as mood disorders, metabolic issues, cardiovascular disease, obesity, cancer, and menstrual disruptions. And unfortunately, this doesn’t appear to be a part of our physiology we can override or “hack”. A lack of adequate bright light during the day or excessive exposure to light at night both have consequences. In an era when it’s increasingly more tempting to live out of sync with light-dark cycles, aligning with the rhythms of nature may be one of our most potent forms of preventive medicine.

SO, what exactly disrupts our “inner clocks”? Our circadian clock is primarily set by exposure to light and dark. For my science lovers out there, let me explain how this works physiologically. In our brains, the suprachiasmatic nucleus (SCN) keeps track of light-dark signals from the optic nerve and triggers hormonal and behavioral outputs accordingly. The reduction of light at night is detected by our SCN and triggers the release of melatonin from our pineal glands, which causes sleepiness.

For most of our evolutionary history, as the sun went down we were no longer exposed to bright light (more specifically light in the blue spectrum) so the current problem lies in an evolutionary mismatch from what our bodies have evolved to expect versus recent technological developments. With the invention of the lightbulb in 1879 and the technological revolution, we have unprecedented inputs of light at night ( or LAN, as it is called in the scientific literature) that lead to circadian disruption. The use of artificial light and devices after dark disrupts the environmental cue and our levels of melatonin are abnormally suppressed which reduces both the quality of sleep and the ability to fall asleep. This is problematic for reasons beyond melatonin’s impact on sleep quality. It is less commonly known that beyond its influence on sleep, melatonin is also an incredibly potent anti-inflammatory, antioxidant, immunomodulating and oncostatic hormone. It’s currently being widely researched because of its potential anti-cancer effects. So basically, every hour after dark that you are exposing yourself to blue light, you’re decreasing the levels of this powerfully health-promoting hormone you’re exposed to. Or in simpler terms, as far as our physiology is concerned, exposure to adequate darkness each day is a form of vital medicine. The official recommendation is maintaining a window of 9-10 hours of darkness each 24-hour cycle. For most of us this would mean an hour or two before bed we’d stop looking at screens (T.V., computers), devices (phones, Ipads) AND dim the lights or use lights in the red spectrum.

Secondary inputs that influence our circadian clock are eating patterns, exercise, social inputs, and levels of stress hormones such as cortisol. The most powerful secondary input is meal timing or more precisely, cycles of feeding and fasting. For optimal health, our meal timings would correspond with light/dark cycles (a.k.a no late night eating). Limiting feeding to daytime hours and increasing periods of fasting at night does the body good. This doesn’t need to be extreme. See my recommendations below for the details.

HOW TO RESET YOUR CIRCADIAN RHYTHMS FOR OPTIMAL HEALTH:

1. Expose yourself to natural light first thing in the morning. Circadian alignment starts as soon as you wake up. Exposure to natural light, ideally in the morning before 10:30 am, aligns your circadian rhythm and has been proven to result in better sleep at night. The best way to do this is to get outside in the morning, without sunglasses, for at least 10 minutes (cloudy days included). At the very least, open the shades and let natural light into your living space. If it is not possible to get outside, considering using a light box of at least 10,000 lux.

2. Exercise in the morning. By getting some gentle movement in the morning, even 5-10 minutes counts, you optimize your circadian rhythm by appropriately setting your cortisol curve. Exercise helps ensure a spike of cortisol in the morning which leads to lower levels at night, which improves sleep quality and melatonin levels.

3. Avoid screens AT LEAST 1 hour before bed. Again, think of darkness as medicine. Darkness leads to the release of melatonin and melatonin increases sleep quality and reduces chronic inflammation. The most powerful way to ensure optimal levels of melatonin is to set a digital sunset each night. This means no longer looking at your phone, screens, Kindle, etc. after a certain time each night. As a compromise, you can download f.lux on your computer and use Nightshift (if you have an iPhone 5 or higher) which limits the blue light emitted from your computer and phone. Another option is wearing really dorky blue light blocking orange sunglasses at night.

4. Make sure your bedroom is completely dark. Using an eye mask is a great start but it been discovered that your skin has photoreceptors which detect light and can disrupt your melatonin levels, so it's important that your room is completely dark. Invest in blackout curtains and get all devices out of the bedroom. For extra insurance, consider getting a nightlight in the red spectrum for your bathroom and hallway so you don’t have to turn on the blue-light emitting overhead light if you wake up in the middle of the night.

5. Stop eating or drinking alcohol at least 3 hours before bedtime. Late night alcohol or eating disrupt sleep architecture. A lot of great functional medicine practitioners recommend a 12-hour window between dinner and breakfast, or simply stopping eating 3 hours before bedtime. Alcohol may help you fall asleep but it disrupts sleep quality and depth so it is best avoided near bedtime.

6. Ritual and consistency are key. Going to bed and getting up at roughly the same time each day entrains your circadian clock. Ideally, go to bed between 10-11p and wake up around 7 am.  Create sleep rituals that help you wind down at night and do your best to stick to them.

7. Start Earthing. One of the best ways to reset our circadian rhythms is to get barefoot contact with the Earth aka Earthing or Grounding. This is a slightly unconventional recommendation that I’ve written off in the past as too hippy, even for me. But I’ve become convinced after reading some amazing journal articles on the benefits. According to Chevalier et al., “Mounting evidence suggests that the Earth's negative potential can create a stable internal bioelectrical environment for the normal functioning of all body systems. Moreover, oscillations of the intensity of the Earth's potential may be important for setting the biological clocks regulating diurnal body rhythms, such as cortisol secretion”. From a practical standpoint, the recommendation is “barefoot sessions” (weather-permitting) for as little as 30-40 minutes daily. There are also some emerging grounding technologies that give you the same benefits without the barefoot time. For more on Earthing, visit this website.

