Regular readers will appreciate the rapidly accumulating body of evidence linking much of the current obesity epidemic to a rather marked reduction in sleep that has befallen us all (not least our kids).
In a commentary published in the Canadian Medical Association Journal (CMAJ), Jean-Philippe Chaput and Angelo Tremblay discuss this increasing evidence pointing to a critical role of sleep (or lack thereof) in weight management.
As the authors note:
“Chronic sleep restriction is pervasive in modern societies, and there is robust evidence supporting the role of reduced sleep as contributing to the current obesity epidemic. New studies provide evidence that insufficient sleep enhances hedonic stimulus processing in the brain underlying the drive to consume food; thus, insufficient sleep results in increased food intake. In addition, lack of sleep has been reported to decrease plasma leptin levels, increase plasma ghrelin and cortisol levels, alter glucose homeostasis and activate the orexin system, all of which affect the control of appetite and might compromise the efficacy of dietary interventions.”
Although interventions focusing on sleep are still scarce, they do discuss one randomised controlled trial in which decreased sleep (5.5 vs. 8.5 hours) together with a calorie-deficient diet resulted in amost 60% less weight loss than in the long sleepers.
In another study, participants in a 6-week weight loss intervention who reported better sleep and/or sleeping at least 7 hours experienced almost 35% more weight loss than those who did not.
As the authors point out:
“The Canadian Obesity Network recently launched a set of practitioner tools — the 5As of Obesity Management (ask, assess, advise, agree and assist) — that highlight the importance of addressing sleep for weight management.”
They recommend the use of the Pittsburg Sleep Quality Index for screening and diagnosing common sleep/wake disorders and remind clinicians that the association between inadequate sleep and obesity can also be confounded by factors such as stress, depression, psychosocial problems, chronic illness and the use of hypnotic agents.
Reason enough to go well beyond ‘eat-less-move-more’ (ELMM) recommendations on obesity management.