The Indoor Epidemic: How 17 Minutes Outside Resets Your Circadian Rhythm
with Dr. John La Puma
Dr. Wendy Myers
Welcome to the Myers Detox Podcast. I’m Dr. Wendy Myers, and on this show we talk about how heavy metals and chemicals are causing health issues. We talk about different topics related to bioenergetics, emotional trauma, and other topics like advanced biohacking. Today’s show is no different.
It sounds like a basic topic that we’re talking about today. Dr. John La Puma is going to be addressing the indoor epidemic, why we’re spending so much time indoors, and what that’s doing to our health. But he really goes into the science of the health issues that are being caused by spending so much time indoors, and what you can do, with very little effort, to improve your health by going outdoors for just 17 minutes a day.
More so, he talks about the indoor air quality, why you need to go out and get light at certain times of day, what that’s doing to our circadian rhythms, to our sleep issues, and how people can improve seasonal affective disorder by getting outdoors more. We also talk about insulin resistance, forest bathing, and how you can improve your immunity for 30 days after just walking through the forest. We’ve got some really interesting tips and facts on the show today, so definitely you want to tune in. John, thank you so much for coming on the show.
Dr. John La Puma
Wendy, pleasure to be here.
Dr. Wendy Myers
Why don’t you tell us a little bit about yourself, your history, and how you got into health?
Dr. John La Puma
I’m trained as a board-certified internal medicine physician. I’m also trained as a professional chef, and for the last 15 years I have had a career as a regenerative certified organic farmer. I think of these things as continuous on a spectrum, and they have culminated in what I think puts them all together, which is my new book called Indoor Epidemic. It is about how being inside plays with your biology in negative ways.
The toxins, the inflammation, and the loss of circadian rhythm inside all add up to the missing lever for many people who’ve been doing everything else right but can’t quite seem to get well. That’s simply deploying outdoor time in a medical way, making it a medical intervention and doing so deliberately, intentionally, and in blue and green spaces.
Dr. Wendy Myers
Tell us a little bit about that. I know a lot of people don’t think about it. They don’t think about going outdoors, getting the sun, and the role that its exposure plays in their health. We’ve been told that sun exposure is so bad. What is the indoor epidemic exactly?
Dr. John La Puma
It’s spending 93% of our waking hours indoors. If you think about that for a moment, it’s kind of impossible not to hear it and to leave it alone. Once you hear it, you think, “Oh, that doesn’t sound right”. It’s not right, because we actually evolved as an outdoor species over 200,000 years ago. Just in the last generation or two, we’ve moved back indoors and never left.
It became normal to have a screen-centered life after COVID, but what’s happened is that we’ve lost the biological connection we have with the outdoors, and that has resulted in accelerating a number of chronic diseases, including immune problems, chronic inflammation, insomnia, isolation, insulin resistance, and many more.
Mental health problems such as anxiety and depression accelerated and worsened in ways that we’ve just begun to understand. We also notice an increase in cardiovascular disease and diabetes. What happened when we’ve moved indoors is that we’ve had this double whammy of chronic inflammation brought on by indoor toxins and the loss of the circadian rhythm and inputs that we need to thrive: light, air, and movement. We can obtain them in ways that are not just casual or incidental, like we usually spend time outdoors.
Dr. Wendy Myers
Talk about the circadian rhythm, because I think so many people are having sleep issues, which leads to so many metabolic, blood sugar, and other health issues. Explain to people the importance of going outside to manage and improve your circadian rhythm.
Dr. John La Puma
A lot of people don’t know that we have in our bodies a clock, and everything is supposed to run on a clock. Your body’s clock is set by an instance called zeitgebers, which are biological signals to your brain that set your body’s clock to know when to get up, go to sleep, metabolize, exercise, and what genes to express and when.
About 50% of your genes are governed by your circadian rhythm, your body’s clock. What genes do, as you know, is that they make proteins and watch other genes. The proteins they make and how they watch other genes change by what kinds of information your genes get. The information that half of your genes need is what time it is, because that influences when they make proteins and which ones they make.