The full effects of aligning your circadian rhythm with natural rhythms of light and dark are just beginning to be understood. We’ll likely find out more details about the consequences of circadian misalignment as more of the population experiments with living out of sync with natural cycles. My bet is that it is a bit like how we’ve come to understand the importance of eating whole foods. We don’t fully understand all of the intricate biochemical components in the whole plant that positively interact with our physiology, but since we’ve co-evolved eating plants it has a net positive impact that processed food can’t match. Similarly, our bodies have evolved eating, sleeping, moving in rhythm with natural cycles or light and dark and thus following this evolutionary pattern impacts our health in ways we may never fully understand. Try optimizing your circadian rhythm yourself and see how you feel!!  As always, I’d love to hear how it goes.

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The Female Orgasm Gap Part 4: The Power of Owning Your Orgasm!

“Masturbation is a primary form of sexual expression. Not just for kids or those in-between lovers or for old people who end up alone. Masturbation is the ongoing love affair that each of us has with ourselves throughout our lifetime” - Betty Dodson, from her book Sex for One

I’m going to close out this series with my #1 DIY tip for closing the female orgasm gap.....masturbation. I intentionally saved this recommendation for last because I first wanted to highlight the broader sexual norms that contribute to the orgasm gap rather than placing the responsibility for solutions exclusively on individual women.

To set the context, it’s important to know that there is not only a female orgasm gap but there is also a female masturbation gap. Of men in their thirties, 93% report having masturbated at any point in their life whereas only 80 % of women report the same. Yet, multiple studies show that women are infinitely more likely to achieve orgasm during masturbation than in partner sex, making it a more accessible way for women to explore their orgasmic capacity. While I can’t prove this, I’m convinced the female masturbation gap has a lot to do with the orgasm gap.

In a culture that has historically sought dominion over female bodies, it isn’t surprising that female masturbation isn’t encouraged. Women who are tapped into their bodies amazing capacity for pleasure and can access it at will, without male assistance, are a huge threat to the status quo. In this way, taking ownership of your sexual energy through masturbation is revolutionary and flips the script on the sexual narrative women are fed. The female body and sexuality are traditionally valued through the lens of the male gaze, leading to an emphasis on appearance and sexual objectification. If internalized, this can lead to a sense of disembodiment and disconnection from felt experience. This can remove women from the glorious fact that we are all sovereign sexual beings whose sexuality is first and foremost an amazing gift for each individual to enjoy and cultivate for the sheer joy of it----rather than just of value for the pleasure it can endow on a partner. In this way, it is revolutionary for women to know their bodies’ pleasure potential deeply and to enjoy it for themselves frequently. The way to do this is through masturbation, or as I prefer to call it, self-pleasuring.

So why, is there a masturbation gap? Unfortunately, there is still a lot of shame and taboo surrounding female masturbation. Language reflects the culture it exists in and it’s telling that there are myriad common phrases for male masturbation but no equivalent for females (somehow “jilling off” never really caught on). It’s common to hear about young boys discovering masturbation but not as much for young girls, which frames it as a normal developmental process for males but not females. Also, from a young age women are force fed a narrative around love and sex where prince charming swoops in and offers security, happiness, and lots of orgasms. As a result, many women expect men to give them their first orgasm. Unfortunately, this is not realistic as most men are not prepared with accurate knowledge about female bodies. If women are faking orgasms, their sexual partners aren’t given the opportunity to learn, and the cycle persists. The tendency to “outsource our orgasm” can be seen when people talk about whether or not someone “gave them an orgasm”. It’s essential that we start owning our orgasm. We are all responsible for our own orgasm - for learning how we have them, and how to communicate what works best for us to our chosen sexual partners.

Another reason that many women may not masturbate is shame. Shame can be a result of a sex negative culture/parent/religion/trauma etc. It’s normal to feel some level of shame around your sexuality and consequently, masturbation can be a shame trigger. So, in order to combat shame and get comfortable with solo sex it’s imperative to surround yourself with sex positive content and information. If you still feel a bit awkward about masturbation, it can also be useful to get some specific instruction on how to begin a masturbation “practice” (top resources: Emily Nagoski’s nuts and bolts of masturbation article here and Betty Dodson's instructions for first-time orgasm here). The “Mother of Masturbation” is the feminist artist and sex educator, Betty Dodson, and I can’t recommend her work highly enough. She wrote a masterpiece book on the topic called Sex for One and has tons of resources on her website, including a masturbation technique that is designed to translate into easier orgasms during partner sex (if you’re interested click here). Dodson considers solo sex an act of meditation and extreme self-care and will make you feel all giddy, empowered, and feminist about being a ‘self-lover”. Shame thrives in isolation so hearing others talking openly and positively about masturbation helps dispel lingering shame.

If you need additional motivation to prioritize masturbation consider it an essential part of your wellness plan. Masturbation (orgasm) releases a cocktail of positive endorphins and hormones that create less stress and greater health. As a result, orgasms are associated with endless health benefits including stress reduction, increased mood, pain relief, improved sleep, and even increased body confidence (more on all of that here). Another benefit is that it stokes your sexual fire as sex energy begets more of the same. Since many women today suffer from low libido, this increase in desire can benefit your current sexual partnership or fulfill your sexual needs if you’re single. Also, masturbation offers a safe way to explore your fantasies and turn-ons, which helps you more intimately know your sexual desires and preferences. This knowledge empowers you to more clearly share your needs with your partner. And last but not least, masturbation is one the best way to increase your orgasmic capabilities whether you’re seeking a first-time orgasm or looking to deepen your repertoire. You can then bring your orgasmic virtuosity to any partners that are lucky enough to play with you.

