Health & Fitness

Niacin is a precursor to nicotinamide adenine dinucleotide (NAD+), a vital signaling molecule¹ that’s also believed to play an important role in longevity. This is partly due to its role as an essential substrate for sirtuins,² which are enzymes related to healthy aging, as well as its role in DNA repair.

NAD+ modulates energy production and many enzymes and in so doing controls hundreds of processes in your body including the survival of cells and energy metabolism. NAD+ is influenced on a daily basis by what you eat, exercise levels and more, and also declines with age, leading to changes in metabolism and an increased risk of disease.³

Boosting NAD+ levels may be akin to a fountain of youth, which is where NR comes in. While there are many ways to increase NAD+, including time-restricted eating and exercise while fasting, supplementation with NAD+ precursors may also be useful.

Why Is NR so Beneficial?

There are multiple precursors to NAD+, each with its own physiologic effects. Nicotinamide riboside (NR) is a popular one with several notable benefits over other precursors like niacin (NA) and niacinamide (NAM). NA, for instance, may induce uncomfortable flushing, while NAM may inhibit sirtuin at high doses, both undesirable effects.⁴

“Therefore, administration of niacin or niacinamide is unlikely to be widely adopted for maintaining health and function with aging,” researchers wrote in Nature Communications.⁵ NR has also been shown to offer a variety of significant health benefits. Among them:⁶

Life extension — In yeast, NR elevates NAD+ and increases sirtuin 2 (SIRT2) function.7 It’s through these increases in NAD+ and sirtuin 2 that calorie restriction is believed to help extend lifespan in mice as well.8

Protects against weight gain — NR supplementation in mice increased NAD+ levels and activated SIRT1 and SIRT3, leading to enhanced oxidative metabolism and protecting against high-fat, diet-induced metabolic abnormalities, including obesity. The researchers concluded, “Our results indicate that the natural vitamin NR could be used as a nutritional supplement to ameliorate metabolic and age-related disorders characterized by defective mitochondrial function.”9

Heart failure — In a mouse study, NR preserved cardiac function in mice with heart failure.10

Brain injury — NAD+ depletion is common in cases of neurodegeneration. In a mouse study, intracortical administration of NR helped protect against central brain injury.11

Noise-induced hearing loss — Administration of NR, even after exposure to loud noise, prevents noise-induced hearing loss by reducing neurite degeneration.12

Liver protection and antidiabetes effects — In prediabetic mice, NR improved glucose tolerance and reduced weight gain and liver damage. It also prevented fatty liver and helped prevent sensory neuropathy. The researchers concluded the results justified testing NR in humans with obesity and Type 2 diabetes.13

Stem cell regeneration — Among mice exposed to radiation, oral NR improved survival and hematopoietic stem cell regeneration—a benefit that wasn’t seen with in mice given NA or NAM.14

Reversal of chemotherapy-induced neuropathy — In rats, oral NR not only promoted resistance to chemotherapeutic neuropathy but also prompted its reversal.15

Reproductive benefits — Female mice and rats given NR had increased lactation and offspring with a number of health advantages, including increased strength, better memory, less anxiety and enhanced body composition and hippocampal neurogenesis as adults.16

NR Is a Superior Choice Among NAD+ Precursors

Because of its unique profile of benefits and low risks, NR has emerged as a popular choice, especially by its discoverer, biochemist Charles Brenner, among the NAD+ precursors. In Scientific Reports, researchers noted:¹⁷

“Because NR does not cause flushing or inhibit sirtuins and the genes (NRK1 and NRK2) required for the metabolism of NR to NAD+ are upregulated in conditions of metabolic stress, NR has a particularly strong potential as a distinct vitamin B3 to support human wellness during metabolic stress and aging.”

Further, according to scientists, these things combined make NR a popular choice for boosting NAD+:¹⁸

“NR has unique properties that differentiate it from both niacin and nicotinamide. Unlike niacin, NR does not cause flushing — even at high doses, NR has been shown to be safe in human studies at doses as high as 2000mg/day and does not inhibit sirtuins like nicotinamide. In fact, NR has been shown to activate sirtuins in multiple preclinical studies.

Furthermore, a preclinical study published in Nature Communications, demonstrated that when all three forms of vitamin B3 (niacin, nicotinamide, and NR) were tested head-to-head, NR was not only the most effective at increasing NAD⁺ levels, but it was also the most effective at activating sirtuins.”

The Nature Communications study they referred to found, in fact, that single doses of 100, 300 and 1,000 milligrams (mg) of NR produced dose-dependent increases in NAD+ in humans. They also revealed that blood levels of NAD+ can rise as much as 2.7-fold after a single dose of NR.¹⁹

The scientists compared NR to a ski lift, citing that it provided a more direct route to increased NAD+ levels than NR or NAM:²⁰

“NA and NAM both reach the top of the mountain (successfully produce NAD⁺), however, the paths are winding, and the path for NAM includes inefficiencies in the form of obstacles. Traveling these paths takes more time and energy, which ideally, we would like to conserve in efforts to maximize energy production. The path of NR to NAD⁺ is analogous to the ease of using a ski lift to reach the top of a mountain.