So your circadian rhythm is governed primarily by light, specifically outdoor light. Why? Because outdoor light is 25 to 50 times brighter than indoor light. Indoor light is dim to the brain. It’s 300 lux, maybe 400 in a bright TV studio, maybe 500 or 450 in a really bright grocery store. But outdoors it’s seldom less than 5,000 lux, even on a cloudy day.
Your brain needs that bright light signal to set your clock for the day. So the best time to get it is in the morning, with bright light, and it does all kinds of good things for you. It allows you to go to sleep that night. The melatonin from your brain is released 14 hours later, after you get that initial stimulus of bright light, which in turn allows you to get better quality sleep.
The brain’s cleaning cycle, which is called the glymphatic system, was discovered in 2013. I didn’t learn about it in medical school. It hadn’t been discovered. The Nobel Prize was given for it in 2017. The brain’s cleaning system, the glymphatic system, works only during deep sleep, or slow-wave sleep, and you only get that phase of sleep if you get morning light, if your circadian system and rhythm is set. If you don’t, or if you delay it with bright screens at night, your melatonin release drops by 80%. If you have blue light within an hour of going to sleep, then your glymphatic system doesn’t kick in until later or not at all. In fact, more often than not, it’s only during the first third to half of sleep that your brain can clean itself.
You get a tiny little bit late in your sleep cycle in the morning, but most brain cleaning occurs early. You only get that early cleaning if you get morning sunlight to set your circadian rhythm for the day.
Dr. Wendy Myers
If you don’t get that glymphatic brain cleaning, and that happens over years and over decades, what happens?
Dr. John La Puma
Your brain begins to accumulate the proteins that accumulate during Alzheimer’s disease. They don’t cause Alzheimer’s disease. Rather, they accumulate during it. That’s our current knowledge anyway. Those beta-amyloid and tau, and other metabolic waste products that the brain metabolizes and produces during the day, simply accumulate.
Unfortunately, your brain can’t clean itself. It wants to clean itself, but its own detox cycle runs at reduced capacity or not at all. So you can take every binder and chelator available, and still have a brain that isn’t cleaning properly. If your sleep architecture is broken by not getting adequate deep sleep, you didn’t set your circadian rhythm.
Dr. Wendy Myers
That’s so important. I wanted you to dive deeper into that because I think so many people are not getting that morning sunlight, not going to bed early enough, and really short-changing themselves and their health. You set yourself up.
Dr. John La Puma
Bedtime, as you say, is critical. Going to bed at the same time within an hour every night is the most consistent predictor of reduced all-cause mortality, more consistent than the number of hours of sleep that you get. This is a recent huge study published just this year. Your bedtime is a better predictor of reduced all-cause mortality than the number of hours of sleep that you get.
Dr. Wendy Myers
Interesting.
Dr. John La Puma
If you go to bed at 10:30, 10, 11 o’clock every night, and you have an hour to play there, that’s great. That’s really good for your longevity and your health span. But, you know, you go to bed at 10 one night, and 2:00 a.m. the next, and 9 o’clock the next day to try to catch up on the 2:00 a.m., and your brain doesn’t like it, and your longevity doesn’t like it either. Over time, those patterns add up. We’re just really beginning to understand how powerful sleep is as a tool, not just to improve health span and longevity, but in daily performance, productivity, daily mood, and memory.
Dr. Wendy Myers
It’s so helpful to use an Oura Ring or other similar type device to get that sleep discipline and start tracking your metrics. It reminds you, “Hey, it’s time for bed.” It’s a nice way to compete with yourself to try to improve your sleep habits.
Dr. John La Puma
I think trackers have a terrific role. I have a Fitbit. I just ordered a Whoop, and I like the idea because it does give people structure. It allows you to have some feedback about what’s going on in your body that you may not recognize. Yet you don’t really need a tracker if you don’t like wearing a watch or a ring or a sensor of another type.
What you need to do, though, is understand the power that you actually have to beat the toxins and heavy metals that are inside in sealed environments, essentially, and do so in a way that lets you leverage the outdoor natural forces that are there to improve your body.
A lot of people think going outside is sort of a nice-to-have. It’s a luxury in that you get to go outside and play. That’s terrific. But it also has biological value if you know what to do. Often what people should do is almost as individual as they are. I say that the minimum effective dose of going outdoors from the research that I did, looking at 2,200 studies in this area, is 17 minutes a day, which is not very much.
Dr. Wendy Myers
No, that’s not much at all.
Dr. John La Puma
No, it isn’t. But most of us get almost zero minutes a day of intentional time outdoors. Sure, we walk from car to car, walk down the block to the subway, go to the parking lot, run errands, pick up a DoorDash, but that’s not intentional time. That time is biologically thin, to be nice about it. It doesn’t help your brain or your body, except in movement, which is good, in the way that intentional time in a blue space, which means near water or especially running water, or a green space, which means near shrubbery or trees, and pocket parks in cities.
For people who are beginning gardening, I have a chapter in the book on gardening. Having your hands in healthy soil improves your microbiome and is a serotonin intervention. Even that small direct interaction with a living thing that is green counts as time spent with plants and near greenery.
Dr. Wendy Myers
So that minimum effective dose is just that.
Dr. John La Puma
It’s the minimum. But how, where, and when you spend that time is almost as individual as you are.
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Dr. Wendy Myers
Tell us a little bit about light and the timing of the light, when we should go outside. Like, what time in the mornings are ideal to get light exposure?
Dr. John La Puma
As I’ve said, the minimum effective dose of being outdoors is 17 minutes a day, and that’s where the data starts showing measurable changes in all these systems simultaneously. Bright light is the best light because you’re getting all the wavelengths of the light, as opposed to dim light indoors, which is what we have most of the time. If you’re not able to go outdoors because the weather’s bad, you can stand in a doorway or a threshold.
If you live in a city, on a fire escape, open a window because a window will block the important rays of the light. That’s why it’s important to go outside. But if you have a screen on the window, then you can open the window and look out and accomplish two things at once. First, you look in the distance to relax your eyes, the ciliary muscles around your eyes, which often scrunch up when you’re doing what we call near work on a phone or a computer.
Second, you can allow your brain to look at the different colors, shapes and movement in the landscape while soaking up 10 or 15 minutes of bright light in the morning. Getting that bright light in the morning is important because that’s when your eyes and brain are most receptive to setting your circadian rhythm.
How you get this light and when can depend on your own schedule. I like to think light first, coffee second. Because when you have that bright light in the morning, you get a big cortisol activation response, which you want early in the morning because it wakes you up and tells your body, “I’m alert for the day.” In a way, it helps your coffee work better, because coffee gives you a little boost that if you don’t get the bright light, it can kind of cover exhaustion. But we don’t want that. I mean, a lot of people who have optimized everything else and still feel off are missing this outdoor environment piece.
Given this, I’m aiming to show in Indoor Epidemic, that the outdoor environment piece is what you’ve been missing. If you feel like you’re already taking the best chelators, you’re detoxing your environment, living as clean as you can and not attaining health, you need to consider going outdoors. Not knowing that outdoors has specific biological value and how to deploy it in your own life with specific protocols in really a clinical way, I think would surprise a lot of your listeners.
Dr. Wendy Myers
I know it surprised me when I did the research.
Dr. John La Puma
It’s a powerful tool. Of course, it’s not just light, but it’s also air and movement in green spaces. It’s also, as you said before, optimizing sleep. Three nights of interrupted sleep, deep sleep, where you consolidate memory, build bone and repair muscle reduces insulin sensitivity by 25%. That means that the calories you’re eating are going to be more likely to be stored as fat than they would be, and not metabolized. We want to use air, light, and movement in specific ways so that we can feel better and beat some of the chronic medical problems that so many of us are beset by, whether they’re insomnia, immune problems, inflammation problems, and of course, specific medical problems.
Dr. Wendy Myers
You talk in your book about the 7% solution, how just two hours a week outside helped improve your biology and longevity. You just talked about a lot of those things. Is there anything more that you want to add to that?
Dr. John La Puma
There’s quite a lot. For example, many people don’t know that Mycobacterium vaccae, which is a bacterium that lives in soil, activates serotonin-producing neurons in the brain and gut just by having your hands in healthy, organic garden soil. That’s really powerful because the sterile indoor environment, combined with processed food and antibiotics, has severed our relationship with the outdoors and with a healthy microbiome, unless we very deliberately supplement it with specific foods.
But gardening, having your hands in healthy potting soil that’s organic, is vital. There’s some evidence, which I mention in the book, that grounding and having your bare feet on grass is healthy. These aren’t lifestyle interventions but rather microbiome interventions that result in less anxiety, better mood, lower hemoglobin A1c in diabetics, and reduced neuroinflammation over time.
There are very specific protocols for this that you can take advantage of because it’s really amazing that this is almost free. We’re not selling widgets here. I’m not giving you another detox system that you have to buy and take by product after product and track. This is a natural input that has powerful biological input that we have simply missed.
When you disrupt slow wave sleep by not getting your circadian rhythm set, the brain’s hunger signal switches on and flips the same chemical pathway as does THC from cannabis, which means you feel hungrier when you don’t sleep well, because you’ve missed deep sleep.
People who can’t lose weight often are missing this switch. They don’t understand that nature, in many ways, is an original GLP-1. It has an effect on your microbiome. It works directly in your brain. It activates upstream some of the same pathways that GLP-1 agonists activate. It’s a powerful tool and yet underutilized.
Dr. Wendy Myers
You know, I say this so many times on the show that there are so many things that are just foundational and simple that people need to do that they just miss. It’s not always a medication or a complicated therapy or a detox.
Dr. John La Puma
People need to make sure they have these basics covered first, and then see what other symptoms are left over. It’s the simplest thing in the world: just get outdoors.
Dr. Wendy Myers
Are there any tips you can give people to start some habits or things they can develop to help them be more mindful of this and what they can do outdoors?
Dr. John La Puma
I think the first thing to recognize is that your indoor environment keeps reloading the toxic burden. It’s something that we don’t realize. Molds, particulate matter, mites, dusts and off-gassing and VOCs affect our health But if you’re reloading that environment and staying inside 93% of the time, as most of us do, you’re continually subjected to it, and you get inured to it so that it doesn’t feel abnormal, but it is. The way that you can escape that is by thinking about nature as the original metabolic reset.
Your brain’s detox system runs during deep sleep. So morning light, green movement, and exercise. When you move outdoors, it’s 20% less perceived exertion than the same routine indoors. Why is that? Because your brain recognizes familiar patterns outdoors that are easier for it to digest and to accommodate. It likes the way that fractals appear and leaves move. It’s relaxing. You’re using your senses, not your prefrontal cortex, to process linear and demanding information. In fact, when you’re moving outdoors, the outdoors draws your attention.
Outdoor space pulls you a little bit in the right direction, as opposed to a phone, which demands your attention when you’re getting notifications, direct mail, buzzing, and a call that you have to answer right away. Nature isn’t like that at all, and that is good for your brain because it’s using your senses to complement and make your focus work better, which in turn allows your focus to return.
The kid that’s looking out the window at school is not daydreaming per se. He or she is trying to reset his or her brain’s focus by giving it a rest. Too many of us are overwhelmed by pixels and undernourished by nature. I call this digital obesity, where the number of pixels we’re getting is just crazy, and it doesn’t allow us to reset our brain to focus and to improve the neuroinflammation that is so common among people today.
The simple thing to do is to take advantage of the two hundred and fifty different ideas I actually wrote Indoor Epidemic like a workbook. At the end of each chapter, there are four or five pages of fill-in-the-blank ideas of what to do when you’re outside, in the morning light area, in the sky and stars and sea area, in the gardening area, in the green exercise area, in the social connection area.
Many people don’t recognize until it’s pointed out that nature is incredibly social. It’s not just the Pacific Ocean or the Rocky Mountains. It’s where you run into people because you go to the park, walk your dog, and fly a kite. Take a child to the park, you’re changing that kid’s neurobiology.
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Dr. Wendy Myers
Can you talk about how effective it is, or the benefits of watching the sunrise and the sunset? Because I think people don’t realize how beneficial those can be to our circadian rhythms, and any other benefits that you researched.
Dr. John La Puma
There are quite a few. I’m lucky to live in California and near a beach, and it’s often that we go to the beach to watch the sunset. The sunset rays, if you watch, turn from blue to orange and red. Those orange, red and amber waves are the only waves that don’t suppress melatonin. They’re the only light waves that let melatonin be released that evening. You set the stage in the morning by getting some bright morning light at the right time in the right dosage. That’s a powerful signal to the brain to drop your body temperature a degree or two as you go to sleep, to drop your focus because the day is coming to an end, to relax your body, to lower your blood pressure a little bit before you go to sleep. All of those are positive signs.
Sunset is, as I’ve said, a reinforcing zeitgeber. It doesn’t set your rhythm, but it reinforces the rhythm that you’ve set in the morning. So watching the sunset is both thrilling, because it’s also an awe experience, which has neurological implications, but it’s even more importantly a kind of signal to your brain that it’s about time to power down, to prepare for a good night’s sleep.
I do recommend watching the sunset, and those are wavelengths you should look directly at. It doesn’t matter if you have sunglasses or not, unlike the morning light, because the red and amber waves don’t interfere with melatonin, and you’re telling your body, “Let’s not wake up. Let’s go to sleep soon.” That’s the powerful message.
Dr. Wendy Myers
Can you talk about how going outdoors and spending time outdoors compares to prescription medications, or even helps you get off prescription medications?
Dr. John La Puma
You know, there are some pharmaceutical equivalents and pharmaceutical approximations that occur with specific nature therapies. One of the easiest ones we’ve spoken of briefly is the treatment of seasonal affective disorder, which, as you know, is a form of depression that’s usually mild, sometimes moderate, that afflicts a lot of people who live above a line drawn between Los Angeles and Atlanta, particularly in the fall and winter months when the angle of the sun is not acute enough to help us.
Seasonal affective disorder is a serious problem. It’s a form of depression. But one of the very first treatments for it, if the depression is not harmful directly, is to use bright light. We recommend, and I’ve recommended for many years, using a 10,000 lux lamp that is usually within eight inches of your face, between 20 and 30 minutes in the morning. This is actually very useful for people who get up before the sun. They need what I call a double anchor. They need a 5:00 AM, if they get up that early, 10,000 lux signal to their brain from this therapy lamp to tell their cortisol response to wake up, set their melatonin that evening, and get deep sleep that night.
They also need, when the sun does come up, say 6:30 or 7:00, to go outside and get the other blue light rays they’ve missed, because the spectrum of what’s outdoors is much broader than what you get from a 10,000 lux super bright light. So using a therapy lamp is one example of a pharmaceutical equivalent. There are eight or nine others in the book.
It’s not widely known that a lot of simple interventions, even forest bathing, where there’s an entire chapter in the book, can also be an immune intervention. Trees release compounds called phytoncides, primarily alpha and beta pinene or D-limonene in citrus, and pinene in coniferous trees or pines. These, when you inhale them, activate your own immune system. Trees release these compounds to defend themselves against bugs and to communicate with other trees.
At the same time, we benefit from the compounds, and our immune systems are activated in a positive way, not overactivated, but moderated, because we make more natural killer cells, and the activity of the natural killer cells we’ve already made also increases. Those cells are important because they go around our body and kill cells that are infected by viruses, or are tumor cells themselves. So you want more natural killer cells. Having a two-hour forest bathing session can improve natural killer cell activity and number by 56%.
This finding was first identified in the 1980s in Tokyo, where Dr. Li, who identified forest bathing as a therapy intervention, measured these chemicals, and it’s since been repeated throughout Europe, in Germany and elsewhere. These phytoncidal chemicals are important for anybody who’s struggling with immune conditions. Anybody who has chronic infections, immune dysregulation, or autoimmune patterns, this is a free immune intervention with up to a 30-day lifespan. This increased activation and number of natural killer cells has been documented to last for 30 days.
We’re leaving our gains on the table if we’re doing everything right and not using nature as a tool to improve our health span, our immune systems, inflammatory level, blood pressure, anxiety, depression, mood, memory, and focus. This isn’t just me. This is a culmination of the literature, which is coming out even faster than I can keep track of it.
Dr. Wendy Myers
That’s so fascinating about forest bathing. I have a park that I go to here in Houston, full of trees, and you just feel so much better going for a walk, looking at the fractals, and breathing in all the essential oils and compounds that the trees release. It’s fascinating because of all the many benefits, even up to 30 days after just going on a simple walk. Let’s talk about how the Outdoor Rx can amplify what you’re already doing, say, with your supplements, daily protocols and biohacking.
Dr. John La Puma
Outdoor Rx is this seven-day outdoor reset program in the book that uses the chapters about using the morning light, gardening, the sea, sky, stars, the sunset, the social aspect of nature, and green exercise, in a deliberate, focused way where you get your minimum effective dose of 17 minutes a day, which is, by the way, a floor.
The optimum dose is not very much (only 43 minutes a day) used in a deliberate way that’s almost as individual as you are. Because how you spend those minutes, where and when, and sometimes even with whom, because nature is social, really matters. That’s why the prescription isn’t the same for everyone, and why I found 250 ways for people to try this in each of those areas.
That’s really the take-home. We want people to try as many of these ideas as they can, because you’ll find the ones that are right for you, and, much like the right diet, those are the ones you’ll keep doing because it feels really good and joyful. Plus it has amazing biological and medical benefits of prevention, and in some cases, certainly an ally to treatment. There are not many places where nature replaces treatment in a peer-reviewed, randomized, controlled, double-blinded way. But there are places where it’s getting close, and we need more research to understand how much further we can get.
In the meantime, we don’t have to wait for the research to know about these modalities. Bright outdoor light, movement in green spaces, and breathing healthier air matter are vital. The EPA has documented that outdoor air is between two and five times cleaner than indoor air, no matter where you are, unless you’re living next to a smokestack. Even that is so powerful, simple, and easy. Yet the details really matter. Where you spend your time, how you spend your time, and when you spend your time matter for biological change. That’s the take-home. You want to find out what works especially for you. That’s why I detailed so many choices in the book.
Dr. Wendy Myers
Tell us, what is the name of your book again? Can you show it to us, and tell us where the listeners can get it?
Dr. John La Puma
The book is called Indoor Epidemic, and it’s at indoorepidemic.com. I actually wrote a free seven-day outdoor reset, which is a single-page PDF download everybody can have for free that gives some of the main points. Try these main points, and if you like it, there are 200 more of them in the book.
Dr. Wendy Myers
John, thank you so much for coming on the show. That was so good. We all know we need to be going outside and getting more sunlight and things like that, but you beautifully illustrated all the science behind it and a lot of details and distinctions there. So thank you so much for coming on the show.
Dr. John La Puma
My pleasure, Wendy. Thank you for having me.
Dr. Wendy Myers
Everyone, I’m Dr. Wendy Myers. Thanks so much for tuning in every week to the Myers Detox Podcast. I love doing this show and bringing experts on like Dr. La Puma to give you guys a lot more distinctions and a lot of reasons why you should be doing the things you know you need to be doing. It kind of motivates you to get out there, get lighter, and do some forest bathing. Thanks for tuning into the show every week. Thanks so much.
Disclaimer
The Myers Detox Podcast is created and hosted by Wendy Myers. This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast, including Wendy Myers and the producers, disclaims responsibility for any possible adverse effects from the use of information contained herein. The opinions of guests are their own, and this podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guest qualifications or credibility. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician
