Dr. Sheldon Zablow: “Improving restorative sleep is also essential”

Improving restorative sleep is also essential. A patient was not responding well to treatment for depression. After setting up a program that included reducing exposure to late evening bright light, decreasing bedroom temperature and setting a standard seven-day-a-week bedtime, her mood, focus and work improved. The cooler the bedroom, the deeper the REM sleep and […]

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Improving restorative sleep is also essential. A patient was not responding well to treatment for depression. After setting up a program that included reducing exposure to late evening bright light, decreasing bedroom temperature and setting a standard seven-day-a-week bedtime, her mood, focus and work improved. The cooler the bedroom, the deeper the REM sleep and the more rested upon awakening. Upon recommendation, the patient also elevated the head of her bed by two inches which improved her sleep quality by reducing gastric reflux symptoms and reliance on medications.

As a part of my series about “5 Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”, I had the pleasure of interviewing Sheldon Zablow, MD.

Dr. Zablow is a Nutritional Psychiatrist and has published a nutrition/health and wellness book, Your Vitamins Are Obsolete. The book describes the connection between the deficiency of bioactive forms of the vitamins B12 and folate and the universal illness of chronic inflammation which can lead to major medical disorders. He explains how most supplements are synthetic, poorly made, poorly absorbed and poorly metabolized leading to increased health risks.

Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the story about how you first got involved in fitness and wellness?

I got involved in health and wellness by the necessity of optimizing the treatments provided to my patients. Over the years, I found that simply prescribing medication was not enhancing healthy outcomes so a more universal approach was needed. The comprehensive approach of encouraging a healthy diet, good sleep hygiene, cardiovascular and weight resistance training, relaxation exercises and medication always gave the greatest improvements.

Can you share the most interesting story that happened to you since you started your career?

Among the most interesting of my experiences as an adult and child psychiatrist was my opportunity to join an excursion to the USS Carl Vinson aircraft carrier while she was stationed off my hometown of San Diego. A twin turboprop C-2 Greyhound transported me and the other guests out for a tour and overnight stay. I interacted with many sailors including the parents of a few of my patients, listening to their concerns about parenting while being away from home. Watching flight operations and learning about each team member’s duties was fascinating, but I was more drawn to the crew themselves. They each projected teamwork and pride in attendance to their routine labors which seemed heroic to me including launching, capturing and servicing aircraft, plus the thousands of other tasks needed to maintain a massive sailing vessel and its crew.

Young men and women of all religious beliefs and ethnic backgrounds, showed respect for each other and for themselves. The captain, officers, and every chief impressed on all us guests the pride they had in these young adults. The admiral shared with me that his definition of a successful mission was that with many days of dangerous training for 6,000 personnel on the carrier and in the flotilla of support ships above and below the water, not one sailor had been seriously injured. Training was constant, with everyone serving as both teacher and student on this floating college campus.

Our return to San Diego turned out to be memorable in its own way. Our transport plane had a normal catapult shot off the carrier, but a problem in one of the engines caused the pilot to shut it down mid-flight. Returning to the carrier was impossible so the crew prepared us to ditch into the Pacific if the remaining engine could not sustain a powered glide back to Naval Base Coronado. I guess they wanted to give us the full naval experience. Once again, the Admiral’s faith in his crew was validated. We landed safely as the firefighters covered the plane in flame retardant foam. As they opened the back hatch, fresh air rushed in, and we deplaned into a bright fall San Diego afternoon.

Can you share a story with us about the most humorous mistake you made when you were first starting? What lesson or take-away did you learn from that?

It was my first day as a psychiatry resident. I had finished medical school, an internship in pediatrics and was finally starting my training in psychiatry. My initial rotation took place at a Veterans Administration hospital on the inpatient psychiatric unit. I had been looking forward to and planning for this day for several years. I was about to enter a whole different world and was apprehensive but looking forward to working with veterans. I wore my new resident’s white coat, a new shirt and tie and had my own key to the locked unit. I really wanted to make a good first impression on my first day as a psychiatrist.

After being directed to the day room for the morning group meeting for staff and patients, I introduced myself and took a seat next to my psychiatry supervisor. As he went around the circle talking to each patient in turn, I remained quiet and attentive thinking I had finally made it.

But when it was the last patient’s chance to speak, things took a shocking turn as he leaped right over me, grabbing my supervisor by the throat, and strangling him. Years of judo and wrestling training instinctively kicked in as I threw my body into the struggle and put the patient into an armbar restraint. Orderlies rushed to our assistance and took him to the “quiet room”. After making sure my supervisor was not hurt and the patient was stable, I retreated to the bathroom to collect myself. I was a mess — my face was bruised, my tie torn, my shirt shredded, and my white coat was no longer all white. It was a long day explaining to each professional and patient I met why I looked the way I did and still do the work in helping my patients. When back at my apartment, I could not stop laughing at how hard I had tried to project a perfect professional appearance. I learned that being a good psychiatrist had less to do with my appearance than communicating a willingness to listen and understand.

