How Many Hours of Sleep Do You Actually Need?
Edge Marketing Lite • December 14, 2021

It depends on how well you want your brain to work.


Sleep is a time suck. If you multiplied the average recommended number of hours we should sleep in a day—eight for a typical adult—by the number of days in an average lifespan (78.8 years in the United States), that would amount to about 9,587.3 days. That’s one third of your life spent unconscious. From an evolutionary standpoint, sleep is quite literally a waste of your time, yet it’s fought its way through countless years of adaptation in nearly every living animal on Earth. So it must be important, right?


In fact, researchers have found that sleep plays a vital role in the functioning of nearly every organ system in the body. At the same time, medical conditions, a busy schedule, and even the simple unavoidable act of aging constantly challenge the number of hours we allow ourselves. But that begs the question: how much sleep do we actually need? And can we train ourselves to need less?


First, let's talk about that eight hour figure that gets tossed around. It’s far from some arbitrary number. It's truly the number of hours we naturally crave, and there are two pretty strong pieces of evidence for it. In a series of experiments, researchers took study participants into a laboratory with no sunlight or other visual cues and, at night, gave them a non-negotiable, nine-hour-long opportunity to sleep. They did this each night for a number of weeks, and the results were always the same: even when provided with more time, humans will typically spend an average of eight hours catching up on their Zzz.


And that wasn't the only study to support the eight-hour sleep schedule. Back in 1938, a sleep researcher named Nathaniel Kleitman and one of his students spent 32 days living in Mammoth Cave in Kentucky, one of the longest and deepest caves in the world—an environment completely void of sunlight. When they analyzed their sleep patterns, they found that they, too, slept about eight to eight and a half hours per night.

But what happens when we deprive ourselves, as many Americans do, of all or some of these recommended hours? It turns out, a lot. In 2003, David Dinges and Gregory Belenky, both sleep researchers at the University of Pennsylvania and the Walter Reed Army Research Institute, performed some of the most pivotal studies on the consequences of sleep deprivation thus far. Their goal was to figure out how little sleep a person could get away with, without having it affect their cognitive performance.


The two studies involved two-week-long experiments where researchers deprived participants of varying hours of sleep. Before they did so, they first allowed subjects to receive eight hours of sleep, followed by a series of cognitive tests the next day—which measured things like someone’s speed of response, how well they could interpret a written passage, and the number of times they dozed off for a second or two (what science calls a microsleep). All of this gave them a baseline for each subject's normal cognitive performance.


The researchers on Dinges’ team then assigned the participants to one of four groups: one group was allowed eight hours of sleep for the following two weeks, the next six, then four, and the last group received zero hours of sleep for up to three days straight.


That last group, says Matthew Walker, the director of the sleep and neuroimaging lab at the University of California, Berkeley, showed just how much your cognitive performance suffers after just one night of total sleep deprivation. What Dinges and colleagues found (and what subsequent studies have confirmed) is that to your brain, one sleepless night is the cognitive equivalent of being legally drunk, says Walker.


The rest of the groups weren't so far behind. While the group that received eight hours of sleep saw virtually no change to their cognitive performance throughout the two-week study, after just 10 days the participants that slept six hours each night were as cognitively impaired as those suffering from a night of total sleep deprivation. And the group that got four hours? It only took them three days before they reached that same level of impairment. By 10 days in, they were as cognitively impaired as if they had gone two days with no sleep. As the days went by, these detriments didn't slow down. “If you looked at the data graphs, there’s no end in sight. That was the frightening thing,” says Walker.


When Dinges compared his results to his colleague’s at Walter Reed—who had done the same exact study but with odd hours (meaning seven, five, and zero hours of sleep), their findings were basically identical. Even the group that slept seven hours a night—which some people think of as a luxury, says Walker—were dozing off at a rate three times greater than the group sleeping eight hours a night just five days into the experiment. So, how much sleep can you take away before someone becomes cognitively impaired? Sorry, but the answer is less than one hour.


Okay, so that’s sadly settled: we should all be getting no less than eight hours of sleep per night. No exceptions. But we all lead extremely busy lives, especially during the workweek. Can we make up any of those hours lost during the week on the weekends (similar to those weekend warrior who still receive health benefits from only exercising on twice a week) so that you average eight hours a night? The researchers asked the same question.


