More Sleep Equals Less Weight -- An Opportunity Lost?

There is an epidemic of obesity in this country affecting all ages, both genders and all ethnic groups. Thus, the report "Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation" from the prestigious Institute of Medicine, adds to the decibel of beating drums calling for national action. However, close examination of the document raises a significant concern. Importantly, the report promotes the roles of increased physical activity and better nutrition as cornerstones of a strategy to combat obesity, but what about sleep?

A search of the document finds the word "sleep" written only four times, and all of these are in reference to sleep apnea. Did the authors of this report ignore the accumulating data implicating sleep deficiency as an important contributing factor to development of obesity? Moreover, did the Institute of Medicine ignore their own previous report, "Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem," in which they cite evidence linking sleep loss to obesity? Unfortunately, the answer appears to be "yes."

What are the lines of evidence linking insufficient sleep to obesity? First, there is general agreement that time spent sleeping has declined over the past 30 years. This roughly approximates the rise in obesity. Second, a number of general population studies demonstrate that obesity is more common among those who sleep fewer than six hours per night. Furthermore, short sleep durations also are predictive of future weight gain. Third, basic research shows that short sleep durations increase levels of a hormone that stimulates appetite and simultaneously reduces the levels of a hormone that reduces appetite. Fourth, night shift workers generally sleep less than day shift workers but on average weigh more. Finally, on a personal level, have you felt hungry after staying up all night? I have, and my guess is that many of you have as well. Perhaps this is the best evidence of all linking inadequate sleep to obesity.

With the "weight" of the evidence implicating sleep deficiency as a risk factor for obesity and the indisputable fact that we should be spending one-third of our lives sleeping, can it be denied that sufficient sleep is the third pillar of health along with good nutrition and regular physical activity? Why the Institute of Medicine failed to come to this conclusion is unclear to me. However, the fight against obesity will be difficult to win unless all obstacles are addressed. A golden opportunity may be lost unless America recognizes that more sleep equals less weight.

For more by Stuart F. Quan, M.D., click here.

For more on sleep, click here.

 

Comments

[Julie Flygare]

10:29 PM on 05/31/2012

Thank you so much for this great article, Dr. Quan. I attended the Congressional Briefing on the 2011 NIH Sleep Disorders Research Plan today at the U.S. Capitol in Washington DC and I'm pleased to report that the connection btw sleep and obesity was highlighted there.

As a sleep disorders patient advocate, I am cheering you on! I do suggest that doctors look introspectively as well at their own training traditions that include 30 hour work shifts. If doctors and researchers hope to impart the importance of sleep upon society, I dare say they aren't leading by example. I'd love to hear your thoughts on this dichotomy.

[Irena Stevanovic]

06:24 AM on 05/30/2012

Very interesting and primarily a warning. Almost all of us who work and have our own business and family obligations do not sleep enough ever. Perhaps only sometimes on weekends ...

[livingbettertherapy]

02:12 PM on 05/29/2012

Now it turns out that lack of sleep may be contributing to the rise in obesity.
Many have said “I have tried everything” in their battle to lose weight or accomplish anything else that is difficult. People commonly say this when they want to justify giving up. They usually haven’t tried everything; they have done several things that don’t work and finally decide to sit on their hands and call it a day. They didn’t tell themselves the truth. They may not have even begun to try everything because some of the things that can resolve the problem take lots of time, patience and effort.
If you lie to yourself and say that you tried everything to justify inaction, time will only pass you by and you will be further away from what you wanted. The lie that one has tried everything will build a cage around you that keeps you from getting to a solution. Here’s another lie-“I keep trying and I just don’t get anywhere.” The truth may well be that you keep trying the same things over and over again that don’t work. The most important thing that you can do is tell yourself the truth, base your action on the truth and keep moving forward. Get a restful night's sleep tonight tell yourself the real truth tomorrow. The truth reveals what you have, what you can do, who can help you, what opportunities are available, what's possible and that's how it sets you free.

[spitfiredd]

12:17 PM on 05/28/2012

I sleep 8-10 hours a night and I work full time, priorities.

[olempe]

04:20 AM on 05/28/2012

How funny, I initialy thought much sleep equals more weight. Nice article.

[DrP]

10:04 PM on 05/27/2012

Another "red herring" that will prevent people from addressing the real issue with obesity : excess carbohydrate consumption. If people eat a proper, high-fat, low-carb diet, then sleep issues will also be resolved along with all of the other health issues "associated" with obesity.
Until everyone "gets it" about carbs and obesity, this is a lost cause.

[Kevin Gilkes]

08:35 AM on 05/28/2012

High fat, low-carb? Really? That's your DrP offering to this? There are many facets that attribute to weight gain and loss with sleep being one of them. Carbs are good WHEN NEEDED. Fats are good WHEN NEEDED. Folks need to learn to eat according to their physical activity, or lack thereof.

These B.S. "diets" being shoved down the human throat are the most hideous things I have ever seen.

[DrP]

10:19 PM on 05/28/2012

We are talking about people with insulin resistance, here. We cannot tolerate carbohydrates because our insulin-resistant cells do not respond to insulin signaling to use glucose for fuel, so we store the glucose we consume as fat and are starving and malnourished and the high insulin levels cause inflammation, high blood pressure, and heart disease. The solution is severely restricting carbohydrates and replacing them with dietary fat. It works. It has saved the health and lives of most of my family members who would be obese and "diabetic" if we had not adopted the low-carb, high-fat, paleo lifestyle. Read the science.

[DrP]

10:21 PM on 05/28/2012

My low-carb, high-fat nutritional plan is not a "diet" it is a lifestyle that I have followed successfully for 12 years, after nearly destroying my health and that of my children following the conventional advice of "calories in, calories out" and "fat makes you fat" and "being fat gives you diabetes" so restrict fat and just cut calories and exercise more. That is the BS.

[Sweet-Marie]

09:45 AM on 05/28/2012

Actually your body doesn't need all that much fat. It doesn't require any metabolic process to actually park itself in your body as fat. A combination of protein, carbohydrate and fat is needed for a healthy life - protein for building the body, fat and sugar as fuel. It's the relationship of one to the other that matters, and the individual that determines the optimal diet. I am slender and my diet consists largely of complex carbs. It's all about knowing what combinations work best for you, when to stop eating, how much exercise you get (otherwise excess fuel gets stored as fat) and finally, not allowing yourself to get too fat in the first place. It becomes that much more difficult to lose after a threshold has been crossed.

[DrP]

10:14 PM on 05/28/2012

I consume a high-fat, very low-carbohydrate ketogenic diet, of the type promoted in the excellent book "The Art and Science of Low-Carbohydrate Performance" by the cutting-edge researches Jeff Volek and Steve Phinney. Today, I got up and drank a cup of coffee, then biked for 5.5 hours with no snacks. By the end of my ride (over 60 miles), I was sprinting up hills and would have ridden another 20 miles or more if I hadn't had a social obligation. I am a 59-year old female with a major family history of diabetes. If I followed your advice about not eating fat, I would be, like my grandfather and father, obese, sitting in a wheelchair, blind, and missing at least one limb, or dead.

[BookQueen]

10:19 PM on 05/25/2012

Does it matter if you sleep in shorter blocks? In other words, if you get 8 hours total, but can't sleep that long through the night so you sleep later on?

Any advice on what to do if you have trouble staying asleep?

[Sweet-Marie]

09:47 AM on 05/28/2012

According to the article, "short sleep durations also are predictive of future weight gain" so it seems that blocks of short sleep even if they add up to 8 hours may still effect those hormones the writers refers to.

[BookQueen]

07:55 AM on 05/29/2012

From the context of the article, I think short duration just means sleeping 6 hours or less at night. I'm not sure what it means about naps, etc.

[afgail]

10:17 AM on 05/25/2012

Just shut down the computer and turn off the TV at 9:30 pm and climb into bed. You will feel better in the morning and over time lose weight??? More likely just stop gaining weight. Either one is a plus, healthwise.