This post may contain affiliate links.
Thanks for joining us for episode 104 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.
Today we are answering the following question from a listener:
“I recently read an article in a major newspaper stating that eating late at night has again been found to be bad for you. According to the article, it can raise risk of cardiovascular disease, weight gain, and deteriorate sleep quality. Personally, I find it very hard to avoid eating at night. If I don’t, I tend to feel hungry when going to bed or I wake up too early because I’m hungry.Sometimes this happens even if I eat rather close to bedtime. I wonder if this might be from some metabolic problem like issues with insulin, leptin, melatonin, or something else. What foods would you recommend to avoid waking up hungry? What’s your take on whether it is actually bad to eat late at night? I found contradicting information when trying to research the topic.”
We keep hearing the warnings to curb late night snacking, but many of us can relate to the familiar hunger pangs of the nighttime munchies. Is hunger at night really a problem that can lead to negative health outcomes?
On today’s show we’ll be discussing whether or not nighttime snacking is detrimental to health and the reasons why you may experience late night hunger. You’ll come away with fresh insight into this controversial topic as well as practical tips on how to promote healthy hunger signaling.
Here’s what Laura and Kelsey will be discussing in this episode:
- Effects of circadian rhythm disruption on hunger signals
- Situations where eating before bed is not harmful and can even can be beneficial
- Why appetite may not be regulated simply by the concept of calories in and calories out
- Research that suggests increased hunger at night is normal and based on circadian rhythms
- How the time you eat dinner can affect appetite level before bed
- The effect under eating calories during the day has on nighttime appetite and waking up hungry during sleep
- The importance of maintaining blood sugar balance in regulating hunger
- The effects of stress on cortisol levels, blood sugar, and emotional eating
- The prevalence and possible causes of night eating syndrome
- How consistent meal timing and macronutirent balance throughout the day can help balance hunger signals
- The importance of a nutrient dense diet in supporting healthy hunger signaling
- Tips on how to support healthy circadian rhythms
- This episode is sponsored by Maty’s Healthy Products
- Article about circadian rhythm and nighttime appetite
- Online calorie calculator
Laura: Hi everyone! Welcome to episode 104 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.
Kelsey: Hey everyone!
Laura: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, at LauraSchoenfeldRD.com, and Kelsey at KelseyKinney.com.
Over the next 30 to 45 minutes, we’ll answering your questions about health and nutrition and providing our insight into solving health challenges with practical tips and real food. Stick around until the end of the show where we will be sharing updates about our businesses and our personal lives.
Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re there, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.
Laura: Today on the show we’re going to be discussing the causes of hunger late at night and how to solve your night eating habits if they’re truly contributing to poor health. Before we get into our interview, let’s hear a quick word from our sponsor:
Today’s podcast is sponsored by Maty’s Healthy Products. Maty’s started simply as a mom determined to help her daughter heal and turned into an amazing company that makes all natural and organic cough syrups, vapor rubs, and now even an Acid Indigestion Relief product. Maty’s All Natural Acid Indigestion Relief works quickly to relieve heartburn and indigestion while promoting healthy stomach acid levels. It aids digestion and promotes your body’s natural healing abilities. Made with whole food ingredients you know and recognize like apple cider vinegar, ginger, honey, and turmeric, Maty’s All Natural Acid Indigestion Relief is safe and drug free. Maty’s natural and organic remedies have powerful healing properties to support your body and improve your health. Try them today by visiting Maty’sHealthyProducts.com. You can also find Maty’s at Walmart, CVS, Target, Rite Aid, and a grocery near you.
Laura: Welcome back everyone! Here is our question for today’s show:
“I recently read an article in a major newspaper stating that eating late at night has again been found to be bad for you. According to the article, it can raise risk of cardiovascular disease, weight gain, and deteriorate sleep quality. Personally, I find it very hard to avoid eating at night. If I don’t, I tend to feel hungry when going to bed or I wake up too early because I’m hungry. Sometimes this happens even if I eat rather close to bedtime. I wonder if this might be from some metabolic problem like issues with insulin, leptin, melatonin, or something else. What foods would you recommend to avoid waking up hungry? What’s your take on whether it is actually bad to eat late at night? I found contradicting information when trying to research the topic.”
Laura: I think what I would like to do is first talk about the controversial suggestion that eating at night is bad for you because I think when we talk about that kind of research, of course just keep in mind that newspapers and magazines like to be a little bit sensational with research information.
This study, I don’t know what study they’re referring to, but it could have been something that said people who eat later than 10:00 at night tend to have obesity, heart disease, poor sleep, blah, blah, blah. A lot of these studies are correlational. I would not be surprised if there was a correlation between people who eat late at night and these health issues. However we have to think about why that correlation would exist and not just say well if there’s a correlation, it must mean eating late at night is bad for you.
There’s a couple of different things that I feel like could lead to late night eating at least in the west, maybe not in third world countries, but in the western modernized cultures. A lot of people tend to stay up a lot later than they maybe should. You and I might go to bed at like 10:00 or something on a normal night, but I’d say the average American is probably not going to bed that early unless they’re super committed to good bedtimes.
Laura: There’s a lot people that stay up late watching TV, or doing work, or just playing around on the internet, or whatever. But a lot of people are going to bed 11-12, 1:00 in the morning later. If you are staying up that late, first of all it just adds extra time awake compared to when you have dinner. If you’re eating dinner at let’s say like 6:00 or 7:00 and then you don’t go to bed until midnight, you’re going to have a 5 or 6 hour gap between eating dinner and going to bed. It’s no wonder that you’d be hungry because a five or six hour break between eating, you’re generally going to be ready for another meal.
A lot of people, they’ll stay up late and then they end up eating before they go to bed. That lack of sleep the next day can affect their hunger, maybe it affects their caffeine intake. If they’re staying up late and then they wake up in the morning and they’re tired, and then they need caffeine, and then that kind of triggers some sugar cravings, and then they may end up just eating more food in general.
If they’re already eating breakfast and then they’re eating a fourth meal at 10:00 or 11:00 at night, then overeating in general is going to lead to weight gain, and metabolic syndrome, and cardiovascular disease especially if it’s overeating of junk food. Which again, most American’s if they’re eating late at night, they’re not going to be eating a steak and sweet potato. They’re going to eating packaged foods, or desserts, that kind of thing, or ice cream. Ice cream in moderation, not a big deal. But if you’re eating ice cream on top of an overly junky diet, then that might not be so helpful.
Then the other thing that I’m thinking could contribute to poor health outcomes is if you’re chronically staying up late and eating late at night, that could disrupt your body’s natural circadian rhythms which then would negatively impact sleep. If you’re just overall not supporting circadian rhythm entrainment, that can make you sleep more poorly, or have weird wake up times, or just generally not having a normal pattern of sleeping. And then those circadian rhythm disruptions can also lead to things like inflammation, metabolic syndrome, insulin resistance, that kind of thing. That could potentially be causing some problems too.
I also don’t particularly associate these affects with someone who’s eating a healthy diet and they just have a little extra food before going to bed to make sure that they’re not hungry and they sleep better. I think this is something that you and I recommend for a lot of people to have a little bit of food right before bed if they’re struggling with not sleeping well, or if they’re super active, or maybe they’re just having a hard time getting enough calories in at their normal meals and they need a little extra before going to bed to make sure that they sleep well.
Even if you are sleeping well, I don’t really think there’s any problem with having a bedtime snack. I don’t think there’s going to be an increased risk of obesity or heart disease if you have a little food before going to bed. I would imagine you’re on the same page there, Kelsey?
Kelsey: Yeah. I think there’s a big difference between what you were talking about, that overconsumption where if that is leading you to over consume calories consistently, then yeah, that might cause a problem. But if it’s within your overall caloric expenditure and you’re eating part of those calories at night, I certainly don’t think there’s anything wrong with that.
Laura: Even just the food quality, I mean we don’t like to be overly consumed with calories, but if you’re food quality is better it’s going to affect your calorie intake.
Laura: If you have a banana and some almond butter right before bed, you’re probably not going to eat as much as if you had Doritos or something.
Laura: There’s a lot to be said for palatability and the processed junk food versus something that’s fairly healthy and it’s just another part of your diet. It’s funny because we just last week talked about the person who was potentially under eating and this would be a situation where maybe having a bedtime snack is actually helpful because she was eating 1,800 calories and we thought she needed at least 2-300 more. She could throw in a banana with a tablespoon of almond butter and easily get that 200 calories right before bed and that could end up just overall making her feel better, helping her sleep better so that way she wakes up more refreshed in the morning. There are some people out there that late night eating might actually be helpful.
There are some reasons that people might be hungrier at night that we’re going to cover, but one issue that I wanted to discuss was the question of whether or not being hungry at night is actually abnormal because from this question we’re assuming she feels that eating late at night is – or actually I should say he or she, we don’t know the gender – but eating late at night is unhealthy and associated with some kind of metabolic problem or having that drive to eat late at night. But when I was doing research to just look into that topic and see is that weird, is that abnormal, is that unhealthy to have a higher hunger level at night, there’s actually some research from the last couple years that suggests that having a higher amount of hunger in the evening is actually normal and based on circadian rhythms.
We may think that your overall appetite is generally regulated by your calorie balance, so if you haven’t had enough food, you’re going to be hungry. If you had too much food, you’re going to be full. Which it does, I mean that definitely impacts your hunger signals if you’re overeating or under eating. But the problem with that being the only thing that’s going to drive appetite is that if it truly was just based on calorie surplus versus deficit, it would make more sense for us to be the hungriest in the morning because we’ve gone 8 to 12 hours without eating, minimum. If you did that during the day, if you went 12 hours without eating, you’d probably be a lot hungrier.
Laura: But we do it overnight just fine. That to me and the research that I saw indicates that it’s not just about calories in and calories out, it’s also about the time of the day and the type of hormones that are released at different times of the day to stimulate or suppress appetite.
Appetite is actually generally the lowest in the morning for most people. The research that they’ve done, most people only get about 16 to 18% of their daily calories at breakfast. A lot of people skip breakfast all together. A lot of the intermittent fasting type recommendations play off that lower appetite and have you do the fasting in the morning when you’re really actually not that hungry for the most part. I mean some people wake up super hungry. I know I tend to get hungry about an hour after waking up.
Kelsey:Yeah, same here.
Laura: But a lot of people, they’re not even hungry at all and intermittent fasting actually works well because they don’t have to worry about eating. But that would like I said indicate that there’s something happening that makes our bodies crave less food in the morning and more food at night potentially.
The research that I looked at was from 2013, and I’ll link to this paper in the show notes just so you guys can check out the study too. But it was from Oregon Health and Science University and Harvard University and their research found that the body’s internal clock, which is that circadian rhythm system, actually could be the cause of having late night cravings or having hunger in the evening.
What they did with this study is they took a bunch of participants and they essentially reset their internal clocks. All of our internal clock systems are based on light and dark exposure, eating, exercise. There’s a lot of different things that affect our circadian rhythms. I don’t remember exactly how they did this, but they basically got everyone on the same schedule to make sure that they were waking up the same time, going to bed at the same time, eating meals at the same time, just basically trying to reset their internal clocks. And then what they did for two weeks is they put the volunteers in a lab suite like a hotel room where they turned the lights really dim so that the person could never really tell what time of the day it was or even what day of the week it was. This actually sounds like kind of torture in my opinion.
Kelsey:Yeah, it does.
Laura: They didn’t have any TV, internet, phones, or visitors for two weeks. Oh my gosh, I’m like who the heck would volunteer to do that?
Laura: You better be paying a lot of money. I don’t know, maybe you would feel like super refreshed after.
Kelsey:Maybe, yeah like after camping or something.
Laura: Only just being in the dark room alone. That’s actually really bad. Well anyway, that was the study. They put them in this dim room for two weeks and the light never changed and then the researchers varied what time each participant ate and slept. And then so that affected each volunteer’s body clock. Even if they went to sleep at 2:00 in the afternoon, it felt like nighttime to them and basically they just had no idea what time it was. If they were going to bed at 2, it’s almost like they were in another country and they had that jet lag experience where all of a sudden you’re like oh it’s 2:00 with my body’s time, but it’s dark out so I’m going to go to bed.
Laura: But the people ate all the same amount of food and it was regular intervals. They tested their hunger and just had the participants rate how hungry they were. Even though they had totally phase shifted everyone’s circadian rhythms so that they were in different time zones essentially, everyone was the hungriest when their body’s internal clock thought it was evening no matter what they were doing. It didn’t really matter if they were awake, or asleep, or if they were doing any sort of activity or anything. The hunger really came on the strongest in the evening.
They identified the circadian peak in hunger to be occurring at about 8 pm and the circadian trough, which is the opposite of the peak in hunger occurred at 8 am. Essentially if people just have no concept of what time it is and their bodies just start to get into the somewhat arbitrary 24 hour rhythm, their hunger is highest at 8 pm and lowest 8 am.
Kelsey:I’m trying to clarify here a little bit. Is that 8 am 8 pm based on the actual time or what the researchers were making them think the time was basically?
Laura: It was based on what the researchers were making the person’s body think it was.
Kelsey:Okay, got it.
Laura: It’s kind of like when you travel, let’s say you fly to Europe and they are 5 hours or 6 hours later than us, and then you readjust to that Europe time, you’d still be getting that trigger of hunger at 8pm in Europe time even though your body came from the United States where it was only 3:00 in the afternoon technically.
Kelsey:Okay, got it.
Laura: Your body kind of adjusts to that new 24 hour cycle. If they’re going to bed at 2:00 in the afternoon, it felt like it was maybe 10:00 for that person.
Laura: They were having their hunger peak at noon because they thought noon was 8 pm and 2:00 was 10 pm. Does that make more sense?
Kelsey:Yes, that makes more sense. Got it.
Laura: It’s obviously very complicated, but I think the interesting thing was just finding that once people got into this phase shifted 24 hour cycle that they just had no idea what time it was, their body still had that peak and trough in hunger that averaged around a peak at 8 pm and a trough at 8 am.
Hypothetically if that applies to all people, you should be basically at your hungriest around 8:00 at night and at your least hungry at 8:00 in the morning. That’s with the assumption that somebody’s got a 24 cycle of circadian rhythm that’s fairly consistent and doesn’t change a lot, and their not staying up really late one night and then going to bed earlier the next night.
Laura: But generally if you’re going to bed and waking up at the same time most days, you should be experiencing your highest hunger amount at 8:00. That’s not super late, but you can imagine if somebody’s eating dinner at like 6 or 7 and then they have that hunger peak later, they may experience some hunger right before going to bed. And then if they unfortunately believe that eating anything before bed is going to cause health problems, they may avoid it and then they will wake up hungry and not feel good. That’s just exacerbated if they didn’t eat enough during the day. My point of going over this research is to suggest that being hungry at night is not abnormal.
Laura: There’s a lot of different things that can contribute to late night hunger that we’ll go over in a second, but if you are feeling the most hungry at say like somewhere between 7 or 9 pm, that’s not bad, or unhealthy, or abnormal. I just want people to keep that in mind because again I think there’s a lot of random crappy recommendations out there that are like don’t eat past 5 or don’t eat right before going to bed because it’s going to be stored as fat. It’s like no, that’s only going to be stored as fat if you overeat that day.
Assuming you’re not in a major calorie surplus, depending on what time of the day you eat, it shouldn’t really affect your health that much. If your circadian rhythms are messed up because you’re staying up too late, that could be a different story. But the actual time that you’re eating shouldn’t really make a huge difference.
Kelsey:Yeah, and I think that piece about the circadian rhythm is really important because a lot of us have messed up circadian rhythms. Maybe we are getting hungry at weird times or we’re just like adding on another four hours of being awake that maybe we shouldn’t be awake if we’re staying up till midnight or even later than that. I think there’s a lot to be said about making sure your circadian rhythm is on target and you’re consistently going to be and waking up at the same time.
But one thing that I was thinking as you were talking through this is that I think culturally in the U.S. we tend to eat pretty early for dinner, which having just come back from Europe, I tended to eat a lot later there because a lot of restaurants don’t even open until 7 or 7:30. Honestly, I think I like that better. I tend to be a later eater at night and apparently from this research that seems to make more sense just by biologically that around that 8 pm time would be when most people are going to be generally the most hungry.
I think that may play a role in it too. If this person is from the U.S., if you’re eating at 5 or 6 pm, your body is just going to be hungry later. Even if you’re going to bed at 10 pm which is a totally normal time to go to bed, that still is quite a long time before you would eat again. I would imagine that by 10 pm you might start to be getting a little hungry.
Laura: Yeah, it’s kind of funny, I had a friend in high school who was French, his family was from France. He used to eat dinner at like 11:00 at night, which to me is just outrageous. I’m like if I’m eating at 11:00 at night, there is something that went seriously wrong that day. It’s just funny because it is such a cultural thing.
Laura: I know in Europe they tend to do afternoon naps, maybe not all of them but there is that siesta type of thing.
Kelsey:And they’ll also tend to have a snack at that evening time. Maybe like 5 or 6 they’ll eat a little something, have a drink, and then they’ll eat way later for their real dinner meal.
Laura: Right. It’s not that we’re suggesting people should eat dinner at 11, but what we’re suggesting is that if you’re eating dinner super early, it’s not that weird that you’d be hungry before bed.
Kelsey:Right, exactly. Let’s talk a little bit more about some of the reasons why you might be hungry late at night. One of them of course is just that if you’re eating at 5 or 6, being hungry four hours later is completely normal and to be expected I would think.
Another thing that I would say that I see very, very commonly in my own practice and Laura, I ‘m sure this is the same for you, is that a lot of our clients will tend to just not eat enough over the course of the day. This is because maybe they’re stressed out at work, they don’t have time to eat to like sit down and have a full meal at work, they’re just sort of working throughout their meals. They’re not paying a lot of attention to their hunger signals necessarily and so they may not be eating enough as they move through their day. Maybe they’re skipping breakfast because they’re trying to rush to work.
There’s a lot of reasons why somebody may not be eating enough during the day. And then when dinnertime comes around, maybe they’re eating more of a normal amount but because they haven’t eaten a lot for breakfast and lunch, by the time after dinnertime rolls around, 8-9pm, they’re still hungry. Dinner didn’t fill them up enough so they will still feel like they need to eat something at night in order to not go to bed hungry or wake up hungry.
Like I said, for me this is probably the number one cause of why somebody who feels, like this person is explaining, that they have to eat at night because otherwise they’re not going to sleep well because they’re waking up hungry maybe even in the middle of the night or they can’t fall asleep because they’re hungry, but they feel like they shouldn’t eat because they’ve heard that it’s bad for them or whatever.
What I would highly recommend that this person does is use an online calorie calculator. We’ll try to link to one here. There’s a lot of them out there where you can just put in your height, your weight, your age, your activity level and it will spit out a calorie recommendation for you. Just track for a couple days and see how close or not you are to that target because chances are you’re probably going to be under eating fairly significantly from what that number comes out as.
Once I have people who are experiencing what this person is talking about, once they start to eat that number of calories overall and it’s coming from real whole food sources, they find that they’re not as hungry at night or they don’t feel like they absolutely need a snack before going to bed as long as they’re getting all of those calories that they needed between their three meals in the day.
Even if you do want to have a nighttime snack and that’s part of your overall calories, that’s fine too, but you won’t be waking up hungry or feeling like you’re hungry when you’re going to bed. You’re going to be perfectly satisfied.
That is a really, really common reason why somebody might feel like they absolutely have to have something to eat before they go to bed otherwise they’ll wake up hungry. Laura, I assume you see this very often as well.
Laura: Yeah, I mean I can say that I even have had that issue for myself, which is kind of annoying because anytime I’ve tried to purposefully lean out a little bit this tends to happen. Even if I’m just a couple hundred calories below what my needs are during the day, I’ll end up feeling super hungry right before bed and then I usually end up needing a snack.
Laura: I’ve definitely experienced that before and it kind of stinks because it’s like on one hand you’re like I have this deficit I’m supposed to be doing. But then you’re like I need to sleep so I’m just going to eat. I always err on the side of eating. But it’s very, very common.
Kelsey:Yeah, absolutely. Another thing that can play into that too is just having low blood sugar. Sometimes you can get enough calories but your blood sugar ends up being too low because for example, and this may not be the case for this person, but maybe they’re eating a lot of processed carbs or something and that’s spiking and lowering their blood sugar, or they’ve got something like adrenal fatigue which is causing blood sugar imbalance.
There’s a lot of things with blood sugar that can happen that make you feel hungrier at times even if you are eating enough calories. One of those things just to consider is exercise. If you do a lot of exercise during the day, sometimes that will end up tanking your blood sugar later in the evening. And of course when you’re blood sugar is low, your body says okay, it’s time to eat. It’s going to turn on those hunger signals for you.
Even if you do that calculation, you see that you’re eating enough, but you’re still having some of these issues, think about the other health conditions going on, think about your lifestyle factors that may be playing into getting low blood sugar and work on those. You may find that that fixes the problem too.
One of those lifestyle factors in addition to exercising is also stress because of course that’s going to mess with your cortisol levels which really plays a controlling factor in your blood sugar. Anytime your blood sugar gets too low, your cortisol is going to raise to help break down proteins and other things to create glucose. Basically when you’re cortisol is out of whack, oftentimes your blood sugar is going to be out of whack. You really need to make sure that your stress levels are under control so that you’re cortisol is normal which will help you to maintain a more normal blood sugar level so you won’t get those really strong hunger feelings when you’re under a lot of stress.
Even outside of the cortisol aspect of stress, I think that just stress in general as I’m sure many of you can relate to, when you’re stressed out, a lot of us tend to reach for comfort foods or just eat from an emotional eating perspective where when we eat it tends to relax us and helps us to cope with the stressors in our life.
This is something that like I said, I’m sure a lot of us have experienced when you have a stressful day, a lot of times you’re just like I just want to go sit down and eat something or grab a sugary snack because it’s going to just give me that little boost that I need to help me get through whatever is going on. That’s a really common thing to experience especially at night because your day is over, a lot of the stressors are over, but a lot of times they’re still taking their toll on us and we just want to relax at that point at night and so we’re going to do anything even if it’s subconsciously to help reduce that stressor and eating can certainly be one of those things.
I think along with this, a lot of us when we watch TV, it’s pretty typical at least in American culture to associate TV or movie watching with snacking. I think that this goes along with the stress piece but it can also be outside of stress too, just that association of watching TV or watching a movie and having something to munch on while you do that, your brain just kind of associates the two. Again, it’s this unconscious sort of reaction that your body does and you just reach for a snack or you want to have a snack when you’re watching TV.
Again, I think this can play into that stress piece because we watch TV as a way to relax at the end of the day and then adding the snacking on top of that is another way to reduce the stressors from our daily lives.
If you notice that that is you, you feel like you’re just eating while you’re watching TV at night, or you’re just eating as a way to kind of cope with stressors in your life, definitely pay action to those stressors and try to reduce them, do some stress management techniques, deep breathing, yoga, that kind of thing to help to manage those stress levels in a way that doesn’t involve eating because you may be triggering a hunger reaction when you’re not really hungry but your body just wants some way of reducing that stress.
Another thing to think about is sleep deprivation. Of course when you are sleep deprived, this is going to raise your stress level again. As a way to reduce that stress level or to get a boost to push through a sleep deprived state, your body is going to want to eat some food. A lot of times it’s not great food either, it’s the sugary stuff, the processed stuff, the comfort foods that we’re going to want to reach for at that point again to either reduce that stress level of having a lot of things to do when you’re sleep deprived or to help boost your energy to get through that sleep deprived state.
Laura: I feel like stress and sleep deprivation are often connected as I’ve been experiencing recently. It’s funny because I don’t know which one comes first. Sometimes I think it can be they just play off each other. I know for me if I am sleep deprived, for example if I’m traveling late and I get home at 12:00, and I don’t get to bed until super late, and then I feel exhausted the next day, I know that my stress resilience is a lot lower when I’m tired.
Laura: And then on the other hand, if I’m super stressed during the day, that tends to make me a little bit more amped up at night and then I can’t fall asleep.
Kelsey:A vicious cycle.
Laura: Yeah, so I think stress and sleep deprivation can definitely play off each other. Then like you said, eating, especially sugar and fat basically, is going to be an easy way for your body to feel comforted, but assuming you’re eating enough during the day, maybe isn’t the best solution.
Kelsey:Right, it’s just adding on calories as a way to comfort the body, which isn’t necessarily a bad thing in the short term, but if that’s consistently happening overtime, that’s when you get into trouble.
Laura: I think that also takes us back to the whole circadian rhythm disruption issue because if you’re not going to bed, even if you’re sleeping 8 hours, if you’re not going to be until super late, that’s going to affect the 24 hour cycle that you’re in, kind of like what we talked about with that study. If your circadian rhythms are messed up, you may just have this hunger that comes at night for that reason that we talked about before that has nothing to do with how much you’ve eaten, what you’re stress levels are, things that are a little bit more fixable. In that situation, you definitely need to focus on getting your 24 hour clock to a more normal state, which definitely going to bed on time, and minimizing stress in the evening, and not doing things that are going to disrupt your circadian rhythms right before bed is good. We’ll talk about some strategies for that later.
But I wanted to just quickly mention there is an actual eating disorder called night eating syndrome. It’s not very common. Experts estimate that about 1 to 1 ½ % of the general population and then 6 to 16% of patients in weight reduction programs, and then 8 to 42% of bariatric surgery candidates experience night eating syndrome.
Laura: I’ll mention why that might be in a second, but the average population around 1 to 1 ½ %, so not very common in the typical person. Night eating syndrome is characterized by a lack of appetite in the morning which then leads to overeating at night and then often times waking up in the middle of the night to eat as well. Sometimes there’s people who they don’t even remember getting up to eat so they’ll have almost this, I don’t want to say narcoleptic kind of experience, but it’s like they’re sleeping – not narcoleptic….
Laura: Yeah, sleepwalking but sleep eating when they get up and go downstairs and eat and they don’t even remember that they’ve done this.
Kelsey:I feel like I watched a science class video about this way back when.
Laura: Yeah, possibly.
Kelsey:Where somebody would get up in the middle of the night and they were eating spoonfuls of mayonnaise and wouldn’t remember it at all.
Laura: Ugh, gross! I’m just imagining eating mayonnaise on a spoon. But yeah, it can be like seriously I guess a disorder as opposed to just making decisions to eat that way. For those people, there is definitely a lot of evidence that there’s either an imbalance in neurotransmitters or their hunger signaling hormones like leptin and ghrelin.
There’s been some brain scans of these people with night eating syndrome that show that they typically have an elevation of serotonin transporters. What that means is that their serotonin ends up getting up taken out of the synaptic, I forget what it’s called. Basically where serotonin is supposed to hang out and be active, it gets taken back into the neurons and then it’s not active. So then basically you’re having less serotonin activity and that actually ends up impairing both the circadian rhythms and boost satiety as well as mood so they can have a lot of depression and anxiety, that kind of thing because they are having lower serotonin.
The other problem that adds to this, which I think you probably get a handful of people who have this serotonin transporter imbalance that affects their risk of this, but then there’s that extra level of kind of the more neurological, cognitive problem where either the person is dieting to lose weight and the restriction of the calories during the day makes their brain increase their hunger signals, and then they’re trying to starve themselves all day, and then they end up overeating at night, and then they feel a lot of guilt and shame around that. It’s kind of this cycle of behavioral decisions that just keeps them in that pattern. Especially if you’re eating a ton at night, you’re not going to be hungry in the morning.
Laura: Even if you’re a normal eater, if you go out to a big dinner the night before a lot of times you’ll wake up like I’m not even hungry, I’ll just have some coffee or something. But if it’s happening every night that the person is not eating anything in the morning and then they’re eating ton at night, they might not have that hunger in the morning and then that is just a self-fulfilling prophecy.
But then the other problem especially if somebody is overweight or obese is that there’s that shame factor of eating a lot a night so then probably it turns into more neurological disorder as opposed to a physiological disorder. It’s kind of more like the typical eating disorder that comes from body image issues, or negative emotions, or control, and that kind of thing. But basically the person feels all this shame around eating. I think it ends up being they end up just bingeing because they feel guilt and then they are almost trying to self-medicate with the food.
Laura: Again, it can kind of be more of that cognitive behavioral problem. But I do think that there could be some more biological triggers that are happening. Again serotonin deficiency or transporter issues, or if the person’s circadian rhythms are super screwed up, that could start the behavior and then it’s kind of like a cognitive behavioral response where they feel guilt and shame around the behavior and then that triggers more of it.
Laura: It’s a very complicated issue and the research that I was looking at shows that it’s very difficult to treat and a lot of people just don’t feel capable of overcoming it. But I would say we have a couple of thoughts about how to reduce hunger at night. So if you do feel like the hunger and the eating at night is actually contributing to some health problems, like let’s say you are bingeing at night and then not being hungry in the morning and kind of stuck in this cycle, assuming you don’t have a severe serotonin issue, then there are some behavior changes that can help.
I do want people to remember, we’re going to talk about how to avoid late night hunger and eating too late if that is something that is causing problems, but I do want people to just keep in mind that eating food just before going to bed, like having a snack or maybe having a later dinner, it’s not really that big of a deal in the grand scheme of things. A lot of people can really benefit from having a bedtime snack, having a little food before they go to bed. Other people like to have their dinner later like you were saying. It’s culturally more acceptable certain places to eat late at night. So don’t necessarily think if you’re hungry at 9:00 that that’s weird. It’s not weird in other countries.
Also, if you’re eating breakfast in the morning, that can sometimes affect how much you need to eat at night. If you’re doing things like intermittent fasting or just accidently skipping meals, that’s going to make you more hungry at night. Eating consistent meals across the day and eating in the morning may help shift your overall food intake earlier. And then it can also can actually promote a shift in those circadian rhythms that may move your hunger signaling closer to what that 8 pm biological norm is. If you’re finding that you’re getting these strong hunger signals at 10:00 at night, it might be that your circadian rhythms are just shifted a little bit.
Laura: Getting your meals earlier in the day will you move it a little bit more to the normal 24 hour cycle that you’d be on. And then just making sure that your food is balanced, a lot of times when people eat breakfast, they’ll maybe just do one major macronutrient. The typical American diet is going to be very carb based breakfast which that can also kind of set people up for blood sugar dysregulation and hunger during the day, and then that can lead to hunger at night.
I’d say the more common thing we see in our Paleo type clients is that they’re doing very low carb breakfast or maybe they’re doing something like bullet proof coffee in the morning which is all fat. If you’re not getting carbs in the morning that might trigger some carb craving at night, which whether or not you indulge in those cravings, I don’t think it really affects how you crave them. If you’re overall low carb or if you tend to do more of the carb back loading where you have a lot of carbs at night, just be aware that’s actually causing you to have hunger in the evening.
And then protein obviously a lot of our Paleo clients don’t have trouble getting enough protein, but if you are not eating much protein, that’s going to affect how well you control blood sugar as well and that could cause hunger not only in general during the day, but then especially at night.
Kelsey:Yeah, absolutely. And then just considering that you really should be eating a nutrient dense diet. Regardless of how your macronutrient balance is split up and how many calories you’re eating overall, all that kind of stuff, you do need to be eating a nutrient dense diet because simply being deficient in some nutrients, your body is going to at that point be searching for those micronutrients in your food. You may end up eating more because your body is like, okay, eat this, eat this, eat this, let me see if I can get some of the micronutrients that I need from any of these foods. It can kind of make you more hungry than you might be otherwise if you’re eating a nutrient dense diet and you’re getting all the micronutrients that you need.
I’m sure this is not a necessary statement for this audience, but in case there’s somebody who is at the beginning of your whole food journey, this can really, really help with reducing some of the hunger signals that you might get that even if you’re eating an adequate amount of calories is still there.
And then you also within that idea try to focus on higher fiber carbohydrates like potatoes, and sweet potatoes, and plantains and really limit your refined grains and sugar especially if you tend to get low blood sugar a few hours after eating them. Because of course if you’re a fairly typical American and you’re eating a refined grain or refined type snack late at night and then a few hours later you’re about to go to bed and your blood sugar is tanking at that point, you’re going to feel hungry and you’re possibly not going to feel like you could go to sleep at that point because maybe your cortisol goes up because you don’t have enough blood sugar at that point.
This can certainly make that cycle continue a little bit more easily if you’re not eating things that would balance your blood sugar very well. Again, this goes along the lines of that nutrient dense diet. But for blood sugar issues specifically, you really want to pay attention to not eating a lot of refined grains and sugar and focusing more on those higher fiber carbohydrates.
If you do eat refined grains, just make use that you’re eating them as part of a whole meal rather than eating your refined grains as a snack on their own. If you’re eating a bag of chips for example, essentially on its own it’s not going to balance blood sugar as well as if you ate a bit of white rice with a meal that has fat and it has protein. That’s going to make your blood sugar a lot more stable than if you ate it on its own.
And then also don’t go to bed too late. As you guys know we’ve talked about circadian rhythm a lot in this episode and how a lack of sleep can raise your stress levels as well. Making sure that you get not only enough sleep but that you also are sleeping at a relatively normal time, paying attention to when it gets light out and when it gets dark out and sort of trying to follow that pattern as much as you can, that’s really going to help make sure your circadian rhythm is on target.
Along those lines too, you want to make sure that you’re not getting a lot of light exposure at night. Turn off your overhead lights, use lamps or turn off your TV, or use orange goggles to reduce the amount of blue light that you’re being exposed to from a TV, or from your iPhone, your computer, any of those things. And then make sure you get sunlight exposure when you wake up so that you are getting that blue light when you’re supposed to get it. That’s going to help set your circadian rhythms in a more normal manner.
And as you can imagine, if you’re going to bed really late because your circadian rhythm is off, like we talked about before, you’re going to be hungrier because if you ate at 5 or 6 and then you’re going to bed at 11 or 12, that’s a good amount of time that you have in between when you’re eating and when you’re going to bed. It’s perfectly normal to be hungry at that time. But of course if you went to be maybe a couple hours earlier, you wouldn’t feel as hungry.
Or if you know that for you 8:00 is about when you’re getting most hungry, you may want to actually consider moving your dinner a little bit later potentially if you’re going to bed at like 10 or so. So think about that, don’t go to bed midnight, 1:00. Really try to get your circadian rhythm on a good schedule and that hungriness that you’re feeling at night should hopefully not be as much of a problem.
And then another thing to consider of course is to focus on your stress management. As we discussed, stress is huge when it comes to eating at times when we aren’t really hungry or promoting hunger signals that aren’t necessary because those comfort foods or just eating in general is going to reduce stress levels, help us to cope with stressors in our daily lives. Don’t ignore stress as a trigger for your hunger levels especially if you know overall that you’re eating enough calories. Implement some stress management techniques like deep breathing, yoga, tai chi, mediation. Anything that you personally like and enjoy, make sure you’re incorporating that on a regular basis.
Laura: Alright. Well, that was a lot of information.
Laura: It’s funny, when we were researching that I was like we could probably talk about that for 20-30 minutes. And now I’m like, wow, actually it’s like 45.
It’s funny because she asked what foods would you recommend. I think that individual food is not so much of the issue as much as it is timing and macronutrient balance. I don’t think it’s helpful to tell you what food to eat. I think everyone is going to have a different experience with what foods make them feel the best and what their general preferences are. At the end of the day, the timing and the balance is really more important than the individual foods that you’re eating.
Laura: Cool! Well, that does it for the question. Now we’re going to get into some personal updates in a moment. But if you have a question that you’d like us to answer, please go to TheAncestralRDs.com. Click the contact tab and you can submit your question there and we will hopefully answer it on an upcoming show. But otherwise, we are going to just chat a little bit about personal life stuff. If you’re jumping off, then we’re excited to see you next week!
Kelsey:Welcome to the updates section of our new and improved Ancestral RDs podcast which we’re trying out.
Laura: Hopefully improved.
Kelsey:Hopefully improved, we’ll see. You guys can always submit your comments, hopefully nice comments or at least semi nice.
Kelsey:Yeah, constructive would be a better word. Laura, what’s going on with you these days?
Laura: Goodness! I feel like the last couple weeks have just kind of been a ramp up into wedding planning, which at this point when this podcast is aired it will be a little over a month away.
Laura: It’s weird because it’s like I feel with wedding planning you have this kind of big bump in the beginning where you have to make all the decisions about all the major things like your venue, and your photographers, and your caterers, and all this stuff that’s like these big decisions. There’s a lot of checks that come out of your checkbook for four figure sums.
Laura: And then there’s this lag. There’s this kind of low point in between then and the kind of crunch time where you might be making some decisions about things, but otherwise it’s a lot of just kind of daydreaming about what is my hair going to look like? Those little things that you really don’t have to decide about, you’re just kind of like on Pinterest for way too much time. And then you get into this period, I want to say it’s like the two to three mark depending on how long you’ve been engaged because for me my engagement is going to be fourteen months long and…or no, not fourteen. Fourteen is how long we’ve been together before we got engaged.
Laura: I think it’s nine months for the engagement.
Laura: I don’t even remember.
Kelsey:I was like God, time has flown!
Laura: Yeah, seriously. Fourteen months from first date to wedding day basically. It’s funny because for some people that sounds really long and then for other people…one of Josh’s cousins got married three months after he met his wife and they’ve been married for fifteen years.
Laura: Yeah, it’s like different strokes for different folks. But for me a nine month engagement is fairly quick and a fourteen month relationship before getting married is fairly quick. I feel like for me the speed of the engagement maybe affects those amount of stress times. Then the fact that I have a long distance relationship probably impacts that as well because at the time of this recording I’m only going to see my fiancé maybe five or six total days before the wedding weekend.
Laura: We still have two months at this point. It’s kind of getting to the point of our long distance that we’re barely get to see each other, so that’s been a little stressful.
Laura: But it’s been really interesting because I know with wedding planning there’s a lot of logistics and I guess expectation management that has to happen with family and friends and all that. That’s normal I think for everybody. But then there’s been this weird experience that I’ve had that all of a sudden I have been dealing with some pretty unpleasant emotions about the whole thing. I don’t know if you had this experience at all. I know you and your husband were together for what, like ten years?
Kelsey:Ten years, yeah.
Laura: I don’t know if you had kind of just felt pretty comfortable about everything. But for me the wedding is going to be 180 degree shift in my life. I think I mentioned this before. At first the first couple of months, super excited, everything was very fairytale, like it’s wedding planning, and Pinterest, and all that stuff. And then I don’t know what happened, but in the last couple weeks, I think part of it is the distance but part of it I think is just the proximity of the date. All of a sudden all that excitement kind of shifted into anxiety and kind of unhealthy fear about things.
Kelsey:About the wedding itself or just that your life is going to change so much?
Laura: Probably a combination. I have the wedding itself being this kind of expensive, intense event that there’s a lot of expectations around for myself and for my family. My fiancé is kind of like he’s just happy to be marrying me, so he could do a city hall event and he wouldn’t even care. Which at this point I’m like, dang it! Why didn’t I do that? There’s all the expectations around the weekend itself and then there’s the life shift that’s going to happen.
It’s funny because at first I was like not sure why I was feeling so nervous, and stressed out, and literally having waking up in the middle of the night with my heart racing and panic attacks. Not like a legit panic attack, but like feeling very cranked up emotionally and stressed. It’s funny because I was thinking about it, I’m like what is wrong with me? Nothing in my relationship with my fiancé has changed. There’s been definitely some challenges with the whole distance piece which that I think creates an extra level of stress that isn’t necessarily normal.
Laura: We both deal with it differently. His tendency is to totally shut down when we’re stressed about that. My typical reaction is to just word vomit it and cry.
Laura: It’s totally opposite, just be telling him everything that I’m sad about and crying. Luckily he’s totally cool with that otherwise we probably wouldn’t be getting married because he would not want to be married to me.
But it’s just been really interesting because like I said it’s almost this weird, I don’t call it this, this is what it is, is cognitive dissonance where it’s like you believe you should feel just happy, and joyful, and excited and just blissful leading up to your wedding, at the wedding, post wedding, everything. And then there’s this underlying sense of, honestly the way I describe it is dread which sounds like really bad, but the more I’ve been digging into it in the last week or two because I really want to figure out what the heck is going on, and if there’s something wrong with me, and why am I feeling this way, it turns out that this is actually super common.
I feel like the reason I’m sharing this is because just in case anyone listening to the podcast is getting married or will get married at some point. Just take it from me, it’s very normal to feel these experiences, these emotions, these negative feelings even if you are in an amazing relationship. I think a lot of times people think if they’re freaked out about getting married it’s because they are not marrying the right person.
For me I’m like 100% confident logically that I am marrying the right person, but I think there’s just that level of life change and going from being single and living alone, and kind of running my own schedule, and being self-employed where I’ll be working some days on the weekends, or working at 7:00 in the morning, or 9:00 at night, not having anyone else’s schedule that I have to worry about, cooking my own food and not worrying about feeding somebody else. There’s just a lot of things that are going to change once I’m married.
I feel like just recently it’s all kind of been, I guess I’ve been realizing it. I hadn’t really thought about it and then I was like, oh crap! Everything is really going to be very different all at once. It’s going to change within 24 hours between the day of the wedding and the day after.
Laura: It’s funny because at first I was feeling a lot of guilt around the anxiety because I felt bad that my fiancé was seeing how freaked out I was, and I was like I promise it’s not because of you! You’re not doing anything wrong! You could imagine how if you’re getting married to someone and they’re freaking out, you’re like uhh…
Kelsey:Oh gosh! Yeah.
Laura: Maybe there’s something wrong here! But I spent the weekend kind of digging into some things about why I was feeling that way. I think it helped a lot. I’m probably going to write a blog post about it because again I feel like a lot of women probably have this experience of panic even if they’re in a really good relationship before marriage.
Laura: What was your experience?
Kelsey:I was just thinking about that as you were talking about this. I think for me, because I know exactly that feeling that you’re talking about where it does feel like this dread which sounds like a terrible word, but it is sort of that feeling. But I think it was a little different for me in that because we had been together for so long at that point, the deep fear for me was that oh my God, what if this life change of being married now changes what we have for the worse?
For some reason that just little mindset shift changes things in a bad way because things are great now and they’ve been great for ten years, what if this one thing changes everything? Which is totally silly when you think about it, but it is that cognitive dissonance where you’re really happy about what’s going to happen, but at the same time there’s a lot of fear and anxiety surrounding that decision seemingly for no real logical reason.
Laura: I think the fear of marriage changing the relationship, I’ve definitely experienced that too. Like I said I’m in a different situation than you are, but I have that kind of anxiety too feeling like once we’re married it’s just going to be boring and we’re not going to put any effort in.
Right now with the distance the way it is we have to put a lot of effort into connecting with each other and talking a lot, and it’s good. It’s funny, I feel like I kind of hate that I’m saying this, but the distance has kind of forced us to learn how to talk to each other which is a good thing. It sucks right now, but it’s a good thing for the long run. But then there’s that little fear in my head that once we’re together all the time, we’re just not going to talk anymore because there’s not going to be that need to, and then our relationship will get stale, and we won’t have the level of romanticness.
It’s funny, I wrote this list of all the things that I would be potentially nervous about with the wedding and it’s like almost two pages typed.
Kelsey:Oh my gosh!
Laura: I told my fiancé about that and he’s like, wait, you have two pages of a list? I’m like well I’m just being very through. I’m trying to figure out all the different things I’ll be afraid of. It’s just funny because he’s like so the opposite of me. He copes by getting super chill and not letting anything bother him. I’m just like here’s all the 50 different things that I’m potentially a little bit nervous about that’s all compounding into this anxiety situation.
It doesn’t help that I also was like maybe I’ll try to lean out a little bit in the next month or two. Then I start to get into the mild under eating state and my body is like, no, screw that, you need to eat right now otherwise I’m going to keep you up all night.
The last couple of weeks have been really interesting because on one hand feeling the anxiety and nervousness…like anxiety and depression obviously there’s the clinical experience of those that are different than just the short term mood dysregulation.
Laura: But it’s just funny to have those feelings and I’m like I don’t understand why I’m not happy right now. I should be excited, it’s getting closer. I don’t know, it really took a lot of sitting with the emotions and not judging myself for the emotions because I think when you think that that’s abnormal, it’s very easy to judge yourself and say what’s wrong with me? Why am I feeling this way? I’ve been experiencing the emotions mindfully as best as possible and then trying to dig into why I feel this way. I think it’s been good. I feel like as much as I hate experiencing this, I think it’s good because I won’t go into the marriage being completely blindsided by the changes that are going to happen.
Laura: But also want to be mindful of not having low expectations or poor expectations, expecting things to be bad. It’s kind of balancing losing the fantasy of what things are going to be like because I think a lot of girls have that experience that it’s like being married is going to be this wonderful, amazing, perfect, love story like The Notebook or something.
I think when you have those expectations obviously you’re going to get disappointed. But then you also don’t want to be going in thinking this is going to suck, our relationship is going to go down the toilet because then I think that can affect how you act.
I feel like for me it’s been this process of finding the balance between not having these expectations of it being a fairytale, but also not believing that being married is going to negatively change our relationship and kind of going into it saying I’m going to keep my expectations low enough that I don’t get disappointed, but not so low that I end up acting in a way that is stemming from those beliefs, if that makes sense.
Kelsey:Yeah, makes total sense. I think one thing that at least for me when I have a lot going on in my life, which certainly two months out from your wedding that second wind of a lot of things that you need to do, and approve, and all that kind of stuff is probably at least started by now. For me when I have that sort of time in my life where a lot of things are going on, I have to make a lot of decisions, it’s just like you feel really busy all the time, it almost seems to trigger some of that anxiety too.
It’s almost like you think more about these things because your body is just in this state of overwhelm too where I would maybe wake up in the morning like with my heart racing or just kind of like not sleeping as well because my mind is racing as well. I feel like it almost forces you to think about these things more than you would otherwise even though you have a lot of other things going on that you could be thinking about.
I don’t know if that’s completely just me, but that was definitely my experience as well. I feel like that happens not only just with wedding planning, but any time in my life where I have a lot of things going on, my brain is just on overdrive I think.
Laura: My business I’d say is definitely busy. This year has been a lot busier than other years have been from a client perspective and then I’ve been doing some things to try to build it from a marketing perspective, so it’s been slightly more busy.
But you’re right, I feel like being an entrepreneur and self-employed you’re always busy unless you’re purposefully taking a break. I think that can compound the stress of the wedding planning. You’re probably like me where you’re somewhat of a perfectionist and you want to do things the right way.
Kelsey: Mm hmm.
Laura: It’s funny because with the wedding it’s like yeah, it’s a really important day and it would be good to have it go as smoothly as possible and also be what you want it to be. You put all this effort in for months and it’s like I want it turn out the way I want it to.
Laura: But at the end of the day, one, it’s probably there’s going to be things that don’t go the way that you expected. And two, I don’t really think anything that bad is going to happen that it could ruin the whole day. I mean I guess some people can have that experience, but realistically most people get through their wedding and they have a great time and they’re really happy with it. I think there’s just that level of anxiety that I have to make sure everything is perfectly set up so that there’s nothing that happens that’s bad.
Laura: It’s that level of perfectionism that definitely adds a layer of stress. I’m trying to manage that. I’m trying to be more laid back about it. It’s funny, I feel like I’m really not that type A of a person, but this wedding planning thing as turned me into one. I don’t like having to be this organized. I don’t like having to have all these balls that I’m juggling. Once the wedding is over, the honeymoon is going to be probably a total crash which is good because I’ll have unlimited food and sleeping.
Laura: Yeah and just don’t have to pay for anything so if I feel like having tacos at 1:00 in the morning, I can have tacos. It’ll be nice and then after that I’ll have to figure out if I need to take a little…it’s not like a break, but almost just kind of like slow the hustle a little bit after the wedding and just kind of chill out and not be on this overdrive mode because I feel like I’ve been on it basically since September and I’m just like I can’t wait to not be thinking about this stuff anymore.
Kelsey:Yeah, and you’re going to have a husband at home at that point too.
Laura: I know, it’s crazy!
Kelsey:Give your body a little bit of a break from maybe some other things going on in your life.
Laura: Let him do everything.
Laura: Let him just do all the chores.
Laura: It’s just kind of funny, it’s just like so weird. The whole long distance thing from day one, like its fine, we’re doing fine with it. But it’s just so weird to think about one day he’s actually going to be in my house all the time. That’ so weird!
Kelsey:Yeah, I bet that’s weird. I can imagine.
Laura: It’ll be good.
Kelsey:I’m sure it will.
Laura: But I’m like I hope I have some alone time. If I need to I can always leave the house.
Kelsey:Well I am very excited for you, Laura. I hope everything goes as planned and it’s all as great as you imaged it to be with a dash of realistic expectations.
Kelsey: Which it sounds like exactly what you’re going for.
Laura: Well, that’s the hope. Hopefully by the time this podcast airs I’m not in a total panic attack mode all the time.
Laura: Yeah. Right now I’m like this better not be the next two months because I really need to be sleeping.
Kelsey:Yeah. Well, I’m wishing you good sleep from here on out.
Laura: Thank you.
+ show Comments
- Hide Comments
add a comment