It is much more direct, saving both time and energy — ultimately resulting in the greatest increase in cellular energy production. This concept is further supported by both preclinical and clinical research that suggest NR is the most efficient and effective form of vitamin B3 at boosting NAD⁺ levels.”

Why Boosting NAD+ Is Important

As mentioned, the reason why researchers are so excited over NR is because it appears to efficiently and safely boost NAD+, which otherwise declines with age. In animal studies, restoring NAD+ levels in older or diseased individuals promoted better health ad extended life span, which suggests NAD-boosting molecules like NR have the potential to increase resilience, reduce disease and extend healthy lifespan in humans as well.²¹

As an aside, it may even have usefulness for COVID-19. According to David Sinclair with Harvard Medical School, the elderly tend to have higher levels of NLRP3 inflammasomes, which appear to be key culprits involved in cytokine storms, which can occur in COVID-19 patients. NLRP3 activity also appears to be influenced by NAD+ levels. Sinclair and colleagues explained in the journal Aging:²²

"In older individuals, NLRP3 may be poised for hyperactivation by SARS-CoV-2 antigens. NLRP3 activity is under the direct control of sirtuin 2 (SIRT2), a member of the NAD+-dependent sirtuin family of deacetylases. During aging, NAD+ levels decline, reducing the activity of the sirtuins.

Old mice … have decreased glucose tolerance and increased insulin resistance. This decline, exacerbated by COVID-19, might promote hyperactivation of NLRP3 and the trigger [for] cytokine storms in COVID-19 patients.

Maintaining NAD+ levels may therefore alleviate COVID-19 symptoms, a possibility supported by recent data showing that SARS-CoV-2 proteins hyperactivate poly-ADP-ribose polymerases PARP9, -10, -12, and -14 and deplete cellular NAD+. Additionally, NAD+ precursors lower inflammation in human subjects.”

NAD+ May Be Depleted by 50% by Age 60

Research into NAD+ is still in its infancy, but James Clement, author of “The Switch: Ignite Your Metabolism With Intermittent Fasting, Protein Cycling, and Keto,”²³ conducted his own research, starting with a clinical trial testing intravenous NAD+ in elderly people, in collaboration with Dr. John Sturges, who has integrated NAD therapy into his private practice.

Clement underwent the treatment himself, which involved an infusion of 1,000 mg of NAD+ per day for six straight days, and found it remarkably effective for tremors he'd had since he was 20 years old. In my interview with Clement, he stated:

"My hands would shake … It was just some neurological problem. It wasn't the onset of Parkinson's at 20 years old or anything else that anyone could point to. But surprisingly, within an hour or two of starting the IV infusion, my tremors went away completely, which I had had for the previous 40 years.

I noticed later that evening that I fell asleep and didn't wake up during the middle of the night … I woke up way earlier than I normally would, completely refreshed and ready to get back to work. This was the same kind of experiences all of our elderly patients were telling us as well. We had several people who had tremors that went away.”

While he believes 1,000 mg may be too much for those who don’t have a severe NAD+ depletion — and is also cost prohibitive, at $1,000 per IV — he noted that many lifestyle factors can reduce your levels, including alcohol consumption.

Aging is another factor and, according to Clement, NAD+ may be depleted by 50% by the time you’re 60 (compared to in your 20s or 30s), and when you’re 70 you may only have 10% of the amount you did when you were younger.

“And then at 80, there's almost none,” he said, adding that this will seriously impair your body’s ability to repair broken DNA. “You can see how this huge buildup of damaged DNA in every cell of your body is potentially one of the driving forces of these morbidities that you see with aging, heart disease, cancer [and] Alzheimer's …"

How to Raise Your NAD+ Levels

I think it is best for everyone to make sure that they are getting about 25 mg of niacin per day. This can be done by using Chronometer.com, a free online nutrient analyzer, and/or taking a niacin supplement. Ideally it should be about 12.5 mg taken twice a day, which would be unlikely to cause flushing in most everyone.

Once you have done that you could use NR, but I believe NR has several major problems. One is that it is not inexpensive, although it certainly is less costly than using NAD+ directly. However, once you swallow it your liver detoxifies it and adds a methyl group to it so it tends not to form NAD+ as well in tissues outside the liver.

An alternative strategy would be to make a homemade rectal suppository and deliver the dose that way. This bypasses the liver and would supply the NR directly into your bloodstream. If you were to use NR this would be the better way to administer it.

If you’d prefer to avoid supplementation, there are additional strategies that can help. As mentioned, this includes exercise and time-restricted eating. It’s also important to remember that NR supplementation is not a magic potion.

To maximize its effects, you’ll want to use it in conjunction with an overall healthy lifestyle — one that involves optimizing your sleep, limiting EMF exposure, exercising, intermittently fasting and avoiding food for at least three hours before bed, lest your efforts all be in vain.