After the sleep deprivation part of the study was done, the researchers then gave the participants three nights of “recovery sleep” where they were allowed as much as they wanted (unsurprisingly, most slept way more than eight hours). After those three days, they took the same cognitive screening tests. But the participants hadn't returned to the baseline levels they had at the beginning of the study. In other words, if you are sleep deprived—meaning you are sleeping seven hours or less each night—then it takes you longer than a weekend to get back to baseline. And no one's figured out how long it actually takes.


“People think that sleep is like the bank. That you can accumulate a debt and then hope to pay it off at a later point in time,” says Walker. “And we now know that sleep is not like that.”


The brain has no capacity to get back all that it has lost, Walker explains. Why is this? Why haven’t we evolved a way to make up for lost sleep the same way we can make up for days of starvation by storing calories as fat? The answer, Walker says, is simple: “Human beings are the only animal species that deliberately deprive themselves of sleep.” There is no storage system for sleep in the brain because life never needed to create one.

Undoubtedly, many of you are reading this and scoffing. If you regularly get six hours of sleep and feel just fine, why should you waste your time trying to squeeze in more?


Consider this: after the first night of reduced sleep, researchers in Dinges’ study asked the participants in the six-hour-a-night group how well they thought they did on the day’s cognitive tests. They replied that they did well—great, even. However, when the study researchers actually compared the two performances, the tests completed after six hours of sleep were significantly worse than the ones done after eight hours of sleep.


“You don’t know you are sleep deprived when you are sleep deprived,” says Walker, “That’s why so many people fool themselves into thinking they are one of those people who can get away with six hours of sleep or less.” Walker argues that there’s no way you can effectively train yourself to need less sleep. You may get used to feeling tired all the time, he says, but that does not mean you can suppress that tiredness and perform as well on cognitive tests as you would if you received eight hours.


But perhaps there is a positive twist—in the form of a mid-afternoon nap backed by science. Researchers who have looked at cultures that remain completely untouched by electricity, such as the Hadza of Tanzania, found that, especially in the summer, these groups tend to sleep biphasically: packing in six hours a night, and then a few hours again in the afternoon. This begs the question, Walker says, of whether human beings should stay awake for sixteen hours straight. In fact, everyone goes through an afternoon lull. Biologists have actually been able to measure this physiological dip in our alertness—what science calls a postprandial dip—through changes in our metabolic system, as well as adjustments in our brain waves, and in our cognitive reaction times. The universal cognitive pause means we might benefit from a nap around this time. “Perhaps human beings need to sleep biphasically for truly optimal performance, though that’s still unclear,” Walker says.

One thing science knows for sure, however, is that the less sleep you get each night, the less cognitively aware you are the next day, the day after, and every day after that. Simple.


In fact, Walker says, if you ever want proof of how much of an effect just one hour less sleep can have on human beings, just remember how you feel the days after daylight savings begins every March, when nearly the entire country has intentionally deprived themselves of an hour of sleep.

But perhaps the most relevant thing to remember, Walker says, is this: When someone tells you the reason they can only get five hours of sleep is that they simply have too much to do, “I tell them, I’m sorry, but there’s an irony in your statement. The reason you are left with so much to do could likely be because you are only getting five hours of sleep and your cognitive functioning is deficient, so it's taking you forever to do everything."


At Restoring Health, we recognize that everyone is different and the above techniques may not work for everyone. Some people need professional help to get back to a more normal state of mind. That is why we offer neurofeedback: a computer-based system for retraining brainwaves into making more healthy patterns. For those with advanced sleep issues, neurofeedback could help get you back into better sleep patterns and a more normal state of mind. To learn more, check out our neurofeedback page on this site or call (321)-444-6750 for more information. 

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Source:
https://www.popsci.com | Claire Maldarelli

