Published by
Stanford Medicine

Behavioral Science, Health and Fitness, Obesity, Public Health, Sleep

How insufficient sleep can lead to weight gain

How insufficient sleep can lead to weight gain

SnackNap

I don’t think I’ve ever met a person who hates sleep and can’t wait to get less of it. Yet, even though most people want more sleep and know it’s important for their health, few people get as much shut-eye as they need. If you’re one of the many who needs a bit more motivation to get to bed earlier, a recent BeWell@Stanford article on how sleep can affect your weight may do the trick.

In the Q&A, sleep expert Emmanuel Mignot, MD, PhD, director of the Stanford Center for Sleep Sciences and Medicine, explains why and how insufficient sleep can increase your risk of weight gain:

It is very clear that if you’re not sleeping enough, you’re putting yourself at risk for increasing your weight.  If you sleep less than six hours a night, you’re likely to have a higher BMI (body mass index). Longitudinal data — and the evidence is quite strong — shows that if you sleep more over time, you’ll lower your BMI, which correlates with weight reduction.

In the first centuries of human life on earth, if humans weren’t sleeping they were probably looking for food or fleeing a predator. Not sleeping enough was a sign that we were in danger or that we were under stress. When we are sleep deprived, we feel hungry. Data indicates that if you sleep less, you eat more, and it disrupts your hormones. This problem is magnified in today’s world because food is too available!

Mignot also discusses the top reasons why people sleep so little, the importance of naps, and how being sleep-deprived skews our perception of doing and performing well. “[W]e have to make sure we don’t burn the candle at both ends, Mignot said. “Sleeping brings creativity, productivity and the ability to perform at a higher level.”

The piece is a quick, and informative, read.

Previously: Exploring the history and study of sleep with Stanford’s William Dement“Father of Sleep Medicine” talks with CNN about what happens when we don’t sleep wellStanford doc gives teens a crash course on the dangers of sleep deprivation, Narcoleptic Chihuahua joins Stanford sleep researcher’s family and More evidence linking sleep deprivation and obesity
Photo by Goodiez

Medical Education, Medical Schools, Mental Health, Stanford News

A call to action to improve balance and reduce stress in the lives of resident physicians

A call to action to improve balance and reduce stress in the lives of resident physicians

4086639111_a7e7a56912_zIn November of 2010, those in Stanford’s general surgery training program experienced an indescribable loss when a recently graduated surgical resident, Greg Feldman, MD, committed suicide. His death wound up being a call to action that brought about the Balance in Life program at Stanford, according to program founder Ralph S. Greco, MD.

With the Balance in Life program now in its fourth year, Greco; chief surgical resident Arghavan Salles, MD, PhD; and general surgery resident Cara A. Liebert, MD, have learned much about the daily stresses that resident physicians face. In a recent published JAMA Surgery opinion piece they wrote:

As physicians, we spend a significant amount of time counseling our patients on how to live healthier lives. Ironically, as trainees and practicing physicians, we often do not prioritize our own physical and psychological health.

A recent national survey found that 40% of surgeons were burnt out and that 30% had symptoms of depression. Another study reported that 6% of surgeons experienced suicidal ideation in the preceding 12 months. Perhaps most startling, there are roughly 300 to 400 physicians who die by suicide per year—the equivalent of 3 medical school graduating classes.

Greco, Salles and Liebert explain that the Balance in Life program is specifically designed to help resident physicians cope with these stresses by addressing the well-being of their professional, physical, psychological and social lives. To accomplish this goal, the program offers mentorship and leadership training activities; dining and health-care options that are tailored to the residents’ busy schedules and needs; confidential meetings with an expert psychologist; and social events and outdoor activities that foster support among residents.

The authors concede that the program may not fix every stressful problem that their residents face, but it does let the residents know that their well-being is important and valued. “This may be the most profound, albeit intangible, contribution of Balance in Life,” the authors write.

Although the program (and the JAMA article) is geared for people in the medical field, it’s not much of a stretch to see how its core principles can apply to any work setting. Learning how to manage stress and reach out to colleagues for support is a valuable skill and, as the authors write, to provide expert care for others you must first take good care of yourself.