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I’ve written many articles reviewing a wide variety of therapies demonstrated or hypothesized to have a positive impact on SARS-CoV-2 infection and COVID-19 disease progression. Now, we can add nitric oxide (NO) to the list — not to be confused with nitrous oxide (N2O, a sedative often referred to as laughing gas). According to Åke Lundkvist, a professor at Uppsala University who led the study¹ in question:²

"To our knowledge, nitric oxide is the only substance shown so far to have a direct effect on SARS-CoV-2. Until we get a vaccine that works, our hope is that inhalation of NO might be an effective form of treatment. The dosage and timing of starting treatment probably play an important part in the outcome, and now needs to be explored as soon as possible."

What Is Nitric Oxide?

Nitric oxide (NO) is a soluble gas continually produced from the amino acid L-arginine inside your cells. While NO is a free radical, it’s also an important biological signaling molecule that supports normal endothelial function and protects your mitochondria — the little “power stations” in your cells that produce a majority of your body’s energy in the form of ATP.

It’s stored in the lining of your endothelium (blood vessels), and can be triggered either through exercise or dietary means. NO is a potent vasodilator, helping relax and widen the diameter of your blood vessels.

Healthy blood flow in turn allows for efficient oxygenation of tissues and organs, and aids in the removal of waste and carbon dioxide. Importantly, NO infuses into areas that are hypoxic, meaning in need of oxygen, and both your heart and brain^3,4 are heavy oxygen users. NO also:

Improves your immune function, making your body better equipped to fight off foreign pathogens

Has powerful antibacterial potential

Protects your mitochondrial health

Helps maintain physiological homeostasis — For example, in your gut, NO regulates mucosal blood flow, intestinal motility and the thickness of mucus

Plays an important role in the homeostasis of reactive oxygen species, which can have a significant impact on metabolic pathways5

Helps suppress inflammation

Promotes angiogenesis, the formation of new, healthy blood vessels6

Helps improve your physical fitness — For example, raw beets have been shown to boost stamina during exercise by as much as 16% as a result of the increase in NO production7

Improves brain neuroplasticity by improving oxygenation of the somatomotor cortex, a brain area that is often affected in the early stages of dementia8,9

Helps reverse metabolic syndrome10 and has antidiabetic effects11,12

NO Effectively Inhibits SARS-CoV-2 Replication

As mentioned, NO is known to have broad-spectrum antimicrobial effects, and Swedish researchers have now demonstrated that NO effectively inhibits the replication of SARS-CoV-2 in vitro by targeting the SARS-CoV-2 main protease. The study¹³ in question was published in the October 2020 issue of Redox Biology. As explained in various sections of this paper:¹⁴

“Nitric oxide (NO) is a broad-spectrum antimicrobial and a potent vasodilator that has proved to be effective in reducing SARS-CoV replication and hypoxia in patients with severe acute respiratory syndrome …

NO has been demonstrated as an effective antiviral against SARS-CoV in vitro and in vivo by inhalation in very low concentrations in a small clinical trial.

Furthermore, inhaled NO improved arterial oxygenation in hypoxemic patients by redistributing blood flow in the lung to better ventilated regions, and counteracted blood clotting, both effects being of importance for COVID-19 patients.

The role of NO-inhalation in the prevention and treatment of COVID-19 has been proposed, but no clinical data has yet been reported. In the present study the antiviral effect of NO on SARS-CoV-2 infected cells was tested in vitro …

The NO-donor S-nitroso-N-acetylpenicillamine (SNAP) had a dose dependent inhibitory effect on SARS-CoV-2 replication … SNAP (NO donor), but not NAP (NO-lacking version of SNAP) showed a dose dependent reduction of SARS-CoV-2 viral RNA copy numbers, which proves that NO has an antiviral effect against SARS-CoV-2 and probably in the similar manner as previously described for SARS-CoV and other viruses …

Although the viral replication was not completely abolished (at 200 μM and 400 μM), SNAP delayed or completely prevented the development of viral cytopathic effect in treated cells, and the observed protective effect correlated with the level of inhibition of the viral replication.”

The image below compares and contrasts the cytopathic effects over time (24-hour intervals) between cells treated with SNAP (a NO donor) at 200 μM and 400 μM, and untreated controls. The cells are magnified 100 times.

SARS-CoV-2 Main Protease Is an Attractive Drug Candidate

The SARS-CoV-2 main protease is a key enzyme in the virus’ life cycle,¹⁵ which makes it an attractive target for drug development.¹⁶ As explained in one Science paper,¹⁷ the SARS-CoV-2 main protease enzyme “cuts the polyproteins translated from viral RNA to yield functional viral proteins.”

By targeting this enzyme, researchers believe you can effectively combat SARS-CoV-2, and that is precisely what NO does. According to the Swedish researchers:¹⁸

“Based on this study and previous studies on SARS-CoV in vitro, and in a small clinical trial, we conclude that NO may be applied for clinical use in the treatment of COVID-19 and other human coronavirus infections.”