I believe the orgasm gap will be closed by individual women who know their bodies and pleasure pathways and communicate that knowledge to their sexual partners. Self-pleasuring women, who take ownership of their orgasms, are less likely to settle for bad sex that exclusively prioritizes male pleasure. This will change sexual expectations in our culture and finally make reciprocity and mutual pleasure the norm.

*I want to be clear that my intention with these articles is not to imply that orgasm is the ultimate goal of sex or put any pressure on women to have orgasms. In my view, orgasm isn’t the goal of sex but rather mutual pleasure. Instead, my goal with this series is simply to encourage a context where female orgasm is more viable and accessible and placed in equal importance as male orgasm.

The Female Orgasm Gap Part 3: Ladies First

When we become educated about female pleasure anatomy, the reasons for the persistence of the female orgasm gap begin to make more sense. It becomes clear that there is nothing lacking in a woman’s capacity for orgasm but rather that the sexual norms are constructed with male anatomy and pleasure as the priority. Once this is understood, the solutions to close the female orgasm gap become more straightforward. One of the barriers to mutual pleasure is that the timing and order in which sex proceeds often doesn’t capitalize on the differences in male and female pleasure anatomy.  

Most women have had the frustrating experience of laying in bed next to a satisfied, post-orgasmic sleeping male, while they remain wide awake, their bodies still in a heightened state of arousal, with no resolution and no hope of sleep. Over time, this sexual satisfaction mismatch can lead to many things, including a perceived low libido and lack of desire for sex, a feeling that your pleasure is less valued than your partners, or even worse an idea that your body is somehow faulty. One simple solution to minimize sexual encounters where only men enjoy orgasm, is to employ a “ladies first” approach to sex, where men postpone their orgasm until their partner has one.

Keeping in mind some basic facts, it’s clear why a ladies first approach provides a context where mutual pleasure is most easily achieved. Let’s take a minute to recap:

1) Less than a third of women orgasm from penetration alone whereas men have orgasmic inevitably once penetrative sex starts.

2) Women require female erections for truly satisfying penetrative sex.

3) Women are easily capable of multiple orgasms whereas men have long refractory periods which make multiple orgasms difficult.

Logically, if mutual pleasure is the goal, it makes sense to craft the order and timing of sexual activities with these differences in mind. 

Sex therapist, Ian Kerner, wrote a whole book on this timing issue called, She Comes First. Kerner delves into the orgasm gap and female pleasure anatomy which leads him to the conclusion that it’s logical for men to postpone their orgasms and to focus on female orgasm first. In his book, he cites a study from Kinsey and Masters and Johnson, which found that among women whose partners, spent twenty-one minutes or longer on foreplay, only 7.7 percent did not reach orgasm consistently. This simple emphasis on female-centric “foreplay” (manual and oral stimulation), drastically closed the orgasm gap. Kerner advocates for renaming foreplay “coreplay” so that clitoris-focused activities, like manual and oral sex, are put in their rightful place, as complete events on their own rather than a precursor to the main event (intercourse).

As an additional benefit, by orgasming prior to penetration (or at least reaching a state of high arousal), the woman establishes an erection prior to the possibility of penetration, making intercourse much more pleasurable if it happens. As stated above, focusing on female orgasm first, also provides a context to take advantage of her body's ability to have multiple orgasms. Kerner discusses the multi-orgasmic potential of women by saying “More women don’t experience their second or third orgasm with men for the same reason that many don’t experience their first--they’re not receiving appropriate clitoral stimulation and male gratification is not postponed.”

Another welcome benefit of a ladies first approach is potentially less performance anxiety for men. Many men feel a sense of performance pressure if they’ve internalized that their size and stamina during intercourse are the main correlates of being a good lover. This belief is a side effect of a culture that is clitoris illiterate and has glorified penetration. It was Kerner’s own struggles with premature ejaculation that led him to study female pleasure anatomy and to adopt his “she comes first” approach. The impact issues like premature ejaculation have on mutual enjoyment of sex can be drastically reduced if men realize that intercourse isn’t the most reliable pathway for female orgasm anyway. So, rather than feeling pressured to maintain their erection and prolong penetration for longer in order to bring a woman to orgasm, men can redirect their efforts to clitoral focused activities and satisfy women regardless. If more men realized the pleasure they could give women through their mouths and fingers alone, they’d relax and enjoy the opportunity to expand their repertoire. When intercourse is no longer the main event but rather one option available among many pleasurable activities, suddenly, performance pressure for men significantly recedes.

With sex, like many other things, it seems that timing is everything. And a ladies first approach, is one that capitalizes on the differences in male and female physiology in the most logical, mutually satisfying way.

Up Next: Solo Sex: The Power of Owning Your Orgasm!

*I want to be clear that my intention with these articles is not to imply that orgasm is the ultimate goal of sex or put any pressure on women to have orgasms. In my view, orgasm isn’t the goal of sex but rather mutual pleasure. Instead, my goal with this series is simply to encourage a context where female orgasm is more viable and accessible and placed in equal importance as male orgasm.

The Female Orgasm Gap Part 2: Why Aren’t We Talking About Female Erections?

In order to close the orgasm gap, it's important to understand what contributes to it. In this series of posts, I’ll be exploring the key barriers that allow the female orgasm gap to persist, followed by proposed solutions. For the first two posts in the series, click here and here.

Sex, like eating, is a natural biological impulse. But the way it’s practiced is a learned phenomenon, highly influenced by the culture it exists in.  For this reason, it’s important to frame the orgasm gap not as an individual problem but rather to investigate what in our sexual culture contributes to its persistence.

One contribution to the persistence of the female orgasm gap is the shocking lack of knowledge about female genital anatomy and physiology. It wasn’t until 1998 that Dr. Helen O’Connell, an Australian urologist, described the anatomy of the female clitoris, including its network of pleasure-inducing nerves. This new, more complete view is slowly trickling down into medical textbooks and gaining traction in popular knowledge. In 2009, Dr. Dr. Odile Buisson and Dr. Pierre Foldès conducted the first complete 3-D sonography of an erect female clitoris, which further educated us to the true size of women’s internal sexual anatomy (more here ).