Previously: After work, a Stanford surgeon brings stones to lifeSurgeon offers his perspective on balancing life and workProgram for residents reflects “massive change” in surgeon mentality, New surgeons take time out for mental health and Helping those in academic medicine to both “work and live well”
Photo by Gabriel S. Delgado C.

Behavioral Science, In the News, Mental Health, Public Health, Research

Green roofs are not just good for the environment, they boost productivity, study shows

Green roofs are not just good for the environment, they boost productivity, study shows

3079545066_67cba2e5a8_z

Boosting productivity can be as simple as looking at a grassy roof for just forty seconds, conclude researchers at the University of Melbourne. It’s been shown that contact with nature can relieve stress and improve concentration and mood, but this is one of the first studies to see if novel urban manifestations of greenery can have the same effect.

The study, published in the Journal of Environmental Psychology and led by Kate Lee of Melbourne’s Green Infrastructure Research Group, involved giving students a mindless computer task to do in a city office building with a brief break spent looking at a picture of either a lush green roof or bare concrete roof. Those who looked at the green one made significantly fewer mistakes and showed better concentration in the second half of the task. The study was based on the idea of “attention restoration” through microbreaks lasting under a minute, which happen spontaneously throughout the work day.

Lee is quoted in a press release:

We know that green roofs are great for the environment, but now we can say that they boost attention too. Imagine the impact that has for thousands of employees working in nearby offices… It’s really important to have micro-breaks. It’s something that a lot of us do naturally when we’re stressed or mentally fatigued. There’s a reason you look out the window and seek nature, it can help you concentrate on your work and to maintain performance across the workday.

Certainly this study has implications for workplace well-being and adds extra impetus to continue greening our cities. City planners around the world are switching on to these benefits of green roofs and we hope the future of our cities will be a very green one.

She and her team next plan to see if city greening makes people more helpful and creative, as well as productive.

Previously: Nature is good for you, right? and Out of office auto-reply: Reaping the benefits of nature
Photo by Jeremy Reding

Medical Education, Medical Schools, Mental Health, SMS Unplugged

Free from school

Free from school

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category

girls running

Summer. It beckons with strawberry warm rays of sunlight, afternoons spent splashing in a pool, and the joys of watermelon-flavored popsicles. We, second-year medical students around the country, look out our windows and see children, newly freed from school, frolicking in the playground next door – and feel miserable. For this is the time when we are experiencing the worst of medical school.

We have completed the pre-clinical curriculum, some of us barely crawling across the finish line. We have spent weeks cramming for the USMLE, an exam described in no softer terms than “the most important exam you will take in your life.” And we are becoming familiar with a new kind of anxiety as we prepare to enter clinics for the first time. Or, rather, my classmates are – I chose to take time off between second and third year.

In the midst of Stanford-high expectations for our professional performance, we are seldom taught exactly how to take care of ourselves. I knew that I needed to change something halfway through second year when I found myself outlining a novel instead of studying during finals week. I nearly failed two exams. But I was happy.

I felt satisfied.

And so, I set about finding a way to incorporate more of writing into my medical school experience. Stanford has funding called Medical Scholars, which is set aside for every medical student to take a year off to work on a significant project or research experience. Their office willingly helped me apply for and receive this funding to work on my novel full-time for a year. I can’t imagine this level of support for an artistic endeavor from any other medical school. And so very soon, I too will be frolicking in the grass, newly freed from school.

Continue Reading »

Big data, BigDataMed15, Events, Medicine and Society, Research, Stanford News, Technology

A look back at Stanford’s Big Data in Biomedicine

A look back at Stanford's Big Data in Biomedicine

Ashley - 560

We reported many of the happenings at last week’s Big Data in Biomedicine here on Scope. Writer Bruce Goldman was also in attendance for the three-day event, and he captured the conversation in a just-published Inside Stanford Medicine piece.

Previously: At Big Data in Biomedicine, Stanford’s Lloyd Minor focuses on precision healthAt Big Data in Biomedicine, Nobel laureate Michael Levitt and others talk computing and crowdsourcingExperts at Big Data in Biomedicine: Bigger, better datasets and technology will benefit patientsOn the move: Big Data in Biomedicine goes mobile with discussion on mHealth and Big Data in Biomedicine panelists: Genomics’ future is bright
Photo of Euan Ashley, MD, welcoming conference attendees last Wednesday, by Saul Bromberger

Autism, Mental Health, Neuroscience, Research, Science, Stanford News, Stem Cells

Brain cell spheres in a lab dish mimic human cortex, Stanford study says

Brain cell spheres in a lab dish mimic human cortex, Stanford study says

ImageJ=1.49e

Mental disorders like autism and schizophrenia are notoriously difficult to study at the molecular level. Understandably, people are reluctant to donate pieces of living brain for study, and postmortem tissue lets researchers see the structure, but not the function, of the cells.