By Dana O'Keefe March 22, 2024
A well-functioning digestive system is essential for overall well-being, as it breaks down food into vital nutrients that fuel energy, growth, cellular repair, and more! When your digestion is functioning optimally, you may not even think twice about it. However, when issues arise, they can have widespread effects on your overall well-being. Poor digestion can manifest through signs such as persistent digestive discomfort, irregular bowel movements, nutrient deficiencies, food sensitivities, and unexplained weight fluctuations. Recognizing these indicators is crucial for addressing underlying concerns. In this blog post, we'll explore the top five signs of compromised digestion and provide actionable insights to improve and optimize your digestive health. 5 Reasons Why You’re Not Digesting Properly 1- Stress and Digestive Function You’ve likely felt “butterflies in your stomach” at some point – that queasy feeling accompanied by intense nervousness or excitement. These sensations occur because our gut and brain are intimately connected. If you feel stressed often, it can significantly alter your digestion. The digestive tract has a nervous system of its own called the enteric nervous system or ENS. The ENS contains thousands of complex neurons that control digestive functions. The ENS works in tandem with the central nervous system (CNS) to communicate messages between the gut and the brain. When the brain senses external factors like stress, it releases chemicals that stimulate the ENS to divert blood flow away from the gastrointestinal tract and toward other organs that support survival. When digestion is disturbed, the ENS communicates distress to the brain. Over time, chronically elevated stress hormones will lead to impaired digestive function. Identifying your stressors with non-judgemental awareness can be a powerful first step to improving digestion. Science confirms the value of keeping a mindful eating journal in which you record the trigger of the stress, its symptoms, and any eating activities surrounding it. Recording this information can help you to acknowledge any problematic stress and take action. Other relaxation practices like yoga can powerfully improve digestion. Not only can yoga help reduce stress by allowing us to tune into our thoughts, but certain poses and movements can help increase blood flow to the digestive organs, improving their function. 2 - Imbalanced Gut Microbiome Your gut is filled with trillions of beneficial bacteria, known as the microbiome, which are important for supporting the immune system and metabolism. A diversity of gut bacteria has been linked to human health and longevity, while lower levels of diversity are associated with several acute and chronic diseases. A pillar of good gut health and digestion is maintaining a balance between these good and bad strains of bacteria. If you are experiencing new or uncomfortable digestive symptoms, it could be a sign that the balance of bacteria in your gut is off. Several factors can lead to imbalanced gut bacteria, but these are some of the most common: ● A high-sugar diet. Studies show that consuming large amounts of sugar and processed foods can lessen the amounts of “good” bacteria present in the gut and increase inflammation. ● Antibiotic use. By targeting harmful bacterial infections, antibiotics inadvertently kill off other good bacteria that our bodies need. Increasingly, studies have found that even a short dose of antibiotics can have a profound negative effect on gut diversity. ● Alcohol consumption. In large amounts, alcohol has been shown to increase inflammation and the presence of “bad” bacteria in the gut (also termed dysbiosis). One study looked at the gut bacteria of 41 alcoholics and compared them to 10 healthy individuals who consumed little to no alcohol. Researchers found that imbalance was present in 27% of the alcoholic population, but it was not present in any of the healthy individuals. ● Lack of sleep. Sleep is a crucial ingredient of our overall health, and recent studies have found associations between irregular sleep patterns and harmful bacteria in the gut. Avoiding these red flags and consuming gut-friendly foods can help improve the diversity of your gut bacteria. We recommend: ● Probiotic rich foods such as yogurt, kefir, kimchi, miso, and sauerkraut. ● Prebiotic foods, which feed the good gut bacteria, like bananas, garlic, and asparagus. ● Plenty of fiber found in beans, whole grains, vegetables and fruits 3 - Enzyme Insufficiency Digestive enzymes are naturally occurring proteins responsible for breaking down food and liquids into smaller molecules that the body can absorb. This allows the body to access critical nutrients from food, which it uses to grow and perform vital functions. There are three main types of digestive enzymes: 1. Amylase, which breaks down carbohydrates, starches, and sugars. 2. Lactase, which helps you digest lactose, the natural sugar occurring in dairy products. 