While we are finally clear on the anatomical structure of the clitoris, it important to also consider the physiology, which is even less commonly discussed – in particular, the female erection. The conversation around female arousal and readiness for intercourse still focuses almost exclusively on vaginal lubrication while ignoring the female erection.

SOLUTION #2: Let’s update our knowledge of female physiology and prioritize female erections.

Surprisingly little is understood about the importance of female erections in female pleasure. It may come as a surprise to learn that women possess the same amount of erectile tissue as men (it’s just internal). A woman’s erectile network is vast and comprised of the entire clitoris, the vestibular bulbs (a.k.a. clitoral bulbs), the urethral sponge and the perineal sponge (for a diagram visit the brilliant sex educator, Sheri Winston’s site). When fully engorged or erect, these tissues surround the vagina, making it both snug and expandable, creating an optimal climate for penetration. When a woman is fully (or at least partially) engorged, penetration is far more pleasurable as her body is prepared.

It is widely understood that attempting penetration before a man is erect is difficult if not impossible. Yet women’s genital erection, which happens to be internal, is ignored despite being equally important to their sexual function and pleasure. For maximum mutual pleasure, it’s key to wait until a woman is erect before entering her. Marcia Douglass and Lisa Douglass, social scientists and authors of The Sex You Want: A Lovers’ Guide to Women’s Sexual Pleasure, refer to penetration without a female erection as premature intercourse. According to the authors, “Intercourse without [female] erection can feel about as exciting to a woman as inserting a tampon. Worse, it can make a woman feel like a mere vehicle of a man’s pleasure, or even as if she is having sex against her will.”  When the erectile network that surrounds the vagina is activated, the vaginal walls are sensitized and prepared, making intercourse far more comfortable and pleasurable.

For maximum pleasure for both partners, let’s make it the norm to minimize premature intercourse. The way to make penetration mutually pleasurable is to wait until a woman’s erectile network is fully engorged prior to intercourse. And – surprise, surprise – the best way to engage a women’s erectile tissues is through clitoral stimulation, which leads to engorgement of the clitoral legs and bulbs. (To engage the full erectile network, also focus on stimulating the urethral sponge, which can be accessed through the anterior wall of the vagina a.k.a. “the g-spot”, and the perineal sponge, which can be stimulated through the posterior wall of the vagina or anus).  With adequate clitoral stimulation, a woman will have a distinct “hard-on” as the clitoral bulbs engorge, forming a tumescent cuff around the vaginal opening. You can tell a woman is erect when her genitals take on a flushed look, and her labia and perineum swell. The vaginal opening will feel more snug as the erectile tissue puff up and press on the vaginal walls. Another clue is that her state of arousal will drastically heighten.

Let’s learn to identify a female erection and make it as important as a male’s erection; because if mutual pleasure is the goal, it is!

Next Up: Why a ladies first approach is best...

*I want to be clear that my intention with these articles is not to imply that orgasm is the ultimate goal of sex or put any pressure on women to have orgasms. In my view, orgasm isn’t the goal of sex but rather mutual pleasure. Instead, my goal with this series is simply to encourage a context where female orgasm is more viable and accessible and placed in equal importance as male orgasm.  

The Female Orgasm Gap Part 1: Rethinking Foreplay

In order to close the orgasm gap, it's important to understand what contributes to it. In this series of posts, I’ll be exploring the key barriers that allow the female orgasm gap to persist, followed by proposed solutions. In my first post, I introduced the details of the issue, so check it out here if you missed it. 

Sex, like eating, is a natural biological impulse. But the way it’s practiced is a learned phenomenon, highly influenced by the culture it exists in.  For this reason, it’s important to frame the orgasm gap not as an individual problem but rather to investigate what in our sexual culture contributes to its persistence. One of the main culprits is in the way sex is defined. Sex is synonymous with intercourse. In sex defined as penis-in-vagina intercourse (PVI), the woman’s clitoris receives only indirect stimulation for a large portion of the sexual encounter.

The acts that directly stimulate a woman’s clitoris—manual and oral contact--are typically relegated to foreplay, a period prior to the real show (PVI) and treated as an optional sideshow. This is largely because sex has been defined in terms of reproduction and male pleasure. This limited definition of sex leads to the misconception that female orgasm SHOULD come from penis-in-vagina intercourse. Yet, with a basic understanding of female anatomy, this is an unrealistic expectation.

We can blame some combination of porn/ movies/Freud/patriarchy for perpetuating this understanding. Most media depictions of heterosexual sex involve little or no foreplay but instead proceed quickly to penetration and the woman’s nearly immediate (typically loud) climax. These scenes show the women’s experience only from the outside observer’s viewpoint and imagination. Women may experience orgasm through intercourse as long as they have first become aroused and erect (yes, women’s clitoral tissues become erect just as men’s do) through direct clitoral stimulation. Yet, these depictions typically ignore the woman’s clitoris, perpetuating Freud’s view that a clitoral orgasm was an “infantile” phenomenon, and that mature women should aspire to the “vaginal orgasm”, meaning orgasm through genital intercourse without any direct clitoral stimulation.  

The result of this persistent narrative is that many women feel “broken” if they don’t orgasm during intercourse without understanding that PVI is an effective path to male pleasure because it directly stimulates a man’s clitoris (Yes, men have what is essentially a clitoris in the erectile tissues that run the length of the penis). Without clitoral stimulation, there is little wonder less than 25% of women say they climax from penetration alone. Yet PVI that ignores the woman’s clitoris persists as a synonym for sex itself.  