Now researchers in the laboratories of psychiatrist Sergiu Pasca, MD, and neurobiologist Ben Barres, PhD, have found a way to make balls of cells that mimic the activity of the human cortex. They use a person’s skin cells, so the resulting “human cortical spheroid” has the same genetic composition as the donor. The research was published in Nature Methods yesterday.

According to our release:

Previous attempts to create patient-specific neural tissue for study have either generated two-dimensional colonies of immature neurons that do not create functional synapses, or required an external matrix on which to grow the cells in a series of laborious and technically difficult steps.

In contrast, the researchers found they were able to easily make hundreds of what they’ve termed “human cortical spheroids” using a single human skin sample. These spheroids grow to be as large as 5 millimeters in diameter and can be maintained in the laboratory for nine months or more. They exhibit complex neural network activity and can be studied with techniques well-honed in animal models.

The researchers, which include neonatology fellow Anca Pasca, MD, and graduate student Steven Sloan, hope to use the technique to help understand how the human brain develops, and what sometimes goes wrong. As described by Barres:

The power and promise of this new method is extraordinary. For instance, for developmental brain disorders, one could take skin cells from any patient and literally replay the development of their brain in a culture dish to figure out exactly what step of development went awry — and how it might be corrected.

The research is starting to garner attention, including this nice article from Wired yesterday. Pasca’s eager to note, however, that he’s not working to create entire brains, which would be ethically and technically challenging, to say the least. But simply generating even a few of the cell types in the cortex will give researchers a much larger canvas with which to study some devastating conditions. As Pasca notes in our release:

I am a physician by training. We are often very limited in the therapeutic options we can offer patients with mental disorders. The ability to investigate in a dish neuronal and glial function, as well as network activity, starting from patient’s own cells, has the potential to bring novel insights into psychiatric disorders and their treatment.

Previously: More than just glue, glial cells challenge neuron’s top slot and Star-shaped cells nab new starring role in sculpting brain circuits
Photo of spheroid cross-section by Anca Pasca

Bioengineering, Research, Science, Stanford News

Fly-snatching robot speeds biomedical research

Fly-snatching robot speeds biomedical research

The drosophila hangs unharmed lifted by the robot’s suction tube.

It looks like nothing so much as a miniature UFO hovering over a plate of unsuspecting flies. When it’s ready to strike, it flashes a brief infrared blast of light that reflects off the animals’ backs, indicating the location of each insect. Then, a tiny, narrow suction tube strikes an illuminated thorax, painlessly sucking onto the fly and carrying it away.

It’s not the greatest new gadget to rid your kitchen of unwelcome pests, it’s the latest biomedical research tool from applied physicist Mark Schnitzer, PhD.

The flies in question are commonly studied in biology labs as a proxy for our own harder-to-access cells and organs. As I wrote in a press release:

Although flies and humans have obvious differences, in many cases our cells and organs behave in similar ways and it is easier to study those processes in flies than in humans. The earliest information about how radiation causes gene mutations came from fruit flies, as did an understanding of our daily sleep/waking rhythms. And many of the molecules that are now famous for their roles in regulating how cells communicate were originally discovered by scientists hunched over microscope staring at the unmoving bodies of anesthetized flies.

Until now, scientists have had to anesthetize the flies and painstakingly assess them by microscope. The robot and its machine vision can assess physical features more quickly and in finer detail than lab personnel and can carry out behavioral studies of awake flies.

I spoke with Joan Savall, PhD, a visiting scientist from the Howard Hughes Medical Foundation, who led the development of the robot. He says it will speed research because the robot is both faster and less sleepy that your average graduate student, but what’s really cool is that it opens up entirely new areas of research.

“In the end you can really push many fields at the same time,” he told me.

