Health & Fitness

In the featured video, “Breaking Points” cohosts Krystal Ball and Saagar Enjeti discuss one of the greatest threats currently facing the people of the world, namely food shortages and skyrocketing food prices.

According to a recent NPR report,¹ the global food price index hit its highest recorded level in March 2022, rising 12.6% in a single month.² On average, food prices were one-third higher than in March 2021. In the U.S., food prices rose 9% in 2021, and are predicted to rise another 4.5% to 5% in the next 12 months.³

But while the Ukraine conflict is cited as the primary cause, it’s not the sole reason. Price inflation was already ramping up well before Russia went into Ukraine, thanks to the uncontrolled printing of fiat currencies that occurred in response to the COVID pandemic. Governments’ COVID response have also wreaked havoc with global supply chains, causing disruptions that continue to this day.

The climate has also been uncooperative, causing poor harvests around the world. China, for example, has reported it expects the lowest harvest yields in history this year, thanks to serious flooding of its farmland in the fall of 2021.⁴

Compounding Crises Threaten Global Food Productivity

That said, the Russia-Ukraine conflict is certainly making a bad problem worse. Ukraine is known as “the bread basket” of Europe, responsible for producing and exporting 12% of all food calories traded on the international market. Russia is also a major exporter of food, and together with Ukraine, the two countries account for nearly 30% of global wheat exports, nearly 20% of the world’s corn and more than 80% of the sunflower oil.⁵

According to the U.S. Department of Agriculture’s projections, wheat exports from Russia and Ukraine will be reduced by more than 7 million metric tons in 2022. At the same time, the Ukrainian government has decided to ban all export of wheat, oats, millet, buckwheat and cattle, to ensure food safety for its own people, while Russia has banned exports of fertilizer.⁶

As reported by Wired, the current food crisis in Ukraine is made up of several components, and the effects will have a worldwide rippling effect, thanks to our dependency on global trade:⁷

“Goods that have already been harvested — last autumn’s corn, for instance — can’t be transported out of the country; ports and shipping routes are closed down, and international trading companies have ceased operations for safety. (Plus, while those crops sit in bins, destruction of the country’s power grid takes out the temperature controls and ventilation that keep them from spoiling.)

This year’s wheat, which will be ready in July, can’t be harvested if there’s no fuel for combines and no labor to run them. Farmers are struggling over whether to plant for next season — if they can even obtain seeds and fertilizer, for which supplies look uncertain ...

Analysts worry that the countries that buy the most wheat from Ukraine — predominantly in Africa and the Middle East — will have the hardest time paying as prices rise.”

Scott Irwin, an agricultural economist and professor in the College of Agricultural, Consumer and Environmental Sciences at the University of Illinois told Wired magazine:⁸

“This crisis is beyond the normal ability to shuffle supplies around. We’ve exploded that system, and the cost is going to be extreme economic pain.”

Serious Fertilizer Shortage Looms

Together, Russia and Belarus provide nearly 40% of the global exports of potash, a key fertilizer ingredient. Russia also exports 48% of the global ammonium nitrate, and combined with Ukraine, they export 28% of nitrogen, phosphorous and potassium fertilizers.⁹

Experts are now predicting fertilizer prices may double as a result of Russia’s ban on fertilizer exports. For some farmers, that will be a death knell that causes them to go out of business. The rest will be forced to charge more for their commodities, resulting in skyrocketing food prices.

Biodynamic Solutions

Are there any solutions to this pressing dilemma? I would argue that there are, but it’ll require rapid response and adaptation from farmers everywhere. As explained in “Kiss the Ground,” a documentary about biodynamic farming, a beautiful harmony exists within nature, and we can benefit by tapping into that natural system with biodynamic practices rather than working against it.

As noted in the film, a preview of which is included above, “Biodynamic farming is simply farming in service of life.” While it requires a leap of faith to make the transition, the results speak for themselves. Biodiversity improves rapidly on farms that make the transition, and the quality of the food (and the quality of life of the farmer) is greatly augmented.

Biodynamic agriculture builds upon the foundation of organic farming. That means zero pesticides and synthetic fertilizers are used. But biodynamic then goes a step further. The goal is to make the land better than it was before. It doesn’t just stop the destruction of soil, but actually regenerates it.

The farm as a whole is basically viewed as one organism, where each part of the farm supports the rest. Livestock have their role, as do microorganisms and beneficial insects. Rather than working against you, they’re now working for you to improve the fertility of the soil and the quality of the food grown in it.

Biodynamic farming is really about being a part of nature and working with it rather than trying to conquer nature through unnatural and ultimately destructive means.

Biodynamic farming can also, over time, help stabilize the climate. Not only do biodynamic farmers not pollute the air, water or soil in the first place, but the plants also pull carbon from the air, depositing it back into the soil where it does the most good, and requires far less watering. Regenerative practices also prevent the loss of topsoil and increase rainfall.

For example, regenerative ranchers in Northern Mexico, in the Chihuahuan Desert, who have added 1 million acres of rotational grazing, report getting 15% to 20% more rainfall than their neighbors who haven’t regenerated their land.

Support Biodynamic Farming

Many of the food products we sell under the Mercola brand are produced by Demeter certified biodynamic farmers in eight countries. Demeter is the oldest ecological certification in the world. Most recently, we’ve initiated the first-ever standards for Demeter Certified Biodynamic supplements as well.¹⁰

We also fund the Billion Agave Project, initiated by Regeneration International on a regenerative farm in Mexico run by the Organic Consumers Association. It’s a fantastic solution that solves several problems at once.