A related myth is that women take longer to orgasm than men. While this can be the case during sex that bypasses the parts of a woman’s anatomy that give her pleasure, this is certainly not a reflection of any inherent physiologic limitation. Both women and men have the capacity for orgasm; any difference is because the sexual culture pays little attention to women’s subjective pleasure. How women (and men) come to orgasm is something that is learned. If all a woman learns via the sexual culture is how men gain pleasure, she may face unnecessary obstacles to cultivating her own orgasmic capacity.

So, what to do? SOLUTION #1: RETHINKING FOREPLAY

Let’s finally do away with the word foreplay and bring the acts that most effectively help women climax to the main stage where they belong. It’s ridiculous that the sexual activities that most reliably bring women to orgasm are still known as “foreplay.” There is deeply sexist bias in the relegation of female-centric activities as optional precursors to the main event of intercourse.

A brief anatomy lesson helps guide us toward sexual activities that are more female-centric. A key concept is that, as mentioned above, women and men alike have a clitoris, though it is situated differently in the body. While men’s clitoris receives maximum stimulation during PVI, woman’s clitoris is mostly bypassed. Expecting a woman to orgasm just from penetration alone, is like a woman rubbing her clit against a man’s hip, occasionally bumping his penis in the process and wondering why it’s difficult for him to reach climax.

To make mutual pleasure a priority, let’s do away with with the very notion of foreplay. Marcia Douglass and Lisa Douglass, social scientists and authors of The Sex You Want: A Lovers’ Guide to Women’s Sexual Pleasure elaborate, “Sex without a man’s ejaculation is considered incomplete. Yet heterosexuals regularly leave out the woman’s clitoris and, as a consequence, her orgasm, and they still call it sex. In reinvented sex, “foreplay” would be forgotten, intercourse, optional, and manual and oral sex done to the woman’s satisfaction.”

We need a common dialogue to redefine heterosexual sex to be centered around mutual pleasure. Sex educator, writer and author of O Wow: Discovering Your Ultimate Orgasm, Jenny Block, offers tips for starting a conversation that sets the stage for requesting and redefining sex to be more female-centered. Try telling your partner “Penetration is not the main attraction for me. It’s not the main attraction for most women. It’s part of the menu but orgasm is easiest for me with manual and oral (or insert your personal taste here)”. This allows women to shift from seeing themselves as deficient or broken if they can’t orgasm easily from intercourse and start acknowledging that the way our culture defines sex is broken instead.

My next post will focus on updating our understanding of female anatomy and physiology, more specifically diving into female erection!

*I want to be clear that my intention with these articles is not to imply that orgasm is the ultimate goal of sex or put any pressure on women to have orgasms. In my view, orgasm isn’t the goal of sex but rather mutual pleasure. Instead, my goal with this series is simply to encourage a context where female orgasm is more viable and accessible and placed in equal importance as male orgasm.  

The Female Orgasm Gap and How To Close It: Introduction

Orgasm is a natural fount of pleasure; it is a birthright and a necessary ingredient to a healthy lifestyle. This powerful pleasure eludes many women because stubborn cultural barriers persist that make female orgasm more difficult and rare than it needs to be.

As a health coach, I partner with women to help them find greater health and happiness. One secret to improving health, I have found, is to simply focus on bodily pleasure. By attending to pleasure, a woman can set off a domino effect that leads to better health overall. When women prioritize pleasure in sex, i.e., orgasm, a similar cascade effect can occur. As a woman discovers the pleasure potential in her own body, food cravings decline and a negative body image falls away. For this reason, I believe the orgasm and pleasure gap are missing conversations in the women's health movement. Accordingly, I've taken a deep interest in examining the reasons behind the persistent female orgasm gap. In my research, I’ve found some fascinating (and often disturbing) statistics. At the same time, I’ve also come across several compelling ways women can expand sexual pleasure.

Research shows that 95 percent of men nearly always orgasm from intercourse while only about 25 percent of women do (statistic from Indiana University Professor of History and Philosophy of Science and Medicine Dr. Elisabeth Lloyd). This is a staggering gap! For too long, many women have internalized this discrepancy, worrying that perhaps they are deficient or that something is lacking in their anatomical make-up. Yet, from a biological perspective women are exquisitely built for orgasm. The clitoris boasts 8000 nerve endings whose exclusive function is pleasure. Women also have the unique ability to have multiple orgasms with no refractory period. The truth is that our cultural construct of sexual norms were simply not built with female anatomy and pleasure in mind.

For several reasons, this blog series will focus on cispeople having heterosexual penis-in-vagina intercourse (PVI). Firstly, I work primarily with ciswomen. Secondly, the available research is mostly about cispeople engaging in this type of sex. Thirdly, of the available research, it is clear the biggest orgasm gap occurs with this demographic. The pleasure and sexual experiences of trans and queer women is an even less discussed topic facing similar cultural barriers of patriarchy and secrecy. An excellent perspective on this can be found here

Over the next month, I’ll post a series of articles exploring the key barriers that allow the orgasm gap to persist, followed by proposed solutions. My hope is that we can finally shift some of the cultural norms around sex that do not provide a supportive context for female pleasure.

Stay tuned!

What’s Underneath All the Noise? Reflections from Ten Days in Silence

Recently, I attended a ten-day silent meditation retreat. At a Vipassana retreat, your aren’t allowed access to books, journals, iPhones or even eye contact. The intention is to eliminate all external noise in order to create a conducive container for meditation.

Left to my own devices, I’m the type of gal that reads three books a week, listens to podcasts constantly, and compulsively checks social media. I knew this was going to be a challenge. My neurons were habituated to constant stimulation and the transition was rocky. On day three, I was sitting on a bench outside and a mosquito bit me. I was elated---finally some stimulation! On day four, I found myself laughing a little too loud at the nightly dharma talk, reaching desperately for some comedic relief. I read and re-read the course rulebook.  And, eventually, I gave up. I finally surrendered to my inability to control my sensory input and started tuning into my surroundings.