Can you share with our readers a bit about why you are an authority in the fitness and wellness field? In your opinion, what is your unique contribution to the world of wellness?

As a nutritional psychiatrist, my focus is on reducing the emotional suffering of my patients while trying to prescribe the minimum amount of medication. I do this by encouraging patients toward more healthy diets, exercise, and the use of essential nutrients. My studies led to a review of the literature about the most essential of the essential nutrients — B12 and folate (B12/F). These two vitamins are the foundation of all good health, positively modulating any intervention to improve healthy living and healthy longevity. The more one has optimal levels of the bioactive forms of these B vitamins, the greater the positive response will be to diet, exercise, sleep hygiene, and meditative therapies. The result of my studies is the authoring a book on this subject, Your Vitamins Are Obsolete. My contribution with this book is the exploration of how optimal levels of these nutrients improve the epigenetic control of gene expression, leading to a reduction in chronic inflammation — the universal illness. Chronic inflammation is the leading cause of disease and death associated with cancer, diabetes, kidney disease, dementia, heart disease, strokes, and autoimmune illnesses.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

If I had to pick one person who helped me the most in my career as a child and adolescent psychiatrist, it would be someone I only met through his writings — Janusz Korczak, aka Henryk Goldszmit, MD. He was well known as a writer of children’s and parenting books and director of orphanages. Dr. Goldszmit started the only orphanage in the Warsaw Ghetto, remained there as director and was eventually martyred along with his charges. He expressed directly in his non-fiction writing and indirectly in his fiction, his thoughts on how to understand and respect children from their perspective. His writings form core principles for working with children in any capacity and I have used them throughout my career treating those children who were depressed, abused, or had developmental delays. I have passed his writings onto the child psychiatrists I trained so they could use them in their therapeutic work.

Ok thank you for all that. Now let’s move to the main focus of our interview. We all know that it’s important to eat more vegetables, eat less sugar, exercise more, and get better sleep etc. But while we know it intellectually, it’s often difficult to put it into practice and make it a part of our daily habits. In your opinion what are the 3 main blockages that prevent us from taking the information that we all know, and integrating it into our lives?

The three main reasons people have difficulty using the science presented to them for healthy living and longevity is a lack of knowledge, a lack of motivation and a lack of a good source of proper nutrients. Most people are not informed about the science behind the importance of essential nutrients and how they can optimize the interventions of proper diet, sleep, and exercise. After they have the knowledge of how modulators of good health work together, they will need motivation to apply it. If there is a lack of motivation, that needs to be addressed directly by evaluating whether the limitations are physical or emotional. Once someone has knowledge and motivation, they need access to basic nutrients which optimize healthy choices. If they are unable to acquire the natural forms from food or supplements, all other efforts will be in vain and motivation will once again drop away.

Can you please share your “5 Non-Intuitive Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”? (Please share a story or an example for each, and feel free to share ideas for mental, emotional and physical health.)

The first lifestyle tweak I recommend (no surprise) is exercise, but it needs to be the right balance of cardiovascular and weight resistance training and to pursue them at the right time of day. I have had patients try an exercise program of one or the other, but they have missed out on the advantage of blending both. The tweak is the timing of the exercise with studies showing morning exercise has the greatest anti-inflammatory, improved sleep, and appetite control benefits. I have also treated patients who over-exercised which instead of lowering their inflammatory load, raised it because of increased muscle and joint irritation.

Improving restorative sleep is also essential. A patient was not responding well to treatment for depression. After setting up a program that included reducing exposure to late evening bright light, decreasing bedroom temperature and setting a standard seven-day-a-week bedtime, her mood, focus and work improved. The cooler the bedroom, the deeper the REM sleep and the more rested upon awakening. Upon recommendation, the patient also elevated the head of her bed by two inches which improved her sleep quality by reducing gastric reflux symptoms and reliance on medications.

Reducing weight is a well-known optimizing agent for good health but most people are unaware that excess adipose tissue uses up the body’s folate — an essential nutrient. When folate is low, fat cells produce excess inflammatory molecules which worsens the risk of every major illness. A patient of mine was overweight, which by itself is a significant risk factor for breast cancer, and she had a family history of this malignancy. She was started on an intermittent fasting program and her weight came down to the normal range as did her blood tests for inflammation.

Another critical component of good health is knowing the status of a specific genetic test called MTHFR. This enzyme is required for the conversion of the artificial folic acid into the bioactive methylfolate that the cells of the body use to regulate genetic expression, reduce chronic inflammation and rid the body of the waste product homocysteine. If you are unable to convert the artificial form into the natural form of this vitamin, you will be unable to utilize the folic acid in fortified food and multivitamins. One young vegan patient was unable to get pregnant. Upon testing for this enzyme, it was found she was deficient and therefore unable to use the vitamins prescribed by her fertility physician. Once bioactive B vitamin versions were taken, she got pregnant and delivered a healthy child. Had she eventually gotten pregnant without the discovery of the MTHFR malfunction with the resulting low folate levels, her child would have been at risk for neural tube birth defects and developmental delays.

