Ask Doc It has happened to all of us... Dad doesn't know when to stop carving turkey. Mom insists we eat more of her sweet potato casserole. Grandma guilts us into a second helping of pie. And inevitably, we find ourselves passed out on the sofa after Thanksgiving dinner.
Most people blame the turkey for the sleepiness. It's popular wisdom to blame the tryptophan (pronounced trip-TO-fan), an essential amino acid found in turkey.
But tryptophan doesn't make you sleepy.
As an amino acid, tryptophan is one of the essential building blocks for our bodies. We need to consume it to build chemical messengers in our brains (like serotonin, our natural mood booster).
But turkey isn't the only food that contains tryptophan. You find it in nuts, seeds, soybeans, cheeses, lamb, beef, chicken, fish, beans, and eggs. Pork has a higher concentration of it than turkey does – but nobody jokes about falling asleep after eating a ham sandwich.
The real culprit behind your post-dinner droopy lids? Overeating.
Overeating can lead to higher blood-sugar levels, which raises insulin levels. Insulin helps break down blood sugar. But when your blood sugar spikes, you get a corresponding spike in insulin. And when insulin breaks down all that sugar at once, the side effect is sleepiness. It's the same reason you get sleepy after a meal heavy in pasta or other grains, which need more insulin to break down.
But insulin also works with the chemicals in your brain to make you feel better – meaning the more you eat, the happier you feel. Recent research has shown a direct link between increased levels of insulin and increased dopamine release. Dopamine is the other powerful "feel-good" chemical. It's associated with the pleasure and reward center of the brain, which makes you want to eat even more.
The simple solution?
Don't stuff yourself and eat slowly.
Many studies have shown that eating slower – and drinking water between bites – reduces the amount of food you eat. The changes to our hormones are complex and still being studied. But the prevailing theory is that eating slower allows your hormones enough time to complete the long process of signaling your brain to stop eating.
One paper, published in 2011 in the American Journal of Clinical Nutrition, saw bigger drops in post-meal ghrelin levels in people who ate slowly (measured by people chewing each bite 40 times instead of 15 times).
If you can't help but succumb to those extra helpings, make sure to get up and get active after dinner. I love to take my family for an evening walk around the neighborhood after a big meal.
So enjoy your meal this Thanksgiving. Take your time, talk with your family, and let the dinner last awhile. Your body will thank you.
Q: Now that I'm 50 should I get a shingles vaccination? – P.W.
A: Generally speaking, if you're over 50, you should get the shingles vaccine. It clearly cuts down on both the pain and the actual occurrence of the disease. In a large, five-and-a-half-year study of more than 38,500 men and women across 22 sites in the U.S. Department of Veterans Affairs system, the vaccine was found to be safe compared with a placebo.
Folks had the usual complaints from a vaccine: redness, swelling, pain, and irritation at the site of injection. Otherwise, this vaccine appears to be quite safe, and it reduces the pain and occurrence of the disease by at least 50%.
The other good news is that the vaccine could cost less than $200. And while not every insurance company pays for it, Medicare Part D covers it the same way it covers regular vaccinations. And even if you have to pay cash... relative to the pain and suffering this disease causes, it could be the best health care money you may ever spend.
For anyone who missed our issue on shingles and why I feel it's important to get the vaccine, you can read it here. And you can find our special Q&A issue on shingles here.
Q: Yesterday my 16-month-old niece had a nine hour surgery to remove a tumor (hopefully benign) from the base of her brain. We are awaiting an MRI before further treatment is recommended. What are her best treatment options? Is there an immunotherapy treatment option? Can you recommend any medical facilities? Thank you. – D.G.
A: We're deeply sorry to hear about your niece and what you and your family are going through, D.G.
Although we can't give advice for individual medical situations, my researcher just attended an immunotherapy patient conference here in Baltimore. Your questions were popular among the attendees.
For most cancers, immunotherapy isn't a frontline option. Typically, your doctor will review your specific type of cancer and figure out how well the standard of care is expected to work. That means things like chemotherapy, radiation, and surgery. Some cancers, like melanoma, work well with immunotherapy as a first-line treatment. But many cancers reserve that as a later treatment option.
If it is cancer, we recommend researching that type to understand the options. We recommend taking the list we wrote about the questions to ask a cancer doctor (you can find this in The Living Cure – you can read it here if you're a subscriber to Retirement Millionaire, or here to buy the book). Don't be afraid to get a second opinion. The best thing you can do is have a great team that works with you in a collaborative, supportive way.
Take the time to find a good cancer center. Often I suggest folks look into the National Cancer Institute's highly specialized treatment and clinical trial centers that focus on specific types of cancer – called Specialized Programs of Research Excellence (SPOREs). They are divided by organ, so here is a list of the ones for brain cancer:
Brigham and Women's Hospital | Website | Phone: (617) 732-5500
Duke University Hospital | Website | Phone: (919) 684-5301
Northwestern University | Website | Phone: (833) 882-7246
University of California, Los Angeles | Website | Phone: 1-800-825-2631
University of California, San Francisco | Website | Phone: (415) 353-7500
University of Texas/MD Anderson | Website | Phone: 1-888-512-7249
Finally, the immunotherapy summit that my researcher attended offered free clinical trial navigators. If this is something you want to consider, you can contact one through the Cancer Research Institute, here.
What We're Reading...
- Did you miss it? How to start collecting a safe 10% a year... today.
- Something different: The accidental invention of Play-Doh.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
November 22, 2019