So, what was underneath my constant need for stimulation? Lots of boredom. Emotions: some pleasant, many not. A mind that is obsessively interested in replaying past memories (mainly regarding ex-boyfriends and even some reality TV episodes. Careful what you take in folks, it stays there.). And a persistent feeling of emptiness that I’ve all my life felt compelled to constantly fill with noise, busyness, and persistent stimulation. Pema Chodron talks about making contact with the fundamental slipperiness and mystery of our being, which has no fixed identity. She calls this place the fundamental “groundlessness” of being. This was the place I’d been running away from.

But, is this “groundlessness” to be feared? What compelled me to persistently run away from it? As I continued to sit with this groundless feeling in my meditations, I realized that it is extremely threatening to the part of me that believes I’m in control, the part of me that’s attached to a fixed identity, and prefers pleasure, and resists pain. Sound familiar to anyone else? These are evolutionary mechanisms our brains have evolved to protect us, so moving away from these instincts naturally brings up resistance. As I began to feel more comfortable with and even to befriend the sense of groundlessness, I found a newfound fearlessness arise. If I could stay with the discomfort long enough to notice that all my sensations were in constant transformation, I felt braver to sit with whatever arose. Also, as I was able to sit with the direct experience of groundlessness, there was, in fact, all the stimulation I could ever crave. Here, everything constantly arises and falls away. There is nothing stable in sight. Everything is always new.

Tuning into this constant flux, with neutrality and kindness, offers wisdom about the very nature of reality. Sit with this direct reality long enough and you may even make contact with that which is eternal and unchanging.

To experience the raw nature of reality for yourself, I’d highly recommend attending a course. They are free (donations accepted) and one of the best investments of time you will ever make. In a culture that is hyper-focused on the value of the mind through education and accumulation of knowledge, we are not given tools to understand the mind’s limitations and train it for liberation. Vipassana is Bootcamp for mind liberation. For more information visit: https://www.dhamma.org/en-US/index

Mindfulness + NEAT: 2 unexpected keys to finally getting enough exercise

Confession: I haven’t exercised regularly in a year. Sure, I’ll go to a yoga class here and there and sometimes will go on a really short jog, but I don’t adhere to a regular exercise regimen. And I don’t feel guilty about it. In fact, I feel pretty great! As an ex-collegiate competitive track and cross country athlete, I can’t say I feel grossly out of shape or that my figure has significantly changed since my college glory days. What’s inspiring my new movement perspective? Two things: the science of NEAT (Non-Exercise Activity Thermogenesis) and the mindfulness research of Ellen Langer. Let me explain.

In our culture, there is a prevalent myth: physical movement doesn’t contribute to your health and fitness unless it happens in a gym as “formal exercise”. Yet in cultures known as hot spots of longevity or health (check out Dan Buettner’s Blue Zones book for more), there is rarely an overt concept of exercise. Rather, movement is integrated into daily living as a necessary, utilitarian part of life—opposite of our sedentary or, at best, “actively sedentary” culture. The regular exercisers among us likely fall into the actively sedentary status: you get your daily recommended exercise but are mostly sedentary for the rest of the day. For example, someone who goes to the gym for 45 minutes in the morning but sits at a desk job the rest of the day. We now know this single bout of movement in a sea of sitting doesn’t cut it. Sobering new evidence shows higher amounts of daily sitting are associated with greater risk of all-cause mortality (even if you exercise). With new emphasis on the dangers of sitting for uninterrupted periods of time, scientistsare finally studying the importance of “smaller” forms of movement that break up long stretches of sedentarism throughout the day. In the literature, these smaller movements are known as Non-Exercise Activity Thermogenesis, or NEAT.

How would your daily life change if you knew reducing sitting and increasing NEAT might be more vital to your health than engaging in formal exercise? I’ll talk more about how to transform your movement routine at the end of this article.

Beyond NEAT, my other movement inspiration comes from the mindfulness researcher Ellen Langer. She concisely defines mindfulness as the simple act of actively noticing things resulting in increased health, competence, and happiness. Langer studies how our perceptions and beliefs (which can be changed with mindful awareness) directly impact our physiology. Her work quantifies the power of the mind-body connection by illustrating how our perception impacts everything from blood sugar levels, the aging process, and potentially cancer remission states. A powerful study she conducted with hotel maids tested the physiological impact of the perception of whether something “counted” as exercise. Initially, most of the hotel maids reported they didn’t exercise regularly. Langer took several measures of their fitness levels which concurred that most had the markers of a sedentary lifestyle. She and her colleagues then told half the maids that, in fact, their job duties, such as cleaning rooms, scrubbing toilets, and vacuuming, actually exceeded the surgeon general’s recommendation of a half-hour of physical activity daily. In other words, they were told their cleaning activities “counted” as exercise. The other half of the maids served as a control group. A month later, researchers retested the biomarkers (weight, blood pressure) of both groups. The control group’s markers had stayed the same, but the group that now believed themselves to be regular exercisers had lost weight and significantly reduced their blood pressure without changing their level of physical activity! For in-depth details on this study, check out this New York Times article.

So how can these two fascinating bodies of work improve your fitness routine?

First, radically expand your definition of exercise to include and prioritize NEAT: all-day, low-impact movement.This will minimize the harmful effects of sitting and allow you to meet your daily movement requirement more easefully.

Second, be mindful of the fact that all movement “counts as exercise”. This awareness means you’ll be more likely to take the stairs, change up your commute, and seize every opportunity to move. Plus, your belief in its effectiveness actually improves its measurable physiological benefits.

Want to revolutionize your exercise routine? Take these 4 steps.

1. Change your mindset to recognize all forms of movement count toward greater health and energy, not just “formal exercise”. Start seizing every opportunity to move, no matter how small, with the knowledge that it’s significantly contributing to your health. Challenge yourself to move as often as possible throughout your entire day.

2. Take movement breaks. To minimize the risk associated with extended periods of sitting, make sure you’re taking a movement break at least every 25 minutes. Set an alarm at first to solidify the habit. Or download an app like Move to remind you to take a movement break at regular intervals. Even just standing up and sitting back down has been shown to reduce damage. Everything counts!

3. Rethink furniture. At the very least, occasionally sit on the floor. If you’re feeling hardcore, consider getting rid of some of your furniture, forcing you to floor sit. Use bolsters and pillows to make it comfortable. Floor sitting basically allows you to get the benefits of a yoga class (diverse joint configurations, stretching and shifting) while just hanging out. When you get up off the floor, try to do it using as little support as possible. It turns out the ability to get up and down off the floor without using your hands, arms, or knees to help boost you is a pretty accurate predictor of life expectancy. Work this skill daily by conscious floor sitting, paying particular attention to working on the ability to spring up and down without support. Check out Katy Bowman’s furniture-free home or this badass guide to going furniture free for inspiration.

4. Walk a lot! Measuring your steps is one of the best ways to encourage all-day movement. Walking is the key movement our bodies evolved to do, and there are myriad consequences when we don’t get our daily intake of walking. Aim for at least 10,000 steps a day. If you’re not already measuring your steps via your iPhone or pedometer, I can’t recommend this highly enough. For a free option, I love the app Moves.

Take a look at your daily routines. How can you add more simple movements throughout your day? Can you change your environment to ensure you’ll move more? Can you rework your perception to acknowledge that any mini-movements throughout your day truly count? With a little bit of awareness and planning, you can increase the effectiveness of your daily life and decrease the risks of common behavior. Happy moving!!

The Struggles of a Tech-Addicted Meditator

Attention is the rarest and purest form of generosity.

 -Simone Weil

My red flag moment was when I found myself scrolling through my iPhone on my meditation pillow. In a laughable yet not uncommon moment my phone worship became undeniable. Through this daily meditation practice, I was committing to training my attention each morning. Yet I also had the habit of checking my phone immediately after my sit, often before I had even left my cushion. As proud as I was of my dedication to my morning practice, it became clear that the remainder of my days often felt like one big training in the art of distraction.

I became interested in attention largely because of the personal consequences I’ve noticed as it’s diminished. With the ubiquity of smartphones and social apps, I’ve noticed my attention span waning (and let’s be honest--mine wasn’t top notch to begin with). A few examples include difficulty finishing books, feeling the need to multitask during movies, and most disturbingly, decreased tolerance for “slow talkers” and lulls in conversation. When you’re used to the predictable and always entertaining input from a device the mysterious, often meandering process of human connection can feel too risky, time-consuming and even boring. Anyone who’s ever attempted a meaningful conversation with someone more interested in their instagram feed knows how damaging this distraction can be.

My movement teacher Katy Bowman teaches that one hour of exercise each day doesn’t offset 23 hours of being sedentary. We are evolved to move with frequency throughout the day and this movement frequency is arguably more important to health than one intense bout of physical activity. I wanted to apply this logic to my meditation practice. A brief attention training in the morning is wonderful, but couldn’t possibly be offsetting the massive splintering of my attention the rest of the day. Perhaps some of my efforts would be better spent reorganizing my 23 1/2 hours to be less of a worship of distraction, which means seriously examining my current relationship with technology.

If our attention is our most valuable and increasingly rare resource, it makes sense to be intentional about how we interact with the devices that strip it of its acuity. And the blame cannot be entirely on those of us who find ourselves unable to control our digital addictions. Some of the brightest minds at the most prestigious companies (Facebook ahem) use the most effective behavioral strategies to keep you clicking, scrolling and liking. Yet, rejecting technology completely is a luxury that many of us cannot afford.These tools can enhance the ability to pursue things like entrepreneurship, education and social connection. In our increasingly tech-enabled world, resistance can seem futile. Yet going with the flow and keeping up with societal norms does not ensure a healthful relationship with our gadgets. Like many other health behaviors, it seems you must deviate outside the cultural norm to protect your health and happiness.

So, in my quest to confront my techaddiction I’ve been experimenting with ways to still engage with technology but set stronger boundaries that prioritize what’s actually important in my life---things like quality of attention, presence and relationships. I honestly had low expectations for my compliance with this new strategy but it’s been surprisingly easy once I started feeling the benefits. Here are some things I’ve been experimenting with.

• Set rules about when I turn my phone on and off each day. I do a digital sunset at the same time each night and don’t turn my phone on in the morning until after my meditation practice. This has drastically improved the quality of my sleep and increased the consistency of my meditation practice. This is coming from someone who used to look at my phone first thing after waking up! Change is possible!

• Beware of the iPhone effect. Research has shown that keeping your mobile device in sight during a conversation significantly lowers empathy level and the quality of conversation. Don’t leave your phone out if you’re talking to someone. This is an easy switch that can significantly improve your relationships.

• Take your most addictive social apps off your phone--- it’s amazing how boring your phone quickly becomes. Or as a compromise try keeping those apps on the last page of your iPhone so you have to scroll for a bit to open it. This gives your slow brain and willpower some time to kick in and decide against opening the sites. I took Facebook and Instagram off my phone. I’m not ready to quit Instagram all together and can’t easily post via my laptop so I now allow myself to re-download the app one day a week if I want to make a post. A bit clunky but worth the sense of freedom I’ve felt.

• Have phone free blocks where you leave your phone at home or hide your device for periods of time.