The final suggestion would be to make sure natural forms of B12 and folate are available from foods and supplementation. This would increase the response to all other interventions. For example, when there is a risk of osteoporosis and vitamin D and calcium are taken, if there are not enough B vitamins, osteoporosis still develops.

As an expert, this might be obvious to you, but I think it would be instructive to articulate this for the public. Aside from weight loss, what are 3 benefits of daily exercise? Can you explain?

The field of medicine is discovering a wide range of benefits of daily exercise. The most important is the increase of the healthy expression of genes by improving DNA epigenetics, which is the way genes are regulated. With regular exercise, healthy genes are expressed, and unhealthy genes are suppressed. As an example, studies have shown that those who engage in regular exercise have a reduced risk of developing breast or prostate cancer. Another advantage associated with exercise is the reduction in chronic inflammation as mentioned above. Any decrease in the inflammatory load is a decrease in the risk of developing most major illnesses. A third little known benefit of exercise is the increase in natural neurotransmitter levels. All nerve cells communicate with the body and each other through chemical connections called synapses. Neurotransmitters are the chemical messengers that flow across the synapses. Exercise increases the production of these communication molecules reducing the risk of depression, anxiety, poor sleep, and weight gain.

For someone who is looking to add exercise to their daily routine, which 3 exercises would you recommend that are absolutely critical?

The three standard fitness recommendations are still the best, a combination of an aerobic exercise, weight resistance training and some form of meditative exercise or technique. I promote brisk walking on a daily basis and, if joints can tolerate it, adding in the occasional slow jog. The importance, as many studies have shown, is not the speed but the consistency. Your muscles and joints must last a lifetime, so it is important to listen to them and moderate accordingly. Weight resistance training is also important because it stimulates muscle cell health by reducing chronic inflammation and increasing neurotransmitter production. Using lighter weights at a slow rate of eight seconds per rep gives the best result with less injury inducing inflammation. The third component is the wide range of meditation/relaxation exercises which also provide anti-inflammatory benefits. These include activities such as yoga, tai chi, breath focus, massage, rhythmic movement, prayer and what has recently become my go-to relaxation activity — passive stretching.

Is there a particular book that made a significant impact on you? Can you share a story?

If I had to recommend a book that would be beneficial for most laypeople and medical professionals to read, it would be Could It Be B12? An Epidemic of Misdiagnoses by Sally Pocholok and Jeffrey Stuart. These authors clearly explain the risks of a deficiency of this critical nutrient with clear case histories of patients who have been misdiagnosed and suffered as a consequence. Most medical professionals are unaware of the significant risks to their patients posed by dietary deficiencies or by prescribed medications which reduce B12 and folate levels. This book should be required reading for all medical professionals.

You are a person of enormous influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

A reduction of billions of dollars in global health care costs is possible if people are given daily access to the bioactive forms of B12 and folate. This is not an exaggeration; the science is there and the expense per individual is minimal. This intervention, backed by the medical literature, is possible and can reduce nine out of ten leading causes of disability and death. As an additional benefit, regular use will significantly decrease the urge to eat red meat, the main concentrated dietary source of B vitamins. This reduction in consumption would have health benefits for people but also health benefits for the planet, by reducing greenhouse gases associated with the manufacture and transportation of beef.

Mandated grain fortification using the synthetic folic acid, is better than nothing, but is only required in a limited number of countries. If natural folate and B12 were added to food, the health advantages would be substantial. As an example, the benefits of their use in obstetrics would be a reduction in pre-eclampsia, gestational diabetes, maternal thromboemboli, low platelet bleeding disorders in pregnancy, premature births and postpartum depression. (If curious, do web search using each term above with B12 or folate deficiency.)

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

“Reduce your expectations of others.” The quickest way to reduce anxiety and depression is to reduce the expectations you have of others. This does not mean allowing people to treat you disrespectfully, rather it means to be aware of the projection of your wishes onto others. They will not be able to consistently meet your expectations thus leading you to constant disappointment in them and in yourself. As an example, you call your best friend on their birthday and expect a call on yours. When it does not arrive, you respond to your frustrated projected expectations with sadness. Don’t set yourself up for this additional stress. Keep in mind others are just as complex in their motivations and desires and they might define their expression of friendship differently than you do.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂

My ideal dinner guest would be Arianna Huffington. With her background in health and wellness, she would understand the science and significance of reducing each person’s inflammatory load by optimizing their physiology. I would like to learn from her the best approach toward getting this vital information to others.

What is the best way our readers can follow you online?

My website is sheldonzablowmd.com

Thank you for these fantastic insights. We wish you only continued success in your great work!

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