How to Increase NO Production Naturally

While the Swedish researchers suggest using NO inhalation therapy — which is already used for conditions such as hypoxic respiratory failure in adults¹⁹ and respiratory failure in neonates²⁰ — you could also boost your resilience against the virus by implementing lifestyle strategies that increase your natural NO production.

For clarity, these strategies would not be of immediate help if you come down with a SARS-CoV-2 infection. Rather, by increasing your body’s production of NO on a regular basis, the virus may be less likely to gain a foothold if you’re exposed to it. That said, three strategies that will increase NO production in your body include:

1. Blood flow restriction training (BFR)²¹
2. Getting sensible sun exposure on large portions of your body, as NO is released into your bloodstream when sunlight hits your skin^22,23
3. Eating nitrate-rich plant foods^24,25,26 such as arugula and red beets. NO production can be further magnified by combining these foods with probiotics²⁷

BFR Boosts Vascular Function by Increasing NO

To give you some more details about these strategies, BFR has been shown to improve your vascular function, and one of the ways by which it does this is by increasing NO production. As explained in a 2012 study published in the International Journal of Vascular Medicine:²⁸

“… after several minutes of arterial cuff occlusion at proximal or distal portion in any artery, for example, brachial and popliteal artery, immediate cuff deflation can lead to increase shear stress induced by reactive hyperemia and activate endothelial nitric oxide (NO) synthase (eNOS).

This activation leads to a shear-stress-mediated augmented NO production in endothelial cells … NO bioavailability in the endothelial cell … is an important factor and predictor in protecting against cardiovascular disease.”

The local muscle hypoxia brought on by BFR exercise also significantly increases vascular endothelial growth factor (VEGF), which act like “fertilizer” for your blood vessels. The medical term for this development of new blood vessels is angiogenesis. Angiogenesis, in turn, enhances NO bioavailability.

The following graph illustrates the vascular changes that occur in response to BFR. To learn more about BFR, including how to perform it properly, see “What You Need to Know About Blood Flow Restriction Training.”

Whole Body UVA Irradiation Triggers NO Release

Next up: Sun exposure. It doesn’t get any easier than this, really. All you need to do is expose as much skin as possible to bright sunlight. As always, you’ll want to make sure you don’t stay out too long. Sunburn is counterproductive as it will only harm your skin. Once your skin turns the lightest shade of pink, move into the shade or put on clothing and a hat.

Ultraviolet A (UVA) and the near-infrared light spectrum both increase NO, so you’re getting that benefit from both ends of the light spectrum. As explained in a 2009 paper²⁹ in the journal Circulation Research, when you expose your body to sunlight, photolabile NO derivates such as nitrite and S-nitroso thiols decompose and form vasoactive NO. (Photolabile means the compounds are altered or undergo chemical changes in response to light).

Eat a Nitrate-Rich Diet

Lastly, the dietary component. Dietary nitrates are converted into nitrites by oral bacteria during chewing. Once the nitrites are swallowed and come into contact with stomach acid, they get converted into NO. You can find more in-depth details about this conversion in “Top 9 Reasons to Optimize Your NO Production.” Nitrate-rich foods that can boost your NO level include:^30,31,32

Arugula	Red beets / fermented beets	Rhubarb
Cilantro	Butter leaf lettuce	Spring greens like mesclun mix
Basil	Oak leaf lettuce	Swiss chard

As mentioned, taking a probiotic can optimize the NO production when eating nitrate-rich foods. The reason for this is because gut bacteria are involved in the first step of the NO metabolism chain. Probiotic bacteria such as Lactobacillus reduce nitrate to nitrite, the latter of which becomes a substrate for NO. So, by adding probiotics, you increase the NO substrate, which allows for higher levels of NO to be generated.

Aside from the many benefits already listed, NO has also been shown to improve muscle contractions in your diaphragm, thereby improving breathing. This, beside its antiviral effects, can have a direct benefit for COVID-19.

For the study,³³ researchers split old mice into two groups. (For reference, the mice used in the study were 24 months old, which is equivalent to about 70 years of age in humans.) One group was given drinking water that contained sodium nitrate daily for 14 days. The other group was given plain water.

After the study period, they measured the isometric force and peak power of the diaphragm muscles in the mice and found that both significantly increased in the nitrate group. This increase in force and power translated to improved contraction of the diaphragm muscle, which can then improve lung function and breathing.

The increased power in the diaphragm could also help older people clear their lungs more effectively, which may help reduce the risk of developing infections. Your body’s ability to produce NO declines with age, so it’s important to take steps to increase your NO production as you get older. Respiratory muscle function also declines with age, contributing to breathing troubles, impaired airway clearance and a decreased quality of life.

Since nitrates can improve muscle function of the diaphragm, it may help improve the outlook for older populations with respiratory infections like COVID-19. Dietary nitrates also improve oxygen uptake by dilating the blood vessels and allowing more oxygen to be delivered to muscles, like the diaphragm, and other cells.³⁴

How Molecular Hydrogen Impacts NO Production

In conclusion, I’d like to address the detrimental side of NO, and how this plays into COVID-19. As explained by Tyler W. LeBaron in a recent video lecture featured in “How Molecular Hydrogen Can Help Your Immune System,” most of the destruction wrought by SARS-CoV-2 is through reactive oxygen species (ROS) and systemic inflammation.

And, as mentioned earlier, NO is both a free radical and a signaling molecule. As such, it can have either positive or negative effects, depending on its levels and what else is going on.

ROS are molecules that cause oxidative damage. However, they’re not all bad all the time. Neutrophils that produce ROS also produce NO and superoxide. Superoxide helps kill pathogens, but you also don’t want too much of it, so it needs to be regulated. The same goes for NO.

While NO can inhibit viral replication and boost your immune system, you don’t want too much, because as levels of superoxide and NO rise, they combine and form peroxynitrites, which are extremely damaging. Peroxynitrites in turn form hydroxyl radicals, the most cytotoxic ROS.

Normally, when superoxide has done its job, it’s converted by superoxide dismutase into hydrogen peroxide, which in turn is converted into water and oxygen. This process is regulated by a transcription factor called Nrf2/keap1.

When this transcription factor is activated, it triggers your body’s natural antioxidants such as glutathione and catalase. Nrf2 — which is involved in phase 2 detoxification — regulates more than 200 protective proteins and enzymes. The problem is that when ROS is overabundant and out of control, the Nrf2 system is depleted and can no longer regulate the inflammatory process.

Molecular hydrogen (H₂ gas) has the ability to activate the Nrf2/keap1 pathway, thereby replenishing your endogenous antioxidants. In so doing, H₂ helps regulate and maintain homeostasis in the whole system, preventing the infection from getting out of control and causing cell death.

H₂ can also lower excessive NO and superoxide production by downregulating NOX and NOS enzymes. In a scenario such as COVID-19, this would be good, as when these two molecules are excessively elevated they combine to create the pernicious peroxynitrite molecule.

Considering very high levels of NO appear to be part of the COVID-19 disease process in the later stages, it seems NO inhalation therapy might be best suited in the early stages of infection, not the more advanced stages when inflammation is running wild.

As noted by the Front-Line COVID-19 Critical Care (FLCCC) Alliance,^35,36 peak viral replication takes place at the earliest signs of symptoms, which include cold/flu-like symptoms, loss of taste and smell, myalgia (muscle pain) and general malaise.

At this time, the focus should be on antiviral therapies — which is what NO inhalation therapy, in this case, could be designated as. As symptoms worsen, viral replication actually diminishes automatically, giving way to immune dysregulation, so at this point, NO might cause more problems than it solves.

Nebulized Hydrogen Peroxide — A Highly Effective Home Remedy

While unrelated to NO, I believe one of the most effective treatment options available is nebulized hydrogen peroxide. This is a home remedy I recommend everyone familiarize themselves with, as in many cases it can improve symptoms within mere hours. It is particularly effective in those who are in the later stages of the illness.

Dr. David Brownstein, who has successfully treated over 100 COVID-19 patients with nebulized hydrogen peroxide, published a case paper³⁷ about this treatment in the July 2020 issue of Science, Public Health Policy and The Law. He also discusses its benefits in a recent interview I did with him.

In my April 2020 article, “Could Hydrogen Peroxide Treat Coronavirus?” I reviewed some of the basic science of how hydrogen peroxide works, as well as some of the studies assessing its therapeutic potential. The most relevant study³⁸ was published in March 2020 in the Journal of Hospital Infection. They studied 0.5% hydrogen peroxide, and found it killed human coronaviruses, including the coronaviruses responsible for SARS and MERS.

Nebulized hydrogen peroxide is extremely safe. Brownstein has used it for 25 years with no ill effects being found. It’s also incredibly inexpensive, and you can administer it at home, without a prescription. In my view, it is one of the absolute best therapies for viral infections like SARS-CoV-2 or even worse respiratory viruses that will likely be unleashed in the future.

I strongly recommend buying a desktop nebulizer. It needs to produce a very fine mist, and desktop versions are stronger than handheld battery operated models. The one I use is the Pari Trek S Compressor Aerosol System with a face mask, (sold separately) not with the supplied mouth piece.

It is important to acquire the equipment and peroxide BEFORE you need it, as the sooner you treat the infection the better your results will be, although the testimonials are unbelievably impressive even in late stage illness. It is not necessary to treat yourself preventively, but only if you are sick or exposed to someone who is.

While I’ve been using a 0.1% dilution, Brownstein uses an even lower concentration of just 0.04%. Neither Brownstein nor I recommend using commercial 3% hydrogen peroxide found in most grocery stores, as it has potentially toxic chemical stabilizers in it. For optimal benefits, use food-grade peroxide and dilute it appropriately, using saline.

To dilute 35% food-grade peroxide into a 0.04% solution, first dilute it down to 3% by mixing 1 part peroxide with 10 parts sterile water, then take 3 cubic centimeters (CCs) of that 3% dilution and add it to a 250CC bag of normal saline. This brings it down to a .04% hydrogen peroxide concentration. In the video above, I go over the basics of how to do nebulized peroxide.

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Sure, toppings like tomato sauce, mustard and pesto add flavour. But some could be more troublesome than tasty, according to nutritionist Stephanie Malouf.

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Researchers have discovered a novel antiviral strategy for treatment of COVID-19 using existing metallodrugs.

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Researchers have developed a unique method to predict influenza epidemics by combining several sources of data. The forecasts can be used, for example, when planning healthcare provision, such that resources can be redistributed in the best possible manner and give everyone the best possible care during an epidemic.

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A new set of assessment tools shows promise in capturing how the COVID-19 pandemic affects patterns of criminal activity.

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An injury to the anterior cruciate ligament (ACL) can lead to severe osteoarthritis in both animal and human patients. Now, a new interdisciplinary study on the protein that lubricates our joints says that lubricant may actually be a precursor of joint disease.

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Discussions about immigration are heated, even antagonistic. But what happens when supporters and opponents undertake to show more empathy? A study reveals that people who support immigration are ready and willing to adopt an empathetic approach and a wider perspective. By contrast, when opponents of immigration are asked to engage in perspective taking, they feel more competition with their 'adversary.'

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Genetic mutations that promote the growth of the most common type of adult brain tumors can be accurately detected and monitored in blood samples using an enhanced form of liquid biopsy.

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American women living in states with less restrictive reproductive rights policies are less likely to give birth to low-birth weight babies, according to a new study. The findings show that women, particularly US-born Black women, giving birth in states with less restrictive reproductive rights policies have a seven percent lower low-birth weight risk, compared to women in states with more restrictive policies.

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The most important pathogenicity factors of the gastric pathogen Helicobacter pylori are centrally regulated by a small RNA molecule, NikS. And this was not the only surprise that NikS provided.

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In a fast-paced society where productivity is often prized more than rest and relaxation, sleep has become an undervalued commodity. Yet, as science has found, sleep is necessary for optimal health, and it is one of the foundational pillars on which your longevity rests.¹

After years of research and analysis, scientists have also found there are unique changes that happen in the body during sleep to help protect your brain and overall health. Unfortunately, during the COVID-19 pandemic and subsequent lockdown, the quantity and quality of sleep have been negatively impacted.² Sleep neurologists are calling the resulting sleep disturbances “COVID-Somnia.”³

Neurology Today reports that from February 16 to March 15, 2020, prescriptions for medications used for sleep problems rose 14.8% compared to the same period in 2019.⁴ This was well before the U.S. experienced the first lockdown in California on March 17, 2020.⁵ In other words, anticipation of a potential event raised anxiety levels and made it more difficult for people to sleep.

Experts from the Johns Hopkins Center for Sleep list other factors that have also created a rising challenge with sleep disorders, including disrupted daily schedules, reduced exposure to sun in the mornings, more napping during the day and excessive use of digital media in the evening.

Dr. Rachel Salas, associate professor of neurology at Johns Hopkins, spoke with a reporter from Neurology Today and described the situation:⁶

“All our patients are suffering from shifts in their sleep patterns due to their fears about getting the virus, concerns about loved ones, not being able to go to work, not having social contact with others.

Some of them now meet the diagnostic criteria for chronic insomnia: not being able to fall asleep within 30 minutes more than three times a week for more than three months. They get into bed, the brain kicks in, they start worrying if they're going to lose their job, if their family member is going to survive, and they literally cannot fall asleep.”

In addition to discovering the small things you can do that a big difference in the quality of your sleep, it may also help reduce concerns by learning how you can take control of your health. One of the simplest, most effective and easiest ways to reduce your risk of COVID-19 and the severity of illness is to raise your vitamin D levels, which I discuss in “Vitamin D Cuts Sars-CoV-2 Infection Rate by Half.”

Mattress Coolers Help Challenges With Foam Mattresses

A 2016 study reported in BedTimes Magazine revealed that specialty bedding is purchased by nearly 30% of people, including 16% who buy foam-only mattresses.⁷ CNBC reports there are nearly 175 online companies shipping foam bed-in-a-box mattresses directly to your front door.⁸

CNBC also reports that the International Sleep Products Association survey in 2018 showed that 45% of mattresses purchased that year were online.⁹ Foam mattresses were first introduced in the 1950s but initially had little impact on innerspring mattress sales.¹⁰

By the 1960s the U.S. space program sought to modify the current foam product for the astronauts' seat cushions. The ability of the foam to contour to the body is triggered by body heat. The rising popularity of these mattresses has likely sparked the development of a new product designed to keep sleepers cool at night.

Traditional innerspring mattresses naturally provide good air flow throughout the product and help your body to regulate temperature.¹¹ However, the design of a memory foam mattress reduces air flow as it absorbs heat from your body to trigger the contouring effect that many find more comfortable.¹²

There are a variety of products that attempt to address the concerns of “sleeping hot” on a foam mattress. These include foam mattresses with built-in stretch knit toppers to wick away moisture and keep you cool, and traditional spring mattresses with foam toppers covered in organic cotton.¹³ Other companies have developed separate toppers for memory foam to help absorb moisture and regulate heat.¹⁴

The Importance of Temperature Control at Night

Companies advertise additional benefits to using a topper such as extending the life of your mattress, isolating movements from your partner or pet and providing relief to tired joints. Choices in material, firmness level, size and cost are available. Another option is a water-cooling topper system, which uses a thermal control unit to regulate the temperature of the mattress.¹⁵

Some, like Chris Masterjohn, Ph.D., are satisfied with their cooling mattress.¹⁶ Yet, not all cooling mattresses help all people. If you choose to try one there are a couple of factors you may consider:

Cooling mattresses have likely found a market since memory foam creates heat that may offset the ambient temperature. Cold and heat exposure during sleep influence your sleep quality and therefore your health. Greater amounts of heat can affect the first segment of sleep, making it more difficult to fall asleep naturally, increasing wakefulness and decreasing rapid eye movement.¹⁷

Subjective data from 765,000 people in the U.S. showed that increases in nighttime temperatures increased self-reported nights of insufficient sleep.¹⁸ Other data also indicate that high temperatures affect multiple aspects of sleep, leading to:¹⁹

• Worse sleep duration
• Shallow sleep
• Less sleep calmness
• Difficulty falling asleep
• Lower sleep satisfaction

On the other hand, cold exposure affects the later stages of sleep. In a real life setting experimental design, researchers found there were no differences in observed sleep patterns when people slept in rooms between 55.4 degrees F (13 C) and 73.4 degrees F (23 C).²⁰

When you go to sleep, your core temperature goes down, and as you wake up it rises.²¹ However, this does not affect your peripheral skin temperature, which plays a role in maintaining your core temperature by adjusting blood flow to your skin.

Your core and peripheral skin temperatures are influenced by your sleep environment, including your clothing, ambient room temperature and the number of blankets used. Increasing your skin temperature just 0.72 degrees F (0.4 degrees Celsius) can suppress nighttime wakefulness and shift your sleep into deeper stages.²²

Weighted Blankets May Also Improve Sleep Quality

Both the quality and quantity of sleep are important to your health. Experts recommend sleeping at least seven hours each night on a regular basis.²³ A second option to help improve sleep quality is using weighted blankets.

According to one study, Swedish researchers found that people with psychiatric disorders who also had insomnia reported better sleep and less daytime sleepiness when they used a weighted blanket.²⁴

The authors of the study engaged 120 people who were randomized into one of two groups who either used a weighted chain blanket or a light plastic chain blanket for four weeks. They concluded that the weighted blanket was an:²⁵

“… effective and safe intervention for insomnia in patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, or attention deficit hyperactivity disorder, also improving daytime symptoms and levels of anxiety.”

Weighted blankets work by applying deep pressure stimulation that lowers neurological arousal. They reduce activity in the sympathetic nervous system, while at the same time increasing activation of the parasympathetic nervous system.

This lowers your heart rate and blood pressure and induces a feeling of relaxation and calm.²⁶ Additionally, weighted blankets help release serotonin that regulates sleep and oxytocin that helps reduce pain and stress.²⁷

The authors of one study published in 2015 in the Journal of Sleep Medicine and Disorders engaged 33 participants who had complaints of chronic insomnia.²⁸ The study lasted four weeks and the participants acted as their own control group, with the researchers taking a baseline pretest and posttest measurements.

The researchers found the blankets were “effective at improving sleep quality in recognized insomniacs, both in parameters measured objectively and subjectively.” In a separate study, scientists enrolled children with attention-deficit hyperactivity disorder and measured objective and subjective parameters.²⁹

They discovered that “ball” blankets improved the time it took the children to fall asleep and the number of times they woke up during the night; the blankets also reduced the number of nights it took the child more than 30 minutes to fall asleep from 19% to zero. Dr. Cristina Cusin, an assistant professor of psychiatry at Harvard Medical School, spoke with a reporter from Harvard Health Publishing, saying:³⁰

"Weighted blankets have been around for a long time, especially for kids with autism or behavioral disturbances. It is one of the sensory tools commonly used in psychiatric units."

Surprising Benefits to Sleeping Naked

Evidence suggests that ditching your sleepwear may have several benefits. Many of the health benefits come from preventing overheating from sleeping in a home that may be too warm.

Another benefit includes activating your body's brown fat. This is a type of fat that helps regulate temperature by generating heat. People with higher levels of brown fat have faster resting metabolisms, better blood sugar control and higher insulin sensitivity.^31,32

Researchers found that sleeping in a chilled room doubled the amount of brown fat in participants.³³ When your body is cooler at night it also helps reduce the production of cortisol, also known as the “stress hormone.”³⁴ This can help reduce anxiety and stress, as well as improve sleep quality.

Quality Sleep Protects Brain Health and More

It’s important to pay attention to some of the small changes you make in your sleep routine since it can pay big rewards in your overall health. For example, researchers at the University of Rochester Medical Center believe they discovered a clue as to why sleep is mandatory, especially for good brain health.³⁵

During deep sleep, your brain uses a unique method to remove toxic waste, including harmful proteins that are linked to neurodegenerative disorders such as Alzheimer's disease. They also discovered the space between cells increases by 60% in deep sleep to allow for more efficient waste removal.³⁶

The lead author of the article said, “In fact, the restorative nature of sleep appears to be the result of the active clearance of the by-products of neural activity that accumulate during wakefulness.”³⁷ To take advantage of these unique and vital functions during sleep, consider the tips I share in “The Many Health Benefits of Sleeping Naked.”

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The COVID-19 pandemic prompted shortages in food and supplies that haven't been seen since the Depression era. It also shifted, practically overnight, trends in consumer buying behaviors, turning previously mundane items into hot commodities.

Toilet paper, cleaning supplies and nonperishable foods flew off store shelves in the pandemic's early days while, in the weeks and months that followed, disruptions in manufacturing and the supply chain contributed to shortages among lumber, appliances, aluminum cans, meat and even coins.¹

Supplies of some of these items, like toilet paper, have rebounded in many parts of the world, but other staples, like hand soap, can still be hard to come by. It remains to be seen whether a "second wave" of COVID-19 will hit in the coming months, prompting additional lockdowns.

However, in the U.S., the government appears to be preparing citizens for the worst, even though indicators that track COVID-19-like illness and the percentage of laboratory tests that are positive for SARS-CoV-2 — the virus that causes COVID-19 — have decreased nationally since mid-July, according to data from the U.S. Centers for Disease Control and Prevention (CDC).²

Dr. Anthony Fauci, who has served as the director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, also stated that Americans shouldn't expect to return to normal anytime soon, even if a fast-tracked COVID-19 vaccine is released. "If you're talking about getting back to a degree of normality which resembles where we were prior to COVID, it's going to be well into 2021, maybe even towards the end of 2021," he said in a news release.³

With that in mind, it's always a good idea to be prepared in the event you find yourself quarantined, isolated or living in an area with strict lockdowns in place that trigger another round of panic buying.

Following are some of the most important items to stock up on now, but first it's important to understand the psychological reasons why lockdowns may contribute to panic buying and increased hoarding — even when it's not necessary.

Perceptions of Scarcity Trigger Panic Buying

In a letter to the editor of the journal Psychiatry Research, researchers noted that public health emergencies have prompted panic buying, or increased buying behaviors, since ancient times.⁴ There are some psychological explanations, including the fact that a perception of scarcity is linked with panic buying and hoarding, along with feelings of insecurity that trigger people's desire to collect things.

At the same time, a pandemic can contribute to the perception that you're losing control over your environment, and along with it induce fear and anxiety. When you feel you can't control the pandemic, the ability to control your purchases and collect necessities may help bring back a sense of control.

Meanwhile, the stockpiling of goods may be perceived as a method of preparing for and coping with pandemics, and when people see others in their community panic buying, "people tend to indulge to buy madly," they wrote, adding that it may be a form of herd instinct.

That being said, it's often the case that people overestimate the risk of danger and underestimate the options for relief, and this lack of trust and belief that resources could be exhausted also triggers panic buying. Importantly, sensationalized movies, media reports and fear-mongering also contribute to unnecessary panic, which is why sometimes turning off the news is your best recourse for staying sane:⁵

"Sometimes people get threatening perception from the media reports that people are buying more excessively than before; there is a possibility of a global crisis. Sometimes, the media reports the crisis in a sensational way which raises more panic. Another important factor is the way the viruses or any pandemic has been portrayed in the movies. People tend to learn from them and try to imitate whenever they are faced with pandemics."

Stock Up on These Eight Items First

The items that follow are important for health and hygiene. Some of them quickly became in short supply when the recent lockdowns were imposed, while others may help you stay well and avoid infectious diseases. All of them can also be stored for longer periods, making them ideal staples during a lockdown.

Get Prepared, Not Panicked

Panic is contagious, which means the more panic buying that ensues, the more shortages are likely to continue. In addition to the list above, a number of additional products have also faced shortages, including things you wouldn't expect, like mushrooms, carbon dioxide (such as that used in seltzer water and beer) and yeast.²⁹

Other items have also been placed in high demand due to changing lifestyles, which are more focused on the home. Home exercise equipment, board games, sewing machines and bicycles are examples of items that you may want to purchase sooner rather than later if you're at all in the market.

The key to remember, however, is to avoid buying into the panic and instead stay sensible. Get prepared and stock up on the things you'll use and that promote your health and well-being, but avoid purchasing products solely out of fear or the perception of scarcity.

One of my most important foods are grass fed bison and lamb. Since the shortages in the spring I now keep a four- to six-month supply in my freezer as a contingency plan for whatever craziness is fostered in the next "plandemic."

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