Does Diet Affect Sleep or
Does Sleep Affect Diet?
Ruth Schneider, MPH, RD, LD, FAND
September 2016
The Short Answer is…
Yes!
(but not much)
Weight status
• “Improvements in sleep duration have been observed with weight
loss, and reduced weight status is associated with healthy changes in
sleep patterns.” (Golem et.al.)
• Numerous reviews and meta-analyses reporting an inverse relation
between sleep duration and weight status have been published.
• “A few studies reported U-shaped associations between sleep
duration and weight status, indicating that too much sleep (>9
h/night) as well as too little sleep (<5 h/night) are associated with
increased risk of over- weight status in adults.” (Golem, et.al.)
Daytime sleepiness is associated with higher BMI (Grandner)
Eating behaviors
• Short-duration sleepers (< 6 hours) showed a distinct picture of eating
characterized by skipping main meals and higher contributions of
snacks; earlier and later eating episodes, and more beverages.
However, total energy intake was very similar to normal duration
sleepers.
• In a study where sleep was actually restricted, this led to higher
energy intake. (NHANES 2005-10)
Eating behaviors
“Difficulty maintaining sleep was associated with fewer foods in the
diet and being on a special diet.” (Grandner) (not significant after
adjustments)
Many specific nutrients (viatmins D, B12, and folate, calcium, selenium)
and fatty acids associated (positively and negatively) with sleep.
(Grandner) However, it is difficult to translate this into specific
recommendations, other than general good diet.
Disease Risk
• “In humans, partial sleep restriction alters sympathetic nervous system
activity, impairs glucose tolerance, and alters hormonal levels.”
“Inadequate sleep may be a risk factor for Type 2 Diabetes.” (Golem)
• “Short sleep duration (<7 h/night) is associated with higher risk and
incidence of cardiovascular disease and poor cardiovascular health
outcomes, including hypertension, hypercholesterolemia, myocardial
infarction, and cerebrovascular accident.” (Golem)
• “Inadequate sleep also is associated with increased inflammation that
overwhelms the immune and antioxidant systems within the body.”
(Golem)
• Adequate sleep patterns protect against obesity, dyslipidemia, diabetes
and insulin resistance (study of 52 people) (Crispim)
Possible mechanisms
• From NHANES, 2007-08: Studies show that restricted sleep led to
“changes in appetite-regulating hormones, specifically lower levels of
leptin [a satiety signal] and higher levels of grehlin [an appetite
stimulant] compared to extended time in bed.” (Grandner)
• Circadian rhythm is affected by disruptions in hours of sleep and
length of sleep.
What to do?
• Food intake near bedtime (late dinner or late snack—30 to 60
minutes before bed) negatively affects sleep quality. (Crispim) Eat
your last meal at least 2 hours before bedtime, and keep it light.
• High glycemic, carbohydrate-rich meal four hours before bed led to
decrease in sleep latency (time getting to sleep). (Crispim)
• However, the closer to bedtime, the more food negatively affects
sleep. (Crispim)
• Eat regular meals instead of snacking along.
• Eat balanced meals to get a balance of nutrients.
What to do?
• Avoid alcohol before bedtime.
• Limit caffeine to morning hours (or eliminate if necessary)
• Drink adequate water during the day, but not before bedtime to avoid
getting up to go to the bathroom.
• Avoid spicy foods if they cause you heartburn, and thus discomfort.
Harvard Women’s Health Watch, February 2014
• What you eat can affect your sleep. Spicy foods can contribute to painful
heart- burn. Big meals leave you uncomfortably full, and over time can
contribute to obesity—a well-known risk factor for sleep apnea. Too much
caffeine could keep you wide awake, even if you finish your coffee in the
morning. “It takes six hours to clear half of the caffeine from your body. If
you have enough caffeine, it’s still in your body at 4 in the morning,” says
Dr. Edelman. And though a glass of wine or two with dinner will make you
feel relaxed or even sleepy, it won’t help you sleep. “You can fall asleep, but
once you’re asleep you can’t sleep deeply,” she says.
• � Solution: Eat dinner at least a couple of hours before bedtime, and keep
the meal light. Avoid spicy, fatty foods, as well as alcohol and caffeine. Also,
don’t drink too many fluids before bed. Having to constantly get up to go to
the bathroom can disrupt your sleep, too.
Nutrition Screening for Geriatric Patients
• Nutrition Screening Initiative (AJPH, July, 1993)
• Found that “24 percent of the Medicare population was at a high risk for
nutrition problems, and
• about 38 percent of that group failed to get even 75 percent of the
recommended intake of three or more nutrients.”
• DETERMINE checklist was developed to identify older adults at risk for
nutrition problems
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