• Check out these additional resources for further inspiration and ideas on living a less distracted and deeper life. The books Deep Work by Cal Newport and The Shallows by Nicholas Carr. A couple quick videos--- Kelly McGonigal’s advice for breaking tech addiction (2 min video) and  Brian Johnson on the digital sunset . Also, Dallas Hartwig's More Social, Less Media Movement. 

Surprisingly quickly my phone has lost its allure. You can only check for a text or email so many times before it gets boring. I knew that something had shifted when I left my phone at home and I didn’t notice for a couple hours. A month ago that would have been unthinkable. The quality of my relationships has increased and my attention feels stronger. Slowly my tolerance for boredom and silent moments has improved. I even took a nap the other day as I couldn’t turn to Instagram scrolling as my go-to way to relax. The only drawback I’ve noticed so far is the pain of looking around, finally ready to connect, only to notice how distracted most people are.

Sexy Wellness Fads: Inspiration or Distraction?

On a bitter cold night in rural Wisconsin, I experienced one of the most nourishing meals of my life. I had been taking a break from my whirlwind NYC lifestyle, living with my folks in hopes of regaining some vitality before moving back to one of the coasts. This respite meant spending more time with my parents than any healthy, self-reliant adult probably should. As such, I found myself sitting down for a meal with two of their close friends, a potter and a professional gardener whose lifestyles epitomized the most aspirational qualities of the “back to the land” movement of the ‘70s.  In their sprawling backyard was a brick oven, pottery kiln, and a remodeled 19th century schoolhouse that now functioned as a gathering for yoga, zen meditation, and community art events. Despite the frigid cold they had miraculously just harvested the last vegetables from their greenhouse which contributed to our dinner. This particular meal started with traditional Italian fermented eggplants, fatty olives, hard sourdough, aged cheeses, and grass fed butter. Wine was poured and conversation flowed as we caught up on each other’s lives. Soon the poached carrots with honey and ginger arrived, as well as a big green salad with shallot vinaigrette. Fillets of venison, hunted by their son earlier in the season, eventually arrived at my plate. I was struck by how nourished I felt by this simple meal. The experience of slowly enjoying whole foods cooked to their highest potential, eaten in a warm communal setting, left me feeling deeply healthy and alive.

When I came back to NYC, I was inspired to bring this culinary enthusiasm back with me. Growing up with hippy parents who emphasized macrobiotic health foods and massive amounts of vitamins left me with an insatiable appetite for the latest health trends. As a budding wellness entrepreneur in the New York City scene, I am inundated and often inspired by the flashy, pristine Instagram feeds of my fellow wellness warriors. While I’ve always loved to cook, I’ve tended to follow health trends rather than focus on culinary pleasures. Feeling inspired by my winter meal in Wisconsin, my boyfriend and I started cooking more in the Alice Waters and Tamar Adler vein. This style emphasizes whole foods-based, pleasure-oriented eating in which health is not the emphasis but rather a natural byproduct. Health arises from using local, fresh ingredients that lead to optimal sensory pleasure. The result is meals that intuitively contain the right combination of nutrients - without the often reductionist approval of movements in modern nutrition.

One night, we sat down for big bowls of homemade ribollita stew. We’d been saving the crusty, stale ends of our sourdough for weeks. We mixed the bread with big tomatoes, homemade chicken stock, bunches of kale, grated Parmesan, dollops of olive oil and cracked pepper. This meal felt indulgent, like a slight deviation from our usual emphasis on healthy eating. No this was not a vegetable curry, kale salad, or chia pudding. Yet, I looked down and realized that within this one bowl lived an amalgamation of health trends that were masked by the delicious full-bodied flavor. This bowl provided the much touted benefits of the fermentation movement with the sourdough bread and aged cheese. We also were inadvertently following the latest dietary trends emphasizing healthy fats with the spoonfuls of olive oil, bone broth and parmesan. It offered the healing power of herbs through the oregano and parsley and our phytonutrient content was maximized through the variety of veggies. It even featured the prom king of all vegetables kale. Yet, the meal felt like it wasn’t fit for a self-congratulatory wellness Instagram post, and I didn’t even register it as a meal that was a net positive contribution to my health. What was causing this disconnect?  

I have the same feeling toward the morning walk ritual I’ve started. Twice a week I meet a friend at an ungodly time and we walk together. Sometimes, we run errands or end up at the grocery store and carry our groceries homes. Despite our frequent jokes that we have officially become our mothers, this ritual of waking up, bathing our cells with sunlight while moving our bodies is already providing huge benefits. Yet, this walk is by no means glamorous in the glitzy world of wellness and pales in comparison to something hardcore and photogenic like the latest bootcamp class.

In a city that makes large profits by generating ever new “wellness status symbols,” simple tried-and-true healthy living seems passé and maybe even a little lazy. Novel, slightly inaccessible trends that make for sparkly Instagram feeds often require isolating one tiny aspect of well-being and repackaging it to seem special. With each new variation we wonder if this is the magic bullet we’re seeking. Think green juices, the latest fitness trend,be it Barre or SoulCycle, or meditating at a fancy loft space filled with dazzling crystals and fashion It girls. Admittedly I love and have participated in all of these things, but I invite us also to remember that health can exist in subtle ways that fit into our lives in more natural and less flashy ways.

I propose that cultivating true health might begin more simply and slowly then we’re often told. Maybe you begin cooking delicious recipes based on wisdom from old culinary traditions rather than from the latest health fads. And yes, maybe kale will even slip into the recipe without you noticing. Or, perhaps rather than trying the latest powder or potion to optimize your health, you could commit to something basic, profound, and unsexy like shutting off your iPhone and getting more sleep. Nonetheless, these fun, sexy wellness fads may have a place in it all; may they exist more like a dessert, something that’s inspiring and nice to have but not essential to the success of the nourishing meal.

What are some ways you cultivate health that you may have dismissed or undervalued in the current climate of flashy wellness trends?