EAST COUNTY
Health Matters Observer
OCTOBER 2021
Your sleep choices affect more than you might realize — and weekend catch-ups won’t help. PAGE 2
MEAL PREP
Food delivery doesn’t always need to be your dinner backup.
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NUTRIENT DEFICIENCY
PHYSICIAN SPOTLIGHT
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Your diet likely isn’t giving you all you need.
Ophthalmologist talks lens tech advancements.
HEALTH MATTERS
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OCTOBER 2021
Sleep patterns and their consequences Sarasota doctor talks about the importance of sleep and how genetics play a factor. LIZ RAMOS STAFF WRITER
W
hile some people are accustomed to staying up past midnight every night and sleeping in, others are in bed by 9 p.m. and wake early each morning ready to take on the day by 7 a.m. People have come to realize they’re either night owls or early birds, but what does that mean for their health? Dr. Tracy Gapin, who opened a health institute for men’s health and performance in Sarasota and has 20 years of experience in urology, has been studying the impacts of sleep on health, including knowing more about
what it means to be a night owl or an early bird. Gapin takes a systems-based approach when helping patients, meaning he looks at various factors that affect health including nutrition, fitness, hormones and mindset. “What I have found is one of the most impactful parts of all is sleep,” Gapin said. “Sleep is when your body recovers and restores. “Sleep is intimately tied to hormone production as well. When we don’t have good quality sleep, hormones are affected, and that will cause elevated cortisol, which is our stress hormone. If cortisol is chronically elevated, it crushes all our other good ones.” THE IMPACT OF GENETICS
Gapin said that genetics play a part in whether people are night owls or early birds because everyone has clock genes that impact the body’s internal circadian rhythm.
Dr. Tracy Gapin has been studying the effects of sleep on a person’s health. Courtesy photo
Some clock genes are related to sleep duration, how long it takes to fall asleep, when you go to bed and the risk of narcolepsy. “Those genetics will dictate how your body handles the circadian rhythm of sleep and awake cycles,” Gapin said. “Based on your genetics, some people will do better going to bed later and waking up later. Other people, based on your genetics, will do better going to bed earlier and waking up earlier.” A simple way to tell if you’re a night owl or early bird is by noticing when you’re at your highest level of performance. Do you find yourself being more awake and aware at night or in the morning? For example, Gapin said he tends to be sharper at night compared to the morning, so he considers himself a night owl. Although some people might
BEHAVIORS TO HELP SLEEP BETTER Dr. Tracy Gapin said sleep is one of the most important factors contributing to a person’s health. He provided a few ways to help you get a better quality of sleep each night: n Establish a routine. n Don’t eat within four hours of bedtime. n Avoid any blue light within four hours of bedtime, or wear glasses that block blue light. n Go to sleep at the exact same time every night, and wake up at the same time. n Sleep in a completely dark room. n Turn your phone on airplane mode to limit electromagnetic frequencies. n Keep the room at a cool temperature. n Practice meditation or mindfulness before going to bed. n Read a book to relax your mind.
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think they’re night owls because they stay up late, Gapin said that if they still wake up early daily, they’re not actually considered night owls. “The whole night owl concept is if you’re a night owl, that also means waking up late,” Gapin said. “If you have to be at work by 7 a.m., you can’t be a night owl. That’s not conducive for staying up late because you have to wake up early anyway.” The constant cycle of staying up late and waking up early can cause “social jet lag,” where people try to catch up on sleep over the weekend, but it never works, Gapin said. “You can’t trick your body to catch up on sleep on a weekend,” he said. “Your body still suffers the consequences of that poor sleep all throughout the week.” As a result, Gapin said that it’s critical for people to tailor their lifestyle to what’s right for their bodies, which will ultimately optimize sleep.
QUALITY VS. QUANTITY
Depending on the person and their genetics, the minimum amount of sleep needed is seven hours, Gapin said. But more important, he said, is the quality of sleep. Gapin said there are several genetic factors related to risk for sleep disruption. Often people think that because they woke up feeling rested, they slept enough, but it’s usually not the case, Gapin said. “When you sleep poorly, your body does not get the restorative effect, and what happens is you have elevated stress hormones,” Gapin said. “When you wake up in the morning when you’ve been short on sleep, you may have sometimes almost a state of euphoria, almost this excited feeling. That’s just your stress hormones kicking in to help your body kind of get going. Even though you haven’t gotten the proper amount of sleep, you think you did because the
stress hormones are stimulating you enough.” Elevated stress hormones disrupt a sleep cycle, which leaves people having a difficult time falling asleep at night. “It becomes this vicious cycle of stress hormones and poor sleep, and that causes weight gain, poor metabolism, inflammation, low hormones and more,” Gapin said. “It’s a cascading effect.” WHICH IS BETTER?
Gapin said he hasn’t found any health benefits to being a night owl or early bird, but some studies, such as a study from the Scandinavian Journal of Medicine and Science in Sports, shows that night owls might have lower physical activity. The Scandinavian Journal study found that night owls tend to have 60-90 fewer minutes of activity per day compared to early birds. A study from Northwestern Medicine and the University of
Surrey in the U.K. found night owls have a 10% higher risk of dying over a six-and-a-half year period compared to early birds, or larks, because they have to conform to societal routines, such as a 9 a.m. to 5 p.m. job. “It could be that people who are up late have an internal biological clock that doesn’t match their external environment,” said Kristen Knutson, the co-lead author of the study and an associate professor of neurology at Northwestern University Feinberg School of Medicine, in a Northwestern University article. “It could be psychological stress, eating at the wrong time for their body, not exercising enough, not sleeping enough, being awake at night by yourself, maybe drug or alcohol use. There are a whole variety of unhealthy behaviors related to being up late in the dark by yourself.” The study also showed night owls had higher rates of dia-
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“You can’t trick your body to catch up on sleep on a weekend. Your body still suffers the consequences of that poor sleep all throughout the week.” — Dr. Tracy Gapin
betes, psychological disorders and neurological disorders. Gapin said there are several ways people can optimize their sleep to ensure they have a good quality of sleep each night, including not eating within four hours of bedtime, going to sleep at the exact same time every night and waking up at the same time every morning, sleeping in a completely dark room, and keeping the room at a cool temperature.
ARE YOU A NIGHT OWL OR AND EARLY BIRD? Take this quiz to find out!
What time would you wake up if you could plan your own day? A. 4-6:30 a.m. B. 7:30-9 a.m. C. 10-11:30 a.m.
How easy is it to get up in the morning? A. Very easy B. Fairly easy C. Not at all
What time would you go to bed if you could plan your evening? A. 8-9 p.m. B. 10-11 p.m. C. 12:30-2 a.m.
During the first 30 minutes after waking up, how tired do you feel? A. Refreshed B. Fairly tired C. Very tired
You have two hours of work that can be done at any time. When do you do it? A. 8-10 a.m. B. 2-4 p.m. C. 8-10 p.m.
If you answered mostly A’s, you’re an early bird. If you answered mostly B’s, you’re neither a night owl nor early bird. If you answered mostly C’s, you’re a night owl.
At what time of day do you feel your best? A. 4-9 a.m. B. 11 a.m. to 6 p.m. C. 9 p.m. to 3 a.m.
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• Steve Ford: actor, mental health advocate and son of former President Gerald Ford and First Lady Betty Ford The Lee & Bob Peterson Legacy Award will be presented to the Seidensticker Family in honor of their late father, Steve. Other event highlights include a “Hope Chest” raffle, silent auction, and live entertainment throughout the evening. Co-chairs: Taylor Karp Teymuri and Sarah Karp. Tickets are $325; numerous sponsorships are available.
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Eli Lebowitz, Ph.D.
Joyce Carter, Psy.D., LMHC
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National and local mental health practitioners and scientists will discuss new treatments, discoveries, and insights on mental health issues. Topics will include better treatments for childhood disorders, creating a trauma-informed community, the impact of COVID-19 on young people, childhood and adolescent anxiety, and the nature of depression; a Q&A will follow the program. The goals of the symposium are to raise awareness of mental health and addiction disorders and to help erase the stigma surrounding them.
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OCTOBER 2021
RECIPES TO TRY BREAKFAST Pina colada overnight oats
LUNCH Lentil salad
The best batch RYAN KOHN STAFF WRITER
B
e prepared. It’s the Boy Scouts’ motto and a devilishly catchy song from “The Lion King,” but it’s also advice that many people have taken to the kitchen in the past few years. Meal prep, as the practice is known, is a trendy way of getting food ready each week. On a fundamental level, meal prep means cooking more now so you have less to do later. To outsiders, getting started can seem overwhelming. How do you begin meal prepping? What are the best tips and tricks you need to know? Why is this such a popular movement in the first place? THE APPEAL OF MEAL PREP
The biggest reason people opt to meal prep is time. If you know your schedule won’t allow much time to cook dinner each night —
or if you know you’ll be too tired to cook — meal prep means you don’t have to do anything but reheat what’s already made. Meal prepping also helps some eat healthier. If you know you won’t have time to cook a full meal on a given day, is it better to pick up fast food on the way home or to already have a nutritious meal ready to eat in your refrigerator?
What is meal prep, and what are the benefits of cooking this way?
If you want more variety and have a bit more time to cook at night, try make-ahead meals: full meals you make ahead of time with no leftovers expected. This method is often used for breakfast; overnight oats or muesli are common options for people who want to wake and eat something without having to use brain power on cooking. Like batch cooking, this saves time on the back end, just with more spread out time allotments on the front end. For meal prep on a much smaller scale, you can also opt to prepare individual ingredients of a meal ahead of time, such as sous vide cooking a few chicken breasts at once so you only have to give them a sear when you’re ready to eat. Whichever method feels right for your schedule, you probably want to start slow. Ease yourself into the process until you feel comfortable making that much food at once. And stick to your schedule: Once you dedicate your
YOU HAVE OPTIONS
Even though the idea behind meal prepping is basic, there are multiple ways to go about it. The most popular method is batch cooking: making a large amount of one recipe and putting it either in the refrigerator to eat throughout the week or in the freezer to eat over a few weeks. Batch cooking allows you to spent the least amount of time in the kitchen. Many people elect to batch cook on the weekend, dedicating a few hours to making everything while stress free.
Saturday or Sunday mornings to cooking, it becomes routine. THINK ABOUT MORE THAN THE FINAL PRODUCT
Food might be the thing you’re preparing, but there’s more to consider than ingredients. For instance, what are you putting all this food in? Make sure you have enough containers to hold everything you cook, and make sure they seal. There’s nothing worse than making a lot of food only for it to go bad quicker than you thought it would. Plastic containers are fine for the fridge, but it might be better to use Pyrex for food you plan on reheating. Wide-mouthed jars are great for the freezer, but leave room at the top of the jar in case the food expands when frozen. Also, if you want to heavily meal prep and still maximize your efficiency in the kitchen, think about what cooking methods your recipes require. Choosing one oven
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recipe and one stovetop recipe (or more) can save time. ADD VARIETY WHERE YOU CAN
The biggest gripe of meal prep is that it can get monotonous quickly if you’re not careful. The best way to avoid this feeling is to add changes wherever you can. If you are making a week of salads, divide them into two categories. Put chicken in half with a honey mustard dressing; in the rest, add chickpeas and Greek vinaigrette. This idea can be expanded in almost limitless ways. Making overnight oats? Add blueberries one day and strawberries the next. You could even make more than one recipe for dinner at one time, though this could require more cooking time depending on the recipes.
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“There’s a big difference between the recommended daily allowance and an optimal level.” — Arielle Bennett, nurse practitioner
Nat Kaemmerer
Heidi Behrens, Meka Schurr, Jan Patitucci, Arielle Benentt, Tina DaSilva, Lesley Miley and Stephanie Pescinski of Sarasota IV Lounge.
TAKE YOUR VITAMINS Most Americans are deficient in one nutrient or another. NAT KAEMMERER STAFF WRITER
Y
ou can eat well, and you can exercise, get plenty of sleep and try to do everything right by your body. But if you’re a person living in the modern world, you should probably be taking some sort of nutrient supplement. “If you’re going to drive your
car really hard, you have to change your oil more frequently,” said Arielle Bennett, a nurse practitioner at Sarasota IV Lounge. “It’s the same thing. If we’re going to drive our bodies really hard, we’re going to require a lot more fuel to do so.” In an ideal world, people could get nutrients they need, such as vitamins A, C, D, E and K, as well as magnesium and B-12, from food. However, according to Scientific American, food has been getting less nutritious, thanks to a higher levels of carbon dioxide in soil. Crops grow bigger but have less nutrients. Combine that
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with intensely active lifestyles, high levels of stress and exposure to toxins, and you’ve got a bunch of anxious, depressed, nutrientdeprived humans. “We all want to be really successful and effective and efficient and all these things, but we forget that we’re putting more stress on our body, so we need to give our bodies more fuel to be able to handle all that,” Bennett said. “That person who is active and doesn’t slow down to eat the right foods or the person who’s just eating a bunch of processed foods all the time, not getting fruits and vegetables, not exercising, you
know, not handling their stress appropriately is more likely to be deficient, or people who have a lot of (gastrointestinal) issues, if your gut is not focused on digesting and absorbing nutrients.” Bennett said people are likely to be deficient in magnesium, B-12 and vitamin D. Despite living in the Sunshine State, she said everyone she’s ever tested who is not taking vitamin D has been deficient in it. Going out in the sun just isn’t enough. “There’s a big difference between the recommended daily allowance and an optimal level,” Bennett said. “A lot of labs will tell you any level of vitamin D level from 20 to 100 (mcg) is normal, but somebody at 20 is really at a high risk for developing viruses and cancers and things like that, so often I would like to see a (level of) greater than 50.” And yet you probably shouldn’t run out and buy the first bottle of multivitamins you see on the shelf at the drugstore. Too much of a good thing can be a detriment, and fat-soluble vitamins like A, D, E and K should be taken with caution. Lots of vitamins are full of synthetic variants or fillers that are harder to digest. It’s not uncommon to have stomach trouble when taking vitamins, too, which can be a benefit of the IV drips at Sarasota IV Lounge, because
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OCTOBER 2021
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it bypasses the gastrointestinal tract to absorb more of a pure vitamin. “You want to make sure it’s third-party tested, pharmaceutical-grade supplements, organic, as much as humanly possible, especially with vitamin C, specifically, a non-corn source,” Bennett said. It’s also possible that a specific person’s system just isn’t equipped to utilize a certain type of nutrient. For example, some people can’t convert synthetic B-12, also known as cyanocobalamin, into the active, usable form. A micronutrient test can help suss out what the best situation is. For some nutrient deficiencies, there aren’t noticeable symptoms. However, magnesium helps run more than 300 biochemical processes in the body, and magnesium deficiency can manifest cardiac abnormalities, muscle cramps, fatigue and anxiety. A deficiency in B-12 can lead to numbness of the extremities. Usually, people get a good amount of vitamin C from their diet, but because it helps the immune system and is a water-soluble vitamin, try to get as much as you can. “It’s not even so much necessarily that people are super deficient in vitamin C, but we require so much more,” Bennett said. Getting a more balanced body starts with eating better. Eat your leafy greens, seeds and nuts to maintain better levels of magnesium, and eat salmon, egg yolks and mushrooms to get more vitamin D. However, it’s probably worth it to take a multivitamin to support your body in a busy world — just make sure you check your sources.
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OCTOBER 2021
Dr. David Shoemaker Ophthalmologist is the first surgeon to implement a new replacement lens technology. HARRY SAYER STAFF WRITER
Advanced Surgical Treatments for Breast Cancer
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r. David Shoemaker is the founder of Center for Sight, a Sarasota group of physicians who specialize in ophthalmology and helping locals maintain clear sight. Shoemaker considers himself a specialist completely devoted to cataracts and lens replacement surgeries — he jokes his career was either going to be delivering babies or making people see. He’s been in a good mood as of late. Shoemaker was the first surgeon in the country to implement the TECNIS SynergyTM Intraocular Lens, a Johnson & Johnson vision replacement lens designed to operate more efficiently in all levels of lighting, for a cataract patient during a recent surgery. It’s a technology that Shoemaker and others in his field have kept their eyes on for a decade.
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Call 941-254-6767 for more information or to schedule an appointment.
Did you always want to be in the medical field? As a kid growing up in Florida in the ’70s, I was attracted to manned space flight. I wanted to be an astronaut.
For language assistance, disability accommodations and the non-discrimination notice, visit our website. 21510863-511922 10/21
My parents indulged me, took me to a surgeon and took X-rays, and they told me I was probably going to be too tall. That made medicine in general rise to the pile to me. Once you get into med school and see the unmet needs, you match up your skill set with that opportunity. What drew you to cataracts and lens replacement surgery? Ophthalmology is an amazing combination of medicine and surgery. We’re able to diagnose just by looking at the eye — we
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Dr. David Shoemaker is well-versed in most matters relating to cataracts and replacement lenses.
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Practice: Shoemaker is the founder of the Center for Sight group and works in ophthalmology. Specialty: Shoemaker is entirely focused in cataracts and lens replacement surgeries. Years in practice: 34 Education: After two years at Stetson University, Shoemaker received a bachelor’s degree and doctorate from the University of Central Florida. He completed his residency (without internship) in ophthalmology at the Ochsner Clinic in New Orleans.
don’t rely on anything. It’s almost instant action to create improvement, to restore sight. It’s a pretty neat job. What attributes lend well to ophthalmology? It’s more of a mental (skill set) than a physical one. You can’t have tremors (in your hands), so if you work out in the mornings, that’s not happening. The mental set is obsessive compulsive perfectionist — hyper-focused on detail, having massive attention to every single thing you do in the operating room. You practice, practice, practice to get it. Only when you’re in the zone where it’s an art is it where you want to be. That’s where the best results come from, and that’s where the joy in being a surgeon is derived for me. What is the TECNIS Synergy Lens, and what is its importance? In the old days, the goal was to restore sight loss from cataracts.
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Before we had implants, we had glasses, and when we had implants, there were still glasses, astigmatism, delayed healing, all of that. Ultimately, the goal is to restore as close to natural vision as possible without glasses. The (Synergy lens) provides a full range of clear vision without glasses. All of the predecessor lens have limitations, side effects, something. We’ve been tweaking technology for at least the last 10 years trying to pursue this holy grail thing. This Synergy lens is the closest we’ve gotten. It’s really quite exciting. We have patients (who are) just thrilled — that’s when you know something is going on.
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Are there any other advancements in your field that you’re looking forward to or hoping might come soon? There are amazingly creative ideas out there, some in FDA trials. But the difference between a great idea and a commercially viable product is not to be underestimated. We’re in a really good spot. I think this lens is going to be the lens of choice for many years.
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