We get this question a lot!

For decades, chiropractors have been saying that sleeping on your back is the best position, with side sleeping the second best option if you absolutely can’t sleep on your back.

There are orthopedic pillows that support the neck while sleeping on your back, and there are those who recommend sleeping with a pillow under your knees to take the strain off your low back, and to keep you on your back throughout the night.

It makes sense, right? If you think about the alignment of the spine, sleeping on your back seems to be the most intuitive way to sleep, with a good pillow that supports the curvature of the neck.

…But recently we’re starting to think differently.

Studies have shown that we actually breathe better when we are lying face-down. During the height of the COVID pandemic, ICU specialists found that those with severe respiratory distress could breathe better if they were lying face-down (or what we call “prone”).

When we are face-up (supine), all the stuff that drains from your nose goes down your airway. Here in the Brazos Valley, we have lots of allergens and lots of sinus infections due to our high humidity. Americans are showing huge increases in the number of sleep apnea diagnoses… perhaps because of the physical blockage of the airway due to supine sleeping.

Also, lying on your stomach forces us to turn the head to one side or the other, which has been shown to create a better neck curvature than using the special pillows. I recommend alternating - sleep with your head turned to the right one night, and then the left the next night.

When SIDS became a big issue in the 1980’s and 1990’s, pediatricians recommended that all babies needed to sleep on their back. But as soon as they are able to roll from front to back and back to front, let them sleep on their stomach. They should hit that milestone by 6 months of age.

When you sleep on your stomach, don’t use a pillow and don’t put your arms up under your head. Sleep with your arms by your sides and legs straight.

If you have been sleeping on your back for all of your life, it can take some time to get used to a new sleeping position. Start in the position you want to transition to, and you will likely turn to a different position pretty quickly. Over time, your body will learn and adapt.

If you absolutely can’t sleep on your stomach, find a position that is comfortable. If it hurts, don’t force yourself to keep doing something that hurts. If you like sleeping on your side but it is becoming uncomfortable, try putting a pillow between your knees to stack the hips on top of each other.

One last note: if you are suffering from a severe pain condition right now - such as a disc herniation - find whatever position is most comfortable. Don’t worry about “best” for your spine, just whatever position is comfortable. We will start working towards changing positions once the inflammation from the disc herniation is calmed down, but in the beginning, just try to find any position that is comfortable.

Two main reasons: we are not getting enough of what we need from the food that we eat, and we are living in a world that requires more nutrients than ever before.

Would you build a house without 2x4s? Then why do we think we can build healthy cells in the body without the essential nutrients we need?

In 1936 a group of researchers presented a report to the U.S. Senate, stating that due to soil depletion, they had measured a decrease in essential minerals in the produce that Americans consume.

Way back, a long time ago, in the early books of the Old Testament, God laid out some rules for how the people of Israel should farm the land. God told them that they should rotate the crops every year (meaning that they should not grow the same crops in the same field year after year), and every 7th year they should let the field rest. In that 7th year, wild animals would graze on the resting fields, re-fertilizing the soil and restoring the essential nutrients that would make healthy crops for the next 6 years.

We don’t do that any more here in America. Yes, farmers are required to rotate crops, but if they rotate between crops that are very similar, it’s not providing the benefit that the rule intends. Wheat and corn are very similar in the nutrients that they need, so if farmers are only ever alternating between grain products, they are not seeing the benefit of crop rotation.

If they alternated between very different products, it would be more beneficial. But money drives everything, and when a farmer has invested a million dollars into buying equipment to harvest wheat, he is going to try to plant other products that are very similar to wheat so that he can use the same equipment when it comes time to harvest.

Additionally, fields are never allowed to go fallow, unless a farmer is willing to reduce his income by $50,000 or more each year. Again, money drives everything. But our produce is suffering.

In 2002 the American Medical Association released a report stating that Americans would need to eat 17-22 servings of fruits and vegetables per day to reach their basic daily requirements. Most Americans are struggling to eat the previously recommended five servings of fruits and vegetables per day, much less seventeen!

If the nutrients are not in the soil, they will never be in the produce that comes from that soil. If we aren’t getting the nutrients we need from the food that we eat, we have to get those nutrients from supplements.

On the other side of the problem, our environment today is filled with challenging toxic chemicals that humans have never had to deal with before. Prior to 150 years ago, humans had never breathed in car exhaust before. Humans had never breathed in bleach fumes before. Humans had never been exposed to PVC products before.

Our bodies are fighting off more oxidizing chemicals every day than we even realize. We need more anti-oxidants today than ever before. The reality is that we just can’t get everything we need from the food that we eat.

We discuss supplements with our patients because it is impossible to build healthy bones, muscles, nerves, ligaments, cartilage, hormones, red blood cells, white blood cells, etc. without supplements.

I know supplements can be expensive. Believe me; I know because I take them myself.

But the point of taking supplements is to give your body all the building blocks that it needs to make healthy cells, tissues, hormones, neurotransmitters, etc. If we are paying for supplements that are not providing those building blocks, it is just a waste of money. Or worse, if we are taking supplements that are actually doing more harm than good, then we will pay a much higher price later.

Sadly, the health supplement industry is not very well regulated in the U.S. Even if there were more rules and regulations regarding supplements, I would not trust the U.S. government to get it right (but that’s just my perspective). As we have seen in all areas of government rules, money has a lot of influence.

We work with and buy from companies that perform independent testing on their products - meaning they pay for a different, non-affiliated lab to study their products for efficacy (how well it works) and purity (free from toxic stuff that could cause harm).

Because we work with high quality companies, the supplements we use and recommend are not cheap. Could you find a multivitamin supplement at one of the big stores for less money? Yes. But I don’t think it’s a good idea for a few reasons:

1. You have no idea how long those products have been sitting in a hot warehouse before you get to them. Supplements break down as they are exposed to oxygen, so we want the freshest supplements available. When we heat supplements, they break down faster. So, if they have spent even a month in a hot warehouse, baking and oxidizing, they are basically useless by the time they get to your house.
2. Most supplement companies use cheap products in their supplements, including things like coal tar and wheat chaff. Coal tar is exactly what it sounds like - the tar that comes out of processing coal. Many supplement companies use it to bind together their hard packed vitamins. Do you really think it’s a good idea to swallow a little bit of coal tar every day? What do you think might happen in 10-20 years if you consume a little bit of a toxic substance every day?Answer: chronic and possibly deadly illness. (Side note - how do supplement companies get away with using bad products? Money has influence.)
3. Consuming unhealthy animal products makes unhealthy people. Do you want to consume fish oil from fish that have been swimming in the ocean their whole lives? Or do you want to consume fish oil from fish that have been swimming in a dirty tank, eating their own feces and corn (not a natural diet for fish), never allowed to build muscle because there’s not enough room to actually swim… fish farming is usually not a pretty system. I want fish oil from healthy fish. The supplement companies that we use and recommend know exactly when the fish was caught that they use in their supplements. So, I can call them up and say, “I have a bottle of your product with this product number: ____. When was that fish caught?” And they can tell me when it was caught. That’s worth my money.

Are high quality supplements expensive? Yes. Are they worth the expense? In my opinion, yes. I see it as an investment in my long-term health.

Vitamins are specific compounds. Vitamin A, vitamin K, vitamin D, etc. are all specific molecules that are essential for us to consume because our bodies can’t make them on their own.

The term “supplements” includes all the things we might take in the form of a capsule, pill, powder, or liquid. We are supplementing the diet with extra things to achieve a specific purpose.

Fish oil is a common supplement. Minerals like iodine or magnesium might be taken as a supplement. Black seed oil might be used for cooking, or it might be taken as a supplement.

Most of the time, we do need to take vitamins as part of our regimen of supplements. One of the most crucial vitamins that we need is vitamin D, and almost everyone is deficient these days.

For all of human history, up until the last ~50 years, it was common to eat organ meat occasionally. Organ meat includes liver, heart, kidneys, etc. Organ meat tends to be highly concentrated in fat-soluble vitamins: A, D, E, and K.

We don’t eat organ meat any more (can I get an “Amen”?), so we need to replace those fat-soluble vitamins in supplement form.

Dark green leafy vegetables tend to be really high in riboflavin (vitamin B2), iron, and calcium. If we eat enough spinach, we may not need to add B2, iron, and calcium into our system through supplementation, but most people are not eating enough spinach to qualify.

We use the term “supplements” because it encompasses more than the term “vitamins”.

That’s a really complicated answer.

Several years ago, when I turned 30, I caught the “I’m going to be a runner” bug like a lot of my contemporaries of the time. So, I got outside and started running.

Eventually I worked my way up to doing two half marathons before my knees decided I was done. Then I thought, “maybe I should look into proper running technique and see if I can change something so that my knees will last longer”. I probably should have done that first… and not the other way around.

Anyway, then I started digging into the research of running technique, and that led me to footwear. It turns out that our shoes play a HUGE role in proper mechanics of running.

When Nike became popular in the 1970’s, they did us a big disservice. They were popular for style purposes, but they made “running shoes” that had a large heel cushion and much less toe cushion. The shoe industry calls it “drop” from the heel to the toe.

Not only did they make these shoes, but the brand sold the image of the runner and the running lifestyle. Thanks to advertising, the population became convinced that Nike shoes were the best for running. The more popular and profitable Nike became, the more other shoe manufacturers followed suit. Eventually all of our running footwear had a large drop from the heel cushion to the toe cushion.

But for most of human history, the human foot didn’t need or use that type of footwear. Your feet have three biomechanical arch systems to absorb shock and act like springs. As our body weight lands on the foot, the arch flattens out and then bounces back, providing propulsion to help move us forward.

When we wear shoes with a large drop - and some of the shoes on the market today have a 12-14 mm drop, which is very large! - we inhibit the normal motion of the foot. So, if the arches in our feet are not absorbing shock, what do you think will happen?

That force gets passed up to the knees, and our knees have to absorb the shock.

In my opinion, a flatter shoe is better. I look for shoes that have zero drop from the heel to the toe, but they are really hard to find. I usually have to order them online because most shoe stores don’t stock zero drop shoes.

It does take some time to adjust to wearing and especially running in zero drop shoes. We will talk about that transition next week.