3. Lipase, which works with the liver allowing you to digest fats. When your body lacks digestive enzymes or doesn’t release enzymes as it should, several uncomfortable symptoms can occur, such as: ● Stomach cramping ● Malnutrition/Nutrient deficiencies ● Bloating ● Diarrhea ● Gas ● Unexplained weight loss When the pancreas doesn’t appropriately secrete these digestive enzymes, it affects your body’s ability to break down the foods you eat and absorb nutrients. Thankfully, there are steps you can take to support and increase enzyme production for better digestion: ● Digestive enzyme supplements: Many people find that over-the-counter digestive enzyme supplements help with problems such as acid reflux, gas, bloating, and diarrhea. Furthermore, combining these supplements with a probiotic has been shown to be effective. ● Enzyme-rich foods: Certain foods naturally have high digestive enzyme content. Incorporating more of the following can have a positive impact on digestion: Papayas, pineapple, pure honey, avocados, miso, and ginger. 4 - Food Intolerances & Allergies An increasingly common source of unwanted digestive symptoms is food intolerances and allergies. While both can produce similar symptoms, food intolerance does not involve the immune system and is not typically life-threatening like allergies can be. Food intolerance occurs when your body has difficulty chemically processing or digesting certain foods. If left untreated, they can cause several disagreeable symptoms, such as: ● Gas ● Bloating ● Fatigue ● Diarrhea ● Constipation ● Stomach pain or cramping If you are experiencing one or more of these symptoms often, you may have a food intolerance. It can be difficult to pinpoint exactly which food is causing the intolerance, though. We recommend trying an elimination diet if you have suspicions about a particular food–stop eating it for at least a couple of weeks and see how your body reacts! Allergy and food sensitivity testing performed by a practitioner can also be a useful step to take. These are some of the most common food intolerances: ● Dairy. As mentioned above, many people lack the enzymes to digest the natural sugars found in dairy products. Some people also experience a negative reaction to the whey protein within dairy. To identify whether dairy may be at the root cause of your symptoms, it’s important to completely avoid all dairy ingredients for a minimum of 2-3 weeks. ● Gluten. Gluten is a protein that is found in grains like wheat, rye, barley, kamut, oats, and spelt. People with celiac disease experience an immune response when they consume the protein, which over time can inflame the small intestine and lead to serious digestive problems. People who test negative for celiac disease but still experience discomfort when they consume gluten may have a milder form, called non-celiac gluten sensitivity. ● Caffeine. For many adults, a cup or two of coffee is an integral part of their morning routine. However, some people are more sensitive to caffeine and unpleasant experience reactions from consuming just a small amount. Researchers have found that this hyper-sensitivity to caffeine is largely genetic. If small amounts of caffeine cause you to feel anxious, jittery, or have difficulty sleeping, we recommend minimizing your intake and instead opting for decaf herbal teas and coffee. 5 - Dehydration Water is essential for human health. Proper hydration helps lubricate our joints, promotes brain function, and supports healthy skin. Hydration is also a critical factor for improving digestion and gut health. Your body uses fluid to lubricate the digestive system, which helps to move food along as it travels through your stomach, intestines, and colon. If there isn’t enough fluid to keep the food moving, it can get stuck or slow down. This can cause uncomfortable symptoms like constipation or bloating. Fluid is also used to transport the enzymes we discussed that are responsible for breaking food down. When you are dehydrated, it can actually cause inflammation in the intestines due to the constant rubbing of food against them without lubrication. OK, so hydration is important for digestive health, but how much water do we actually need? While water requirements are individual and highly variable based on metabolic needs, environmental conditions, and physical activity, it’s suggested that 2.2 liters (nine cups) per day for women and three liters (12 cups) for men is the ideal minimum amount. Here are a few tips for increasing your water intake: ● Keep a non-plastic water bottle in your car and try to take it everywhere you go! ● Limit caffeine and alcohol consumption, as these dehydrate you. ● Eat thirst-quenching foods with a high water content, such as watermelon, celery, cantaloupe, and spinach. Let’s not forget chewing habits! If you feel like you’ve been eating all the right things, yet are still experiencing unpleasant digestive symptoms, the problem may not be what you’re eating, but how! Yes, chewing plays a larger role in digestion than you may think. We tend to have busy lifestyles here in North America that allow us little time to slow down and enjoy our meals. However, eating too quickly can cause a range of digestive issues, no matter how healthy your diet is. When you don’t adequately chew your food, you’re actually creating more work for your digestive system. In turn, this can lead to stomach issues like bloating, cramps, and even acid reflux. Chewing is an important part of the digestive process, as saliva produces digestive enzymes that help move our food along. Here are a few tips to encourage proper chewing habits & digestion: ● Breathe deeply. Before sitting down to eat, take a few deep belly breaths to promote blood flow and relaxation. Take a minute to pause mindfully before a meal can help with overeating or eating too quickly. ● Pay attention. Rather than hurriedly eating in the car or mindlessly snacking during work, pay attention to what you’re eating and avoid distractions whenever possible. ● Chew 20-30 times. According to recent studies and traditional Ayurvedic practice, the magic number of chews for optimal digestion is approximately 20-30. Chewing your food 20-30 times per bite helps ensure proper nutrient absorption and can help in weight management. Everybody experiences digestive issues at some point. They can be uncomfortable, and embarrassing to talk about, and the root cause is often difficult to pinpoint alone. We have covered some of the most common causes of poor digestion and the lifestyle changes you can make to see improvements. If you have digestive issues that are not corrected with lifestyle changes or are getting worse, seeing a healthcare practitioner for a comprehensive diagnosis and treatment plan may be required. Don’t let poor digestion take control of your life – schedule a consultation with us today! Sources:. Cherpak CE. Mindful Eating: A Review Of How The Stress-Digestion-Mindfulness Triad May Modulate And Improve Gastrointestinal And Digestive Function. Integr Med (Encinitas). 2019 Aug;18(4):48-53. PMID: 32549835; PMCID: PMC7219460. Shree Ganesh HR, Subramanya P, Rao M R, Udupa V. Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial. 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By Dana O'Keefe March 22, 2024
Your hormones play a crucial role in maintaining the delicate balance that keeps your body functioning at its best. From regulating metabolism and mood to influencing reproductive health and immune function, these chemical messengers orchestrate various aspects of your well-being. However, achieving hormonal harmony can be a delicate dance, and numerous factors in our daily lives can tip the scales in unfavorable directions. In the pursuit of optimum health, it's essential to recognize that your efforts might be sabotaged by common culprits known as hormone disruptors. These disruptors, often encountered in your everyday routines, have the potential to throw off the intricate balance of hormones, creating a ripple effect throughout your body. In this blog, we will dive into the world of common hormone disruptors, shedding light on the major players that could be working against your health goals. 8 Common Hormone Disruptors You Need To Know These disruptors affect the hormonal balance when they mimic, block, or disrupt the normal functioning of your hormones. They can bind to your hormone receptors, disrupting the information chain regulating hormone production. It’s hard to avoid some of these, but knowledge is an important first step in avoiding or minimizing your exposure! ● Pesticides and herbicides. Harmful pesticides are found in up to 75% of non-organic produce grown in the U.S. ● Bisphenol A. Commonly known as BPA, this synthetic compound lines food and drink containers. ● Parabens. Also synthetic compounds, parabens are used as preservatives in many cosmetic and body care products. ● Phthalates. These man-made chemicals are all around us! They’re found in things like soaps, shampoo, nail polish, body lotion, toys, and food and beverage packaging. ● Perfluoroalkyl substances (PFAS). These are added to products to increase their resistance to water and grease. ● Stress. Your stress response raises your level of the hormone cortisol, which has a domino effect on your other hormones. ● Poor sleep. Not getting enough high-quality sleep affects your body’s ability to regulate stress hormones like cortisol and the hormones that control your appetite, ghrelin and leptin. ● Lack of exercise. A sedentary lifestyle also impacts hormone regulation. Not getting enough movement in your day can lead to reduced insulin sensitivity, altered levels of growth hormone and cortisol, and disruptions in the balance of estrogen and progesterone. The Impact Of Hormone Disruptors The effects of hormone imbalances are far-reaching. Here are some of the major impacts: ● Endocrine system disruption. Your endocrine system is a complex network of glands that secrete hormones, including insulin, stress hormones like cortisol, adrenaline, thyroid hormones, estrogen, progesterone, and testosterone. ● Thyroid dysfunction. Hormone disruptors can compete with thyroid hormone at receptor sites, interfering with thyroid hormone synthesis. The result is thyroid dysfunction, which leads to conditions like hyperthyroidism or hypothyroidism. ● Reproductive system issues. Estrogen, progesterone, and testosterone are also vulnerable to dysfunction. BPA, for example, has a similar structure to estradiol, a type of estrogen, so BPA binds to estrogen receptors. Phytoestrogens, found in many soy products, can also disrupt estrogen in some people. When hormone disruptors attach to sex hormone receptors, the normal functioning of estrogen or testosterone in the body is disrupted. This can lead to infertility and other reproductive issues. ● Metabolic dysfunction. One notable effect of hormone disruption is the impact on metabolism. Many hormones impact your metabolism, and disturbances can lead to serious health issues like obesity, nonalcoholic fatty liver disease, and diabetes. Recent studies have found that exposure to hormone disruptors may be a strong risk factor for obesity. Although more research needs to be done, findings suggest that these disruptors impact energy balance, basal metabolic rate, gut microbiota, and hormonal control, all leading our body to store calories, and disrupting appetite regulation. Avoiding The Impact Of Hormone Disruptors After reading the above sections, it may seem like hormone disruptors are all around us. But knowledge is power. Now that you know what to avoid, you can take some simple steps to reduce your exposure. As a bonus, these steps will all lead to a healthier you! 1 - Hormone-friendly dietary changes Careful food choices are one of the most important things you can do to reduce the impact of hormone disruptors such as pesticides and BPA. ● Choose organic food whenever possible. More and more organic food is available! About 4% of U.S. total grocery sales is organic food. Even when buying organic, be sure to wash all produce. ● Eat less processed foods. Try to focus on the outer edges of the grocery store, and avoid the packaged and processed foods in the middle. Studies have found that ingredients found in overly processed foods interfere with hormone regulation. ● Don’t store food in plastic containers. Plastic containers can expose your food to hormone disruptors like BPA, so look for glass or metal containers. As well, if you buy canned soups or beans, look for BPA-free containers. 2 - Better personal care products There’s a growing market for natural personal care products, so you have many opportunities to find products without phthalates, parabens, or BPA. One report found that people who use natural body care and beauty products have better overall health than people who don’t. Not sure where to start? You can find ratings for hundreds of products on the Environmental Working Group site. 3 - Optimize your environment From the air you breathe to the water you drink, look to minimize contaminants and pollution wherever possible. ● Invest in an air purifier. With more of North America experiencing smoky summers from wildfires, this is more important than ever. Air purifiers with HEPA filters are often the most effective. ● Filter drinking water. Bottled water often contains harmful microplastics, so your best bet is to use a high-quality filter for the water you drink. If you used a filtered water jug, follow directions on how often to change the filter. ● Take a look at your cleaning supplies. The things you use to clean your home may not be so “clean” after all - up to 75% of cleaning products contain at least one harmful substance. Look for products labeled “green” and investigate do-it-yourself alternatives. You’d be surprised by how many things baking soda, lemon juice, or soap can get clean. 4 - Healthy stress management and proper sleep routine Chronic stress heightens vulnerability to hormone disruption, emphasizing the importance of integrating stress reduction techniques into daily life. Practices like yoga and meditation play a pivotal role in regulating the body's stress response, effectively managing stress hormone levels. Simultaneously, ensuring good sleep is paramount for hormonal balance, as disrupted sleep patterns can impact hunger-regulating hormones and disturb the delicate equilibrium between cortisol and melatonin. By incorporating mindfulness activities and prioritizing quality sleep, you can fortify your body against the adverse effects of chronic stress, fostering an environment conducive to optimal hormone production and balance. 5 - Move, move, move! Regular exercise plays a pivotal role in supporting proper hormone production and balance. Physical activity stimulates the endocrine system, prompting the release of hormones such as cortisol, insulin, and growth hormone. Engaging in aerobic exercise, strength training, or a combination of both has been shown to enhance insulin sensitivity, helping to regulate blood sugar levels and prevent insulin resistance. Moreover, exercise promotes the release of endorphins, the body's natural mood enhancers, which can contribute to reduced stress and anxiety. Additionally, consistent physical activity is linked to improved sleep quality, indirectly influencing hormonal balance by supporting the body's circadian rhythm. Overall, a well-rounded and moderate exercise routine is a powerful tool for maintaining proper hormone production and fostering overall health. By understanding where common hormone disruptors are found, how to avoid them, and how to minimize their impact by optimizing your hormone function, you can empower yourself to make informed choices that support hormonal balance and overall well-being. If you’d like some help with finding your ideal balance or more information on hormone health, make an appointment with us today! Sources: Environmental Working Group, “Shopper’s Guide to Pesticides in Produce,” https://www.ewg.org/foodnews/summary.php Heindel JJ, Blumberg B, Cave M, Machtinger R, Mantovani A, Mendez MA, Nadal A, Palanza P, Panzica G, Sargis R, Vandenberg LN, Vom Saal F. Metabolism disrupting chemicals and metabolic disorders. Reprod Toxicol. 2017 Mar;68:3-33. doi: 10.1016/j.reprotox.2016.10.001. Epub 2016 Oct 17. PMID: 27760374; PMCID: PMC5365353. 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