Previously: Thoughts light up with new Stanford-designed tool for studying the brain and New tool for reading brain activity of mice could advance study of neurodegenerative diseases
Image by Linda Cicero

Medical Education, Medical Schools, Stanford News, Technology, Videos

Using the “flipped classroom” model to bring medical education into the 21st century

Using the "flipped classroom" model to bring medical education into the 21st century

To make better use of the fixed amount of instructional time available to train doctors, Stanford and four other institutions are collaborating with the Robert Wood Johnson Foundation on an initiative to dramatically change medical education. They’re doing this by reversing the traditional teaching method of classroom time being reserved for lectures and problem-solving exercises being completed outside of school as homework. This “flipped classroom” model aims to help students engage with the material that they’re learning and create a foundational context for this new knowledge so they’re more prepared to apply it at the bedside.

The above video describes the initiative and how educators are creating new interactive teaching tools to integrate the basic science curricula with the diseases, infections and conditions that students will see during their clinical training. As mentioned in a previous post on Scope, students have been involved in every step of the process to make sure the new curriculum is clear, compelling and relevant. “It’s really rewarding to have this opportunity to impact the education of other medical students all across the country,” Jennifer DeCoste-Lopez, a final-year Stanford medical student, comments.

Stanford is partnering on the initiative with Duke University, the University of Michigan, the University of California at San Francisco, and the University of Washington.

Previously: Stanford Medicine’s Lloyd Minor on re-conceiving medical educationFlip it up: How the flipped classroom boosts faculty interest in teaching, A closer look at using the “flipped classroom” model at the School of MedicineUsing technology and more to reimagine medical education and Using the “flipped classroom” model to re-imagine medical education

Scope Announcements

A Memorial Day break

A Memorial Day break

7275226530_a9abeaca42_z

We’re off today in honor of Memorial Day. Scope will resume publication tomorrow.

Photo by Vjeran Pavic

Big data, BigDataMed15, Events, Precision health, Research, Stanford News, Technology

At Big Data in Biomedicine, Stanford’s Lloyd Minor focuses on precision health

At Big Data in Biomedicine, Stanford's Lloyd Minor focuses on precision health

Minor talking - 560

In the next decade, Stanford Medicine will lead the biomedical revolution in precision health, Dean Lloyd Minor, MD, told attendees of the final day of the Big Data in Biomedicine conference.

Involving all aspects of Stanford Medicine — including research and patient care — the focus on precision health will draw on Stanford’s existing strengths while propelling the development of new discoveries and transforming health-care delivery, Minor explained.

The choice of “precision health” rather than “precision medicine” is deliberate and a distinction that is reflective of Stanford’s leadership role. While both precision health and precision medicine are targeted and personalized, precision health is proactive, with an emphasis on maintaining health. In contrast, precision medicine is reactive, with a focus on caring for the sick. Precision health includes prediction and prevention; precision medicine involves diagnosis and treatment.

Minor used the model of a tree to describe Stanford’s focus on precision health.

Basic research and biomedical data science form the trunk, the foundation that supports the entire endeavor. Nine “biomedical platforms” form the major branches; these platforms include immunology, cancer biology and the neurosciences, among others. The tree’s leaves are its clinical core, with treatment teams in cardiac care, cancer and maternal and newborn health, for example.

The growth of the tree, its tippy top, is fueled by predictive, preventative and longitudinal care — where innovations in knowledge and care drive further changes in the future of health-care.

Minor made two key points about the tree, and its implications for research and care at Stanford.

First, the tree is big and growing. “There is room for everyone on the tree,” he said. “That is one thing that will make this plan — this tree — so powerful.”

Secondly, the tree is ever-changing. “Care will be analyzed and fed back. That’s really the true heart and meaning of the learning health-care system,” Minor said. “Every encounter is part of a much bigger whole.”

The entire effort will be fueled by big data, Minor said. To recognize its importance, and help train future leaders, Stanford Medicine also plans to create a new biomedical data science Department.

“We’re poised to lead,” Minor said. “We build upon a history of innovation, an entrepreneurial mindset, visionary faculty and students and a culture of collaboration.”

Previously: Big Data in Biomedicine conference kicks off todayStanford Medicine’s Lloyd Minor on re-conceiving medical education and Meet the medical school’s new dean: Lloyd Minor
Photo by Saul Bromberger

Stanford Medicine Resources: