Extended sleep tied to less sugar, carb, and fat intake
by Kristen Monaco, Staff Writer, MedPage Today
January 10, 2018
Sleeping longer may lead to a healthier diet, according to British researchers.
Among habitually short sleepers — 5 to <7 hours per night — a behavioral intervention that extended sleep led to significantly reduced intake of free sugars compared with those who continued as short sleepers (-9.6 g, 95% CI -16 to -3.1g versus 0.7 g, -5.7 to 7.2 g, P=0.042), reported Haya K. Al Khatib, MSc, of King’s College London.
Those who extended sleep greatly reduced intake of fats, carbohydrates, and free sugars compared with habitually short sleepers, they wrote in the American Journal of Clinical Nutrition.
“Sleep is increasingly recognized as a potential modifiable risk factor that may be involved in the complex etiology of obesity and cardiometabolic diseases and is becoming an area of increasing public health concern,” the group wrote, highlighting that prior evidence has shown the poor sleep may be linked to insulin resistance, glucose disruption, as well as appetite hormone disruption.
The Sleep Lengthening and Metabolic health, Body composition, Energy balance and cardiovascular Risk (SLuMBER) study included 42 individuals, ages 18-64, all of whom were of normal weight at baseline (BMI <30). They were all self-reported habitual short sleepers. Some exclusion criteria included history of cancer, diabetes, cardiovascular disease, chronic liver disease, renal disease, thyroid disorders, and inflammatory bowel disease.
Prior to the 4-week, randomized controlled study, all free-living participants were fitted with a wrist actigraphy to track sleep duration, as well as an Actiheart monitor to assess total energy expenditure. Dietary behaviors were assessed via the Dutch Eating Behavior Questionnaire.
All participants were randomized at baseline — half to a behavioral sleep extension program (n=21) and half continued with habitual short sleep (n=21). The sleep extension intervention included a personalized consultation with a health psychologist to improve sleep hygiene through behavioral intervention. Factors including body composition, blood pressure, pulse, resting metabolic rate, and total energy exposure were repeated at the conclusion of the trial.
Those who received behavioral sleep intervention significantly extended time in bed (mean difference 0:56, 95% CI 0:31-1:21, P<0.001), sleep period (0:52, 0:27-1:17, P<0.001), as well as sleep duration (0:32, 0:11-0:54, P=0.004) compared with baseline based upon 7-day actigraphy data.
Although not statistically significant, there were trends reported towards a reduction in carbohydrates intake (-22.0 grams, 95% CI -40.3 to -3.6, P=0.083) and fat intake (-2.1% of energy, -4.2% to 0.1%, P=0.074) versus baseline.
In a sensitivity analysis, which excluded implausible reporting participants (n=4), several significant dietary changes were seen among sleep extenders compared with baseline:
- Free sugar intake: mean difference −11.8 g (95% CI −22.4 to −1.1, P=0.031)
- Carbohydrate intake: −28.5 g (−55.8 to −1.2, P=0.041)
- Fat intake: −3.7% of energy (−7.2% to −0.2% of energy, P=0.037)
After 4 weeks there were not significant differences seen among sleep extenders in their levels of physical activity, energy expenditure, or anthropometric measures. Similarly, there were no major differences in terms of body weight, composition, or waist circumference. There were also no significant differences seen in resting metabolic rate, cardiometabolic risk factors, or appetite hormones.
The authors suggested future research blind participants to reduce and prevent bias. They also recommended future studies aim to recruit a more diverse population as their sample “was predominantly white, young women recruited from a university setting, and this may limit generalizability to other sociodemographic groups.”
“We hope to investigate this finding further with longer-term studies examining nutrient intake and continued adherence to sleep extension behaviors in more detail, especially in populations at risk of obesity or cardiovascular disease,” Al Khatib noted in a statement.
Click here for the American Association of Clinical Endocrinologists’ obesity resource center.
The study was funded by the British Nutrition Foundation.
Al Khatib and co-authors disclosed no relevant relationships with industry.
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