Feeling sleepy after eating a big meal or after an early morning is normal. While excessive sleepiness does raise alarm, the key to avoid it to understand what is triggering it.

Our bodies have an internal clock, called the circadian rhythm, that controls when we feel sleepy or awake. According to National Institute of General Medical Sciences (NIGMS), these rhythms include physical and mental changes an organism experiences over 24-hour cycle.

According to John Hopkins Medicine this clock makes us naturally feel a bit sleepy in the early afternoon, usually around 1:00 or 3:00 PM. It's like a built-in dip in our energy levels. Scientists have studied this, and they've found that we're usually most alert in the morning and early evening, with a little dip in between. In some countries, people used to take a short nap in the afternoon to deal with this. It's just a normal part of how our bodies work, but we can learn how to manage it.

Ways You Can Avoid The Afternoon Crash

Everyone gets sleepy in the afternoon sometimes. It's a normal part of life. But you don't have to let it ruin your day. Sometimes, feeling really sleepy during the day can be a sign of a medical problem. If you have a condition like sleep apnea or narcolepsy, or if you take medicine that makes you sleepy, you might feel extra tired in the afternoon. The natural dip in alertness makes it even worse for you. If you're feeling excessively sleepy during the day, it's important to talk to your doctor. They can help you figure out what's going on and find ways to feel more awake and alert. By taking care of your sleep habits, you can make it easier to get through the day without feeling tired all the time. Here are some ways you can avoid the afternoon crash.

Prioritize Sleep

Quality sleep is crucial. Aim for consistent bedtime routines and sufficient hours of rest. Sleep deprivation amplifies afternoon fatigue. A well-rested body manages energy dips more effectively, reducing the severity of the midday slump.

Increase Physical Activity

Even brief movement combats sleepiness. Stand up, stretch, or take a short walk. Physical activity boosts blood flow and oxygen to the brain, enhancing alertness. Regular, light activity throughout the day helps maintain energy levels.

Lighter Lunch Choices

Heavy, carb-loaded lunches divert energy to digestion, inducing sleepiness. Opt for balanced meals with lean protein and vegetables. Lighter meals prevent excessive energy shifts, helping you stay alert and focused in the afternoon.

Caffeine or Hydration

Moderate caffeine intake can temporarily increase alertness. However, avoid excessive amounts, especially later in the day. Hydration is vital; water improves circulation and cognitive function. Choose refreshing drinks to stay hydrated and energized.

Vitamin C Supplementation

Vitamin C's antioxidant properties may reduce fatigue. It combats oxidative stress, a contributor to tiredness. Consider a supplement or vitamin C-rich foods. Remember, individual responses vary, and it's best to consult a healthcare professional.

Shift Mental Focus

When feeling sleepy, change your mental environment. Focus on completed tasks or engage in enjoyable activities. Distraction can redirect your mind, temporarily alleviating the feeling of sleepiness. A brief mental break can provide a needed reset.

Power Naps

Short naps (20-30 minutes) can rejuvenate, but avoid longer naps. They can lead to grogginess. Napping too close to bedtime disrupts nighttime sleep. A brief nap during the early afternoon can restore alertness and improve productivity.

GLP-1 receptor agonist drugs such as Ozempic and Wegovy have shown significant benefits for people with diabetes and obesity. However, not everyone experiences the same results.

Now, a study suggests that this variation may be due to genetic resistance, which means that some people are biologically less responsive to these medications, making these drugs less effective.

The new study by scientists at Stanford University in the US showed that about 10 per cent of the general population carry genetic variants that lead to what the researchers called “GLP-1 resistance”.

The GLP-1- receptor agonist drugs typically work by mimicking the hormone GLP-1 (glucagon-like peptide-1), which naturally helps regulate blood sugar by stimulating insulin release. The process slows the emptying of the stomach and reduces appetite.

However, in individuals with certain genetic variants, the team found that higher levels of GLP-1 did not regulate blood sugar better.

The researchers noted that the findings, published in the journal Genome Medicine, may be key to developing new therapies for people with GLP-1 resistance.

“There are a whole class of medications that are insulin sensitizers, so perhaps we can develop medications that will allow people to be sensitized to GLP-1s or find formulations of GLP-1, like the longer-acting versions, that avoid the GLP-1 resistance,” said Anna Gloyn, professor of pediatrics and of genetics at Stanford Medicine.

The Gene Linked to GLP-1 Resistance

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To zero in on the gene resistant to GLP-1 drugs, the team conducted experiments in humans. They traced this resistance to a PAM variant known as p.S539W.

PAM (peptidyl-glycine alpha-amidating monooxygenase) is an enzyme that is uniquely capable of activating many hormones in the body, including GLP-1.

While the researchers suspected that people with the PAM variant would have lower levels of GLP-1 in their blood, it actually increased levels of GLP-1. Although the exact mechanism is still unclear, experiments in both humans and mice confirmed signs of reduced response to GLP-1.

Analyzing diabetes drug trial data, they found that individuals with these variants were less able to lower their blood sugar levels even after six months of treatment. This suggests that despite having more circulating GLP-1, their bodies are less responsive to it.

“When I treat patients in the diabetes clinic, I see a huge variation in response to these GLP-1-based medications and it is difficult to predict this response clinically,” said Mahesh Umapathysivam, an endocrinologist and clinical researcher at Adelaide University in Australia.

“This is the first step in being able to use someone’s genetic make-up to help us improve that decision-making process,” he added.

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Importantly, participants with the PAM variants did not respond differently to other common diabetes treatments, including sulfonylureas, metformin, and DPP-4i.

The finding may help develop precision medicine, the researchers said. Knowing ahead of time who is likely to respond would help patients get on the right drugs faster, Gloyn said.

Reasons Why Ozempic May Not Help All People Lose Weight

Ozempic is primarily indicated for type 2 diabetes management. But some doctors may prescribe it for weight loss in appropriate patients without diabetes.

Previous research has shown that medical conditions such as sleep apnea, along with certain common medications, such as antidepressants, steroids, and contraceptives, can hamper the process of shedding extra pounds.

Another major reason that can hamper weight loss is the side-effects of these drugs that can prompt a person to halt their prescription mid-way.

Once widely known as non-alcoholic fatty liver disease (NAFLD), the common and dangerous fatty liver condition was rephrased as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) due to its strong link to metabolic health issues like obesity and diabetes.

MASLD now includes patients with fatty liver disease linked to metabolic risk factors such as obesity, diabetes, and hypertension.

MASLD: So What Prompted The Change?

Globally, it was observed that all patients who have non-alcoholic fatty liver disease also have some associated form of metabolic dysfunction. The patients reported having either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.

And all these problems eventually lead to significant comorbidities later, like some people developed heart disease, while others developed complications of diabetes.

In view of these, a global consensus process in 2023 involving hundreds of experts from different countries adopted MASLD as it better reflected these underlying causes of the condition.

What Does MASLD Mean?

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MASLD is an umbrella term for liver conditions that develop in the presence of 1 or more cardiometabolic risk factors—including high blood sugar, elevated body mass index (BMI), and hypertension—but in the absence of other causes of liver fat accumulation.

The condition can be defined by excess liver fat accumulation (more than 5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake.

It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.

“Initially, it was thought that having fatty liver disease without alcohol was a benign condition, but now it is recognized that, since it is associated with lots of metabolic comorbidities, it's no longer benign,” Dr. Ashish Kumar, Professor of gastroenterology and hepatology at Sir Ganga Ram Hospital in New Delhi, told HealthandMe.

He stated that whenever a diagnosis of fatty liver is present, "we should actually include other comorbidities, like obesity, dyslipidemia, which means cholesterol problem, diabetes, sugar problem, pre-diabetes, and hypertension. At least 50–70–80 percent of these patients will have one or more of these comorbidities".

Why Alcohol Is Not The Only Culprit For Fatty Liver

Although alcohol has remained the number one risk for liver disease, MASLD seems to be rising globally, including among people who do not drink. Why?

The reasons include:

a sedentary lifestyle,

increased consumption of fast and processed food,

lack of exercise,

lack of sleep,

stressful life.

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The experts noted that food, especially the increasingly accessible junk food or processed food, is a major culprit.

“So even if the person is not drinking alcohol, people are developing addiction to processed food, and this is causing an epidemic level of obesity and diabetes. Consequently, MASLD is also increasing, and now it is becoming the number one cause of liver disease,” Dr Kumar said.

How To Prevent MASLD?

According to Dr. Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, Gurugram, prevention must focus on following a healthy lifestyle like maintaining a healthy BMI, engaging in regular physical activity, and eating a balanced diet.

Controlling diabetes, cholesterol, and blood pressure is also important to prevent the risk of MASLD.

Dr Siddharth Badola, Manipal Hospital, Ghaziabad, suggested sustainable lifestyle changes such as:

Maintaining an adequate body weight: Even slight weight loss (5–10 percent) has been shown to significantly reduce liver fat and inflammation.

Follow a balanced and nutrient-rich diet: People should focus on consuming whole grains, fresh fruits and vegetables, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods.

Avoid foods with added sugar: Excess consumption of fructose, commonly found in packaged foods and sugary beverages, is a key contributor to fat accumulation in the liver.

Engage in regular physical activity: At least 150 minutes of moderate-intensity exercise per week is recommended to improve insulin sensitivity and liver health.

Manage associated metabolic conditions: Effective control of diabetes, hypertension, and dyslipidemia is essential in reducing the risk of MASLD progression.

Ensure adequate sleep and stress management: Poor sleep quality and chronic stress can negatively impact metabolic balance and liver function.

Keep your body hydrated with ample water intake and follow structured meal timings.

Although a heart attack is generally considered a disease of the elderly, its incidence in young individuals is unfortunately on the rise. The reasons behind this are multifactorial. A heart attack is a condition where one of the arteries (blood vessels) suddenly becomes partially or completely occluded by a thrombus. Although the thrombus generally occurs suddenly, the underlying reason is a chronic process of lipid deposition in the vessel walls called atherosclerosis. Atherosclerosis can begin even in the first decade of life, but events like heart attacks conventionally occurred beyond 45 years in men and 55 years in women. On average, heart attacks occur in Indians about 10 years earlier than in their Western counterparts.

Dr Shyam Sasidharan, Consultant, Department of Cardiology, KIMSHEALTH Thiruvananthapuram, spoke about the early onset of heart attacks. From a population perspective, the rising number of heart diseases due to coronary artery disease (CAD) is significant not only because of its overall negative impact on the healthy population but also due to the potential for preventive interventions.

Heart attacks among younger people

Acute coronary syndromes, or heart attacks, are on the rise among younger individuals, particularly in our country. Studies of the Asian-Indian migrant population have revealed a probable racial predisposition for premature CAD. However, the majority of the risk can still be attributed to the increased incidence of conventional CAD risk factors in young people, such as obesity, inactivity, diabetes, hypertension, and dyslipidaemia.

Smoking and substance abuse are resulting in more heart disease among the young. Lesser-discussed, unconventional risk factors, such as mental stress, lack of healthy employment practices, environmental pollution, and lack of proper food safety regulations, are in fact contributing significantly to this silent epidemic. COVID-19 infection as well as vaccination were widely attributed as causes of heart attacks in young people, but without adequate scientific evidence.

How to reduce heart disease risk in your 30s?

1. Creating awareness: The most important step towards prevention is creating awareness. Awareness regarding heart disease risk factors, healthy lifestyle choices, early symptoms of heart attack, and the need for timely medical attention is crucial.
2. Diet and physical activity: With rapid urbanisation and industrialisation, a nutritional transition is occurring in India. An increase in refined sugars, fats, and processed foods sets the stage for premature heart disease. Efforts to increase physical activity to at least 30 minutes of moderate activity per day, for five days a week, need to be promoted.
3. Prevention programmes: Programmes targeting the prevention of early development of lifestyle diseases such as diabetes, hypertension, and dyslipidemia need to be extended to younger individuals. Improving access to medical services across all social strata can enhance prevention, early detection, treatment, and reduction in morbidity and mortality from heart diseases.
4. Political will: Efforts to curb pollution, promote a better work culture, and enforce strong legislation for food safety will go a long way in not only preventing early heart disease but also promoting the overall health of the population.
5. Preventive health check-ups: At an individual level, promoting healthy habits and undergoing regular health check-ups can contribute significantly towards early detection of risk factors as well as early diagnosis of heart disease itself.
6. Improving mental health: There should be more discussions and interventions focused on overall mental health, work–life balance, and happiness, as these are known to impact heart health.