This project is a game-changing ecosystem-regeneration and reforestation strategy that uses a combination of agave plants and mesquite (a nitrogen-fixing companion tree), to salvage and regenerate degraded semi-arid lands that aren’t suitable for other crops.

Forty percent of the world is arid or semi-arid and in danger of becoming desert where nothing will grow. But we can reverse this process using native plants and permaculture techniques such as this one.

By taking a limb from a healthy mesquite tree, adding some natural hormones and wrapping the branch with a bag filled with compost, you will, after three to four months, have a small tree ready for planting as new roots grow into the compost-filled bag. At that point, you can either plant it into a container or directly into the soil.

This process is known as “air layering.” A 1-year-old mesquite tree grown in this way will be as big as a 7-year-old mesquite tree grown from seed, significantly speeding up the reforestation effort. The roots of the mesquite tree can burrow hundreds of feet down in search of water, and they in turn provide nutrition for other plants, as they exchange liquid carbon from the tree for the nutrients from the soil.

In this way, the mesquite supports the growth of the agave without need for chemical fertilizers, and the agave can then be used to produce a fermented nutrition-rich biomass that supports grazing livestock that otherwise might not have enough to eat.

A Way to Support Grazing Cattle on Semi-Arid Lands

Agave is best known for producing tequila, but a local farmer in Mexico discovered he could use the massive leaves, which are typically discarded as junk, to produce a nutrient-rich livestock feed. Cows, sheep, goats, pigs, chickens and even sheepdogs enjoy it.

The feed is produced by finely chopping up the leaves, each of which can weigh 40 to 80 pounds, and then fermenting them in a closed container. To this fermented mash, you can then add mesquite pods at a ratio of 80% to 90% agave leaf and 10% to 20% mesquite pods. This mix is superior to alfalfa in terms of nutrition, but costs only a third or a quarter of the price.

A big part of the cost-savings is from the reduced water consumption. Alfalfa needs about 26 times more water than agave and mesquite. Most of the animals on the farm eat the natural vegetation and get the agave mash as a supplement.

However, by adding garbanzo beans — another low-water crop — you could produce a feed that the animals could live on exclusively. Considering some areas are now considering culling their livestock herds due to a shortage in cattle feed,¹¹ this could be a novel solution in some instances.

New Market Opportunities

Changing the farming subsidies to prioritize regenerative farming would go a long way to changing the status quo, but private investing is another route to success that is now coming to the fore.

There's a new type of asset being developed on the stock exchange called Natural Asset Stocks, or Natural Asset Corporations. The government of Costa Rica, for example, is putting all government-owned forests and farmlands into a Natural Asset Corporation.

This is a type of stock different from anything we've seen so far. Basically, these stocks will allow fund managers, private investors and corporations to invest in natural assets. The part you end up owning is the ecosystem services of that land.

So, for example, you could own the environmental services resulting from the Billion Agave Project, which include carbon sequestration amounts and water savings. Over time, as the whole system matures and the soils are regenerated, your asset rises in value.

This new asset system will allow Wall Street to divert financial assets into ecosystem assets that benefit the planet in a multitude of ways, and still get a return on their money.

The Organic Consumers Association has also developed a system of verification to go along with this new asset system. Using modern technology, it will be able to accurately measure things like the number and size of plants and the health of the soil.

They’re also using a blockchain accounting system to verify the calculations and make it very difficult to cheat. So, anyone who invests in a natural asset will be able to verify, several years down the road, at a very low cost, whether the asset has improved or degenerated.

Regenerative Farming Could Save the World

A number of people have pushed regenerative farming for decades, warning that the current chemical-dependent monoculture is unsustainable in the long run, and subject to geopolitical disruptions. We’re seeing the reality of those warnings right now.

Had heed been taken sooner, we wouldn’t be in such a precarious position right now. But hindsight is 20/20, and I believe many farmers will now be forced to make the tough choice to make the conversion to biodynamic if they want to survive in the long term.

Their transition is not going to bring immediate help to the global population, as it takes a number of years to turn depleted soils into soils that can support food production without chemical inputs. But we have to start thinking in the longer term if any of us are to survive.

As a nonfarmer, you can support this effort by buying food from regenerative and biodynamic farmers. Regenerative International, incorporated in 2014, has built a global network of regenerative farmers and ranchers, with some 400 affiliates in 60 countries.

You can find a map of these regenerative farms on RegenerationInternational.org. Of course, you can also implement regenerative strategies in your own garden, even if it’s a small one. The future does look bleak at the moment, with food shortages and skyrocketing prices appearing inevitable, but doing nothing is not the answer. We must all start thinking ahead and make wiser choices.

The globalization of food production has led us to the brink of disaster. The answer is to return to locally grown foods. Similarly, our reliance on chemical-dependent monocultures has just been proven to be a weak link that needs to be replaced by regenerative methods that don’t need chemicals to thrive. We have the answers to the problem. We just need to implement them, as rapidly as possible.

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Dietary fats are essential to your good health. However, like everything else, you can eat too much of some or not enough of others. When this happens, your body does not work effectively. Research from Harvard Medical School’s Beth Israel Deaconess Medical Center in Boston demonstrated omega-3 fat could reduce tumor growth by 67%.¹

Your body uses fat to keep your skin and hair healthy, absorb certain vitamins,² temperature control,³ and for an essential role in neurological health.⁴ The most dangerous type of fat is trans-fat, which is commonly found in baked goods and processed foods.⁵

During processing, certain healthy oils can be turned into solids using a process called hydrogenation. This extends the shelf life and creates trans fats in the process. There are no health benefits, and it is not safe to eat any of them. On the other hand, polyunsaturated fats are essential, which means your body needs this type of fat but cannot manufacture it, so you must get it in food.

The two main types are omega-3 and omega-6 fatty acids. The number identifies where the first carbon-carbon double bond appears.⁶ Both fats may be essential, but it's vital to get them in the right ratio to reduce the risk of a chronic inflammatory response.

Omega-6 fats are found in high concentrations in processed foods, corn oil, sunflower oil and safflower oil.^7,8 The optimal ratio of omega-3 to omega-6 fats is 1-to-4 or lower.⁹ Unfortunately, the typical Western diet has a ratio of 1-to-16.¹⁰

Many people are becoming more aware of the importance of omega-3 fats to their overall health. Yet, they may still be unsure of how much is needed to achieve or maintain optimal levels. Adjusting your ratio may help reduce your risk of many chronic diseases that are so prevalent in Western Society.

Excessive intake of omega-6 fats nearly tripled in the last 100 years with the introduction of vegetable oil.¹¹ Researchers have now found that integrating omega-3 fat into the diet and reducing omega-6 could have a significant impact on the prevention and treatment of cancer.¹²

Omega-3 Fatty Acids Help Fight Cancer

The research¹³ was presented April 4, 2022 at the annual Experimental Biology meeting in Philadelphia.¹⁴ The animal model showed that omega-3 fatty acids helped promote the cancer-fighting activities of immunotherapy and anti-inflammatory therapy.

Immunotherapy is a type of biological treatment that prompts the immune system to attack cancer cells.¹⁵ Biological therapies use compounds from living organisms. Several types of immunotherapies help promote the immune system's response, including monoclonal antibodies which are used in the treatment of COVID-19.¹⁶

The scientists sought to determine the impact of what a cancer patient eats on antitumor activity after treatment with immunotherapy or an anti-inflammatory therapy designed to inhibit the enzyme soluble epoxide hydroxylase.¹⁷ As of the time of the study, immunotherapy was approved for use in the treatment of cancer, but anti-inflammatory therapy was still under clinical investigation.

The researchers used an animal model to produce primary and metastatic malignancies. The animals were first fed one of three diets for 10 days before tumor injection and the remainder of the study period. One group received a standard diet, one a diet high in omega-3 and the third group a diet high in omega-6. One week after tumors were injected, each group was split into four different intervention groups.

The groups were either given no treatment, immunotherapy, anti-inflammatory therapy or both therapies simultaneously. The researchers evaluated the response of the tumors to diet supplementation in addition to the cancer treatment. What they found was that omega-3 fatty acids helped block tumor growth in the three treatment groups of mice.

The mice receiving the high omega-3 diet and both cancer treatments showed a reduction of 67% growth when compared to the group of mice eating a normal diet and receiving no treatment.¹⁸ By comparison, cancer cell growth increased in the mice who ate the high omega-6 diet and were given immunotherapy.

The researchers believe the results indicated there could be synergistic activity between omega-3 fatty acids and immunotherapy and anti-inflammatory therapy for cancer. The research is being presented by Abigail Kelly from Harvard Medical School Beth Israel Deaconess Medical Center. She commented on the results in a press release, saying:¹⁹

“We demonstrated, for the first time, that the combination of immunotherapy and anti-inflammatory treatment (sEHi) was more effective when mice were fed diets enriched with omega-3 fatty acids. This is very promising because dietary supplementation is easy to implement for cancer patients and can be added for patients already on immunotherapy.”

Abundance of Omega-6 Fatty Acids Promotes Cancer

The data on omega-6 and omega-3 in the scientific literature is not new. In fact, research showing omega-6 fats promote malignant growth dates to the 1990s.²⁰ And yet, many people are unaware that the imbalance of omega-3 and omega-6 fats in their diet may be increasing their risk of developing cancer.

Data in 2008 revealed that omega-6 fatty acids in combination with heterocyclic amines (HA), produced when meat and fish are cooked, increased the likelihood of breast cancer in post-menopausal women.²¹ The amount of HA was not associated with the potential risk in this cohort. Rather, it was the combination of HA and omega-6 that increased the potential risk of a diagnosis of breast cancer.

Another paper published in 2012 discussed the results of studies that also found a link between omega-6 and breast cancer.²² Data also show higher intake of omega-6 can increase the risk of prostate cancer and a low ratio of omega-6 to omega-3 can improve the effectiveness of treatment.²³

Omega-6 fatty acid metabolites also promote angiogenesis in malignant tumors by increasing growth factor expression.²⁴ Data have demonstrated there is a relationship between omega-6 consumption and the progression of certain types of cancer growths, such as breast, prostate, lung, colorectal and neuroblastoma.²⁵

Combination of D and Omega-3 Helps Prevent Autoimmune Disease

Vitamin D and omega-3 have several things in common,²⁶ not the least of which is that they play important roles in cardiovascular health and most who are deficient in one are also deficient in the other. This sparked the VITAL study,²⁷ which is an ongoing study in which researchers are studying the effect of these dietary supplements on the risk of cardiovascular disease or cancer in 25,871 men and women.

The combination deficiency also has a negative effect on your immune health. One study²⁸ published in the BMJ has suggested that supplementing with vitamin D and omega-3 could lower your risk of developing an autoimmune disease, such as psoriasis, thyroid diseases and rheumatoid arthritis as you get older. The researchers from Brigham and Women's Hospital and Harvard Medical School used data from the VITAL trial.

They followed the participants for more than five years and compared supplementation against self-reported autoimmune diseases diagnosed during the study period. They wrote:²⁹

“Vitamin D supplementation for five years, with or without omega-3 fatty acids, reduced autoimmune disease by 22%, while omega-3 fatty acid supplementation with or without vitamin D reduced the autoimmune disease rate by 15% (not statistically significant)."

However, participants who took both an omega-3 supplement, and vitamin D decreased their risk of autoimmune disease by 30%. Further, when participants took the supplements for at least two years, the risk decreased even more to 39%.

Study author Dr. Karen Costenbader, lupus program director at Brigham and Women’s Hospital, explained that the findings are so powerful, she can now answer one of her patients’ most common questions — “Which vitamins or supplements do you recommend?” She said:³⁰

“Now, when my patients, colleagues, or friends ask me, I can point to our research findings, which suggest that for women age 55 years and older, and men 50 years and older, marine omega-3 fatty acids (fish oil) 1000 mg a day, and vitamin D 2000 IU a day — the doses used in VITAL — lead to a 22% reduction in all autoimmune diseases with vitamin D, and a 15% reduction in the same with fish oil supplementation over 5.3 years of randomized follow-up.

In the trial, these supplements were prescription grade and underwent rigorous quality testing. They were safe and well tolerated and no increase in adverse events was found.”

Omega-3 Level Effects Infection Rate

The name of the infection on everyone’s lips for the last two years has been COVID-19. Yet, colds, flu and gastrointestinal viral infections have not disappeared. Research also indicates that optimal levels of omega-3 fatty acids may have a protective effect on viral illness. Since it may still be top of mind, let’s start with how omega-3 fatty acid levels have helped improve COVID-19 outcomes.

A study³¹ published in January 2021, analyzed the omega-3 index in 100 individuals and compared that against their COVID-19 outcomes. The patients were admitted to Cedar Sinai Medical Center starting March 1, 2020, with a confirmed case of COVID-19. Blood samples were drawn and stored within 10 days of diagnosis.

The primary outcome measurement was death, and the risk was analyzed as a measure of quartiles. When they analyzed the overall data, the researchers found that older individuals and those admitted with a “do not resuscitate” order had a higher likelihood of dying. Blood samples were then separated from the highest to the lowest quartile.

Researchers found there was only one death in the group with an omega-3 index that measured 5.7% or greater. He was a 66-year-old man admitted with a do not resuscitate order. In the other 3 quartiles, a total of 17% of the patient's died. The blood samples also confirmed past results that had demonstrated the average person in the U.S. has an omega-3 index near 5%.³²

Several other studies also confirmed these results, showing individuals with adequate levels of omega-3 had better outcomes from COVID-19.^33,34 Research before 2020 also showed that omega-3 has an impact on viral infections, including influenza³⁵ and bacterial infections associated with COPD.³⁶

Omega-3 Also Helps Heart Health

Several epidemiological and clinical trials have demonstrated that omega-3 fatty acids play a role in the risk of cardiovascular disease. Those with risk factors associated with coronary heart disease benefit from omega-3 fats.³⁷ Supplementation may also reduce heart and all-cause mortality.

In one study³⁸ of 84,688 nurses who were followed over 16 years, researchers analyzed their omega-3 intake and compared the health outcomes of those who rarely ate fish (less than once per month) to those who ate the greatest amount (five or more times each week). They found that those with the highest intake had the lowest risk of coronary heart disease.

Another group of scientists³⁹ used a medication described as a "highly purified eicosapentaenoic acid ethyl ester" that is "a synthetic derivative of omega-3 fatty acid."⁴⁰ They found that those taking the medication experienced a significantly lower number of ischemic events than those taking a placebo, including those taking statin medications. The researchers concluded:⁴¹

"Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic events, including cardiovascular death, was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo."

Choose Krill Oil Over Fish Oil for Omega-3

The best way to know if you need to supplement with omega-3 is to test your level. The omega-3 index measures the amount of omega-3 on your red blood cells as a reflection of the amount found in the rest of your body. Before the test was developed in 2004, an assay was not available.

Since the lifespan of a red blood cell is about 120 days,⁴² the test measures an average of your omega-3 intake and isn't influenced by a recent meal that was high in omega 3. The test has been used to evaluate data from several studies, including the Framingham Study⁴³ and the Women's Health Initiative.⁴⁴

The index is expressed as a percent of all fatty acids in the red blood cell membrane.⁴⁵ Data from studies Harris performed showed the healthy range of omega-3 is from 8% to 12%.⁴⁶ One study showed that a low index is just as powerful a predictor of early death as smoking.⁴⁷

The best omega-3 supplement is from an animal-based source. Krill oil and fish oil provide both eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Krill is sustainable and resistant to oxidative damage since it also contains astaxanthin. Fish oil has a greater potential for contamination and has a higher risk of oxidative damage that can occur during processing and after you open the bottle.⁴⁸

In an analysis of fish oil available over the counter in Canada, researchers analyzed 171 supplements from 49 brands.⁴⁹ They found 50% of the samples exceeded one measurement of oxidation and 39% exceeded what is considered safe by international standards.

In addition to a lower rate of contamination, krill oil is far more potent than fish oil. In one study,⁵⁰ participants who took krill oil required only 62.8% of the amount of those taking fish oil to achieve the same results.

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This article was previously published September 12, 2019, and has been updated with new information.

Benign paroxysmal positional vertigo (BPPV) is one of the most common forms of peripheral vertigo, meaning it stems from a problem in your inner ear, and not your brain,^1,2 BPPV refers to a condition in which calcium carbonate crystal deposits in the labyrinth of your inner ear become dislodged and end up in your ear canal.

While your outer ear canal, eardrum and middle ear are involved in the transmission and interpretation of sound, your inner ear is not directly involved in hearing. Instead, the organs in your inner ear act as a gyroscope that informs your brain about your body's position in space and coordinates with your brain to balance your body as you move.³

The crystals disrupt the flow of the fluids, thereby confusing your balance organs, resulting in vertigo — the feeling of movement or spinning even though you're stationary. As reported by Medical News Today:⁴

"Moving the head can trigger vertigo because the solid crystals respond to gravity. The following head positions and movements can trigger vertigo in people who have BPPV:

In severe cases, it may be difficult to maintain your balance sufficiently to carry out everyday tasks. It can also be accompanied by other nausea, vomiting, abnormal eye movements, headache, sweating, tinnitus, double vision and/or lack of coordination.

Other Causes of Vertigo

Aside from BPPV, which results when crystal deposits are misplaced, peripheral vertigo⁵ can also be triggered by an abnormal production of fluid inside your inner ear, causing pressure to build. This is known as Meniere's disease.⁶

Inflammation (often caused by a viral infection⁷) in the labyrinth of your inner ear⁸ (labyrinthitis) is another possibility that can cause vertigo. In this case, since the labyrinth contains both balance and hearing organs, your hearing will be affected as well.

Similar to labyrinthitis, vestibular neuritis refers to an inner ear infection, in this case affecting the nerves connecting your inner ear and brain, thereby disrupting the normal flow of sensory information.⁹

Another less common cause of peripheral vertigo is acoustic neuritis, which is when a nonmalignant tumor grows in the cranial nerve of your inner ear. As the tumor grows, it pushes against adjacent nerves, causing vertigo, hearing loss, headaches and facial numbness.

Anxiety and stress can also trigger vertigo, as the vestibular system (responsible for sensing your position in space) also interacts with brain areas involved in anxiety.¹⁰

Vertigo can also be caused by damage to your central nervous system (CNS, which includes your brain and spinal cord), which is known as central vertigo. Your CNS is responsible for controlling muscle movement and transmission of sensory stimuli to your brain. In central vertigo, damage or dysfunction in your cerebellum, the balance center of your brain, tends to be at play.¹¹

Common underlying causes for central vertigo include concussion or traumatic brain injury,¹² stroke,¹³ multiple sclerosis, vestibular migraine,¹⁴ and tumors affecting your brain and/or spinal cord.

BPPV Diagnostic Tests

Most cases of BPPV-related vertigo will spontaneously resolve in a short amount of time, but if the problem persists for days or is chronic, seek help from your primary care physician. Tests that can help diagnose BPPV include:¹⁵

• Dix-Hallpike test — While lying on your back, your doctor will rotate your head. If you have BPPV, this will induce vertigo.
• Electronystagmography — This test involves observing your eye movements under various conditions, such as while moving your head or looking into a bright light.
• Electroencephalogram — EEG measures your brain activity, and could be used to rule out a more serious neurological condition.
• MRI — An MRI scan may also be used to examine your head and ears to rule out a more serious condition.

If a doctor diagnoses you with BPPV, he or she may recommend physical therapy to shift the crystal deposits in your inner ear into a location that won't affect your balance.

There are several different particle repositioning procedures that can accomplish this, including the Epley, Foster, Semont and Brandt-Daroff maneuvers.¹⁶ If you suspect you have BPPV, you can also try these at home to achieve relief.

How to Perform the Epley Maneuver for BPPV Treatment

In this video, Dr. Christopher Chang explains how to perform the Epley maneuver, and how it works to resolve BPPV-related vertigo. A summary is as follows:

• Lie on your back with a pillow under your shoulder blades, such that your head leans backward 25 to 30 degrees. Tilt your head 45 degrees toward whichever side is causing the vertigo. Stay in this position until the vertigo stops, typically around 30 to 60 seconds
• Shift your head halfway to the opposite side (90 degrees) without raising it. Wait another 30 to 60 seconds
• Next, shift your body over to the side so that you're looking downward, toward the floor, with your head turned 45 degrees from the horizontal. Wait 30 to 60 seconds
• Slowly sit up. Avoid standing until or unless the vertigo has resolved

A study¹⁷ in the June 2019 issue of Therapeutics and Clinical Risk Management looked at data from 359 patients treated at a Chinese clinic. The two maneuvers primarily used were the Epley maneuver and the "barbecue roll."

The most common cause for BPPV involved the posterior semicircular canal (73.5%), followed by the horizontal semicircular canal (22.5%) and multicanal involvement (3.3%). Particle repositioning maneuvers resolved 95.8% of posterior semicircular canal cases, 100% of horizontal semicircular canal and 75% of multicanal cases.

How to Perform the Foster Maneuver

Some find the Foster Half Somersault maneuver easier to perform, as you don't have to lie in bed. In the video above, Chang explains how to do it. Here's a summary:

• Kneeling on all fours, raise your head and look at the ceiling for a few seconds
• Tuck your chin toward your knees, allowing the top of your head to rest on the floor. Wait for the vertigo to stop, typically about 30 to 60 seconds
• Turn your head about 45 degrees toward the side causing the vertigo. Wait 30 to 60 seconds
• Keeping your head turned at a 45-degree angle, quickly raise up on all fours so that your head is level with your back (tabletop position. Wait 30 to 60 seconds
• With your head still angled at 45 degrees toward the affected side, quickly sit up. If needed, repeat the sequence after resting for 15 minutes

You can also find instructions for another, similar particle repositioning procedure, accompanied by drawings showing the body position, on the Cleveland Clinic's website.¹⁸

Other Treatment Alternatives for BPPV

BPPV that is unresponsive to repositioning maneuvers may be treated with the drug betahistine. According to The International Tinnitus Journal,¹⁹ betahistine "provides short term relief for acute symptoms associated with BPPV by improving the microcirculation in the labyrinth …"

An all-natural alternative is to take ginkgo biloba. This Chinese herb is commonly used to treat vertigo as it helps regulate blood flow to your brain. According to one study,²⁰ ginkgo biloba is just as effective as betahistine.

Ginger-partitioned moxibustion, which would necessitate a visit to a qualified acupuncturist, is another alternative. It involves placing a thin slice of raw ginger on the skin (at the appropriate acupuncture point location) and then placing a burning piece of moxa on top.

In one study,²¹ ginger-partitioned moxibustion at the acupuncture point known as Tinggong (SI 19) was found to more effectively improve vertigo than particle repositioning procedures alone.

Conventional Treatments for Other Forms of Vertigo

If an inner ear infection is at fault, treatment will need to address the infection. Since most inner ear infections are caused by viruses and not bacteria, antibiotics are typically not recommended, as they do not work on viruses. A number of natural remedies may be helpful, however, such as garlic, coconut oil or onion. For vertigo related to traumatic brain injury, you would need to look at concussion treatment.

Naturally, in cases where your vertigo is caused by a more serious chronic disease, such as MS or tumors, the treatment will need to address those conditions as well. Ditto for anxiety and/or stress-related vertigo, in which case cognitive-behavioral therapy can be helpful.²²

If your vertigo is caused by a vestibular or balance disorder originating in your CNS, vestibular rehabilitation therapy may be recommended. As explained by Vestibular.org:²³

"[A]fter vestibular system damage, people can feel better and function can return through compensation. This occurs because the brain learns to use other senses (vision and somatosensory, i.e. body sense) to substitute for the deficient vestibular system …

For many, compensation occurs naturally over time, but for people whose symptoms do not reduce and who continue to have difficulty returning to daily activities, VRT can help with recovery by promoting compensation."

Other At-Home Treatment Alternatives for Vertigo

Aside from the repositioning maneuvers discussed above, other at-home treatment strategies may offer relief from temporary or sporadic vertigo include the following:

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Allegedly, some countries aren’t playing ball.

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In an international phase 1--2 clinical trial of patients with immune thrombocytopenia, an oral investigational drug called rilzabrutinib was active and associated with only low-level toxic effects at all dose levels.

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This article was previously published October 28, 2018, and has been updated with new information.

Satchidananda Panda, Ph.D., is a leading researcher in a very important field of study: the circadian rhythm, which is the topic of his book, "Circadian Code: Lose Weight, Supercharge Your Energy and Sleep Well Every Night." It's a great read, written at a level that is easy to understand.

Growing up on a farm in India, he was initially intrigued by the fact that he slept best during the summertime. Then, going through agricultural school, he realized that different plants flower at certain times of the day.

"A few years later, when I was thinking about grad school, I realized there are so many things about biology of time," Panda says. "Every biological system depends on time; just like throughout the day we have a clear timetable when we should be doing this and that — meeting people and having conversation and having dinner.

Every organism has that [but] we haven't learned the biology of time. That's why I got excited about circadian rhythms, because this is a universal timing system, starting from pond scum to humans … Every organism has to go through this 24-hour timing schedule.

If this is disrupted, then plants will flower at the wrong time and animals will not reproduce well. In humans, lots of different diseases can happen. That's why I got excited about circadian rhythms and got into my Ph.D. Now I'm at the Salk Institute, a nonprofit research organization in San Diego, California."

Circadian Rhythms Are Under Genetic Control

In 2017, the Nobel Prize in Physiology or Medicine was awarded to three U.S. biologists — Jeffrey Hall, Michael Rosbash and Michael Young — for their discovery of master genes that control your body's circadian rhythms.^1,2,3,4,5 Panda explains:

"The bottom line is almost every cell in our body has its own clock. In every cell, the clock regulates a different set of genes, [telling them] when to turn on and [when to] turn off.

As a result, almost every hormone in your body, every brain chemical, every digestive juice and every organ that you can think of, its core function rises and falls at certain times of the day [in a coordinated fashion].

For example, your growth hormone might rise in the middle of the night, in the middle of sleep. At the same time, if there is not [too much] food in your stomach, then the stomach lining will start to repair. For that repair to work perfectly, the growth hormone from the brain has to coincide with the stomach repair time.

In that way, different rhythms in different parts of our body have to work together for the entire body to work optimally. In fact, to have these daily rhythms and sleep-wake cycle, being more alert in the morning, having the bowel movement at the right time, having better muscle tone in the afternoon, these rhythms are the fountain of health. That's the indication of health."

Shift Work Disrupts Your Circadian Rhythm

The idea that you could possibly micromanage this intricately timed system from the outside is foolish in the extreme. As Panda notes in his book, the key, really, is to pay attention to and honor ancient patterns of waking, sleeping and eating.⁶ By doing that, your body more or less takes care of itself automatically.

"Yes, to leverage these daily rhythms that are so ingrained in our body, we just have to do a few things: sleep at the right time, eat at the right time, and get a little bit of bright light during the daytime. That's the foundation. We can do very simple things to reap the benefits of the circadian rhythm and the wisdom of our body," Panda says.

One of the most common circadian anomalies in today's modern world is shift work. If you're like me, you might be under the misconception that it's a relatively small minority of people that engage in this activity, but Panda cites research showing a full 20 to 25% of the American nonmilitary workforce disrupt their natural circadian rhythm by working nights.

In his book, shift work is defined as any work that requires you to stay awake for three hours or more between 10 p.m. and 5 a.m. for more than 50 days a year (basically once a week).

The fact that 1 in 4 is exposed to this circadian rhythm aberration is bad enough, but on top of that there are the health effects of dirty electricity and the unhealthy light spectrum emitted by pulsing light-emitting diodes (LED) and fluorescent lighting, which further exacerbates the problem.

"Only in the last 16 years we have come to understand the impact of light on our health," Panda says. "Before this, we thought that lighting is only for vision. Our eyes just have retinal cone cells to guide us throughout the world. Sixteen years ago, myself and two others … discovered this blue light-sensing light receptor called melanopsin.

These light-sensing cells in the retina — 5,000 of them per eye — are hardwired to many parts of the brain, including the master clock in the hypothalamus, and the pineal gland that makes … melatonin.

That discovery completely changed how we look at light. It's not only lighting for safety or security. We have to now think about lighting for health … We [also] have to now think about blue light.

It's not that we should get rid of blue light completely. We need more blue light during the daytime, and we need less at least three to four hours before going to bed.

The bottom line is in the last 100 to 150 years, we have cleared the man-made world without paying attention to circadian rhythms. Now we have the excellent opportunity to recreate and rebuild this entire world that will optimize our health."

The Price You Pay for Chronic Sleep Disruption

It's extremely difficult to estimate the price paid for widespread sleep disruption, but what is known is what happens when you chronically disrupt your circadian rhythm. Panda explains:

"Starting from babies all the way to 100-year-olds, we know that a few nights of staying awake for three to four hours or even eating at the wrong time can cause irritation, foggy brain, mild anxiety, loss of productivity and insomnia.

At the same time, this can flare up underlying autoimmune disease … We can look at shift workers in controlled clinical studies. When we make a list of diseases that circadian rhythm disruption contributes to, it's a huge list.

It goes from mental health issues such as depression, anxiety, bipolar disease, attention-deficit hyperactivity disorder, autism spectrum disorder and post-traumatic stress disorder [to] obesity, diabetes, cardiovascular disease and fatty liver disease …

Many of these affect more than 10% of the population. And then you bring in gastrointestinal diseases: irritable bowel syndrome, irritable bowel disease, and even heartburn and ulcerative colitis.

If you combine all of these, then we can see clearly why nearly one-third of all adults in the U.S. have one or more of these chronic diseases, more than two-thirds of adults at the age of 45 have some of these chronic diseases. Nine out of 10 at the age of 65 have two or more of these chronic diseases.

Now, the question is, 'How much of this is due to circadian rhythm disruption and other factors, or maybe circadian rhythm disruption with underlying genetic cause?' We cannot come up with a clear figure, but it's very clear that if we optimize circadian rhythm, we can really move the needle."

Sleep Deprivation Induces Glucose Intolerance

Research by Eve Van Cauter, director of the Sleep, Metabolism and Health Center at the University of Chicago, also shows that sleeping less than six hours a night dramatically increases your risk of insulin resistance, which is at the core of most chronic diseases, including those mentioned above. There’s actually a daily rhythm in insulin sensitivity.

For example, if you do a glucose tolerance test in the morning, it may be normal, but done in the evening, it may suggest you have prediabetes. She also showed that when otherwise healthy people are deprived of sleep and allowed to sleep only five hours or less per night, they develop glucose intolerance in as little as four days. As noted by Panda:

"That's really eye-opening. Because many of us go through that kind of disruption on a monthly or weekly basis. Shift workers go through that half of their life. That might explain the rise in glucose intolerance and having 85 million prediabetics in [the U.S.]."

Melatonin Production and Sleep Disorders

In his book, Panda discusses how melatonin production changes with age. With increasing age, melatonin production starts going down such that a 60-year-old may produce one-tenth the melatonin of a 10-year-old. As noted by Panda, reduced melatonin production is at the heart of many sleep disorders seen in the elderly.

So, how can you optimize your melatonin production as you age? One common solution is to take a melatonin supplement. Melatonin receptor agonist drugs are also available. However, a simpler solution that anyone can do, which costs nothing, is to control your lighting.

"Just imagine, 150 years ago, the firelight, the lamplight or even the full moon light was only 1 to 5 lux. Full moon light is maximum 1 lux. Now, we have 50 to 100 lux. In some department stores you can get 600 to 700 lux of light in the evening. That's a tremendously high amount of light. That would slam your melatonin [production] down to almost zero," Panda says.

Ideally, replace LEDs and fluorescent light bulbs in key areas where you spend time in the evening with low-watt incandescent bulbs, and avoid electronic screens for a few hours before bedtime.

An alternative is to wear blue-filtering eyeglasses at night. Just make sure don't wear them during daytime. Also, make sure the glasses filter out light between 460 to 490 nanometers (nm), which is the range of blue light that most effectively reduces melatonin. If they filter everything below 500 nm, you should be good to go.

The Importance of Meal Timing

Panda has also investigated the impact of meal timing on circadian rhythm. Just like many cleanout functions occur in your brain during deep sleep, all other organs also need downtime. Many organs actually need between 12 and 16 hours of rest, meaning a minimum of 12 hours without food, to allow for repair.

In time-restricted feeding trials, Panda has shown that mice whose feedings are restricted to a window of eight to 12 hours are protected from obesity, diabetes, cardiovascular disease, systemic inflammation, high cholesterol and a host of other diseases. This, despite the fact they’re eating the same amount of calories and the same type of food as animals allowed to graze throughout the day and night.

More importantly, when fat mice are placed on an eight- to 10-hour time-restricted feeding schedule, many of these diseases can be reversed. Human trials suggest the same results can be obtained in humans who adopt a time-restricted eating schedule where all food is eaten within a window of eight to 10 hours.

According to Panda, at bare minimum, you should fast for 12 hours a day — that's eight hours of sleep, plus three hours of fasting before bed, plus another hour in the morning, to allow your melatonin to level off. At 12 hours of fasting per day, you will maintain your health, but you're unlikely to actually reverse disease. For that, you need to fast longer.

"The question is how short one can go. This is where there is some limitation in doing controlled studies like we do on animals, where we can do this for a long period of time, because if you reduce access to food for less than six hours in many animals, they will reduce their caloric intake.

So, then we cannot figure out whether the benefit or harm we are seeing is due to the reduction in calories or reduction in timing," Panda says.

"The way I look at it, 12-hour time-restricted eating is something everybody should do. It’s like brushing your teeth every day. What is surprising is only 10% of the population consistently eat within 12 hours … [Then] once every six months or once a year, [go down to] eight-hour eating for a month or so."

There's an App for That

Panda has developed a very helpful free app, available on Android and iOS, called myCircadianClock. By using this app, you will contribute to Panda's circadian research.

"We ask people to self-monitor themselves for two weeks, because we know their weekdays and weekends might be different. We just want to get a broader picture of what is your lifestyle from one day to another. And then after two weeks, people can self-select whether they want to eat all their food within 10 hours, 12 hours or eight hours.

You're free to do whatever you want to do … Over a long period of time, we can figure out what is good or bad for people. In this new app, you can log your food. It also has other bells and whistles. The app can be paired with your Google Health or Apple Health Kit. It can extract your step count, sleep, et cetera. …

After 12 weeks, we also want you to enter your body weight. If you have been collecting lots of other health data, then it's good to enter that. That's how it will help to figure out, at the epidemiological level, in real life situations, what our habits are and how we can change it.

The same app is being used in many controlled clinical studies. There are nearly 10 different studies going on in different parts of the world that use the same app … In that way, we can benefit from a controlled study as we launch this large open-to-all kind of studies."

According to Panda, most people will notice improvements in their sleep within two to three weeks of time-restricted eating. Symptoms of heartburn will also typically begin to resolve. Between weeks four and six, daytime energy levels typically increase while evening hunger pangs are reduced.

Between six to 12 weeks, people with prediabetes or diabetes will begin to see improvements in fasting blood glucose. Those with mild hypertension also tend to notice improvements at this time, as do those with irritable bowel syndrome, as the microbiome improves and the gut begins to repair.

"Once the gut repair improves, then systemic inflammation goes down. Between eight to 12 weeks, that's when a lot of people report that their joint pain goes down, because that's a good sign of inflammation.

Once in a while, we get random reports. For example, some people who have inflammatory disease or autoimmune disease, they sometimes say the severity has gone down," Panda says.

On NAD and Circadian Rhythm

Nicotinamide adenine dinucleotide (NAD+) — one of the most important metabolic coenzymes in your body that helps redox balance and energy metabolism — is primarily generated through a salvage pathway rather than de novo or building NAD+ from scratch pathway.

The rate-limiting enzyme is nicotinamide phosphoribosyltransferase (NAMPT), which is also under circadian control. When your circadian rhythm gets disrupted, it causes NAMPT impairment. NAMPT also helps set the circadian rhythm. In short, by optimizing your circadian rhythm, you're going to optimize your NAD production. Panda explains:

"Studies say it goes both ways, because NAD also affects sirtuins, and sirtuins integrate with circadian rhythm. Nicotinamide adenine dinucleotide phosphate (NADPH) ratio also affects your [circadian] clock and transcription factors bind to DNA.

The bottom line that we have seen with circadian rhythm is if the clock regulates something, then there is a reciprocal feedback regulation from that output into the clock. That's the best way you can clear the homeostatic system. It's the chicken and egg story."

More Information

To learn more, be sure to pick up a copy of "Circadian Code: Lose Weight, Supercharge Your Energy and Sleep Well Every Night." Also consider downloading myCircadianClock. It's free of charge, and will help you track your circadian rhythm while simultaneously contributing to Panda's research.

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