Insufficient sleep undermines dietary efforts to reduce adiposity.

Ann Intern Med. 2010 Oct 5;153(7):435-41.

Insufficient sleep undermines dietary efforts to reduce adiposity.
Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Penev PD.

The University of Chicago, Illinois, USA.

Comment in:

Ann Intern Med. 2010 Oct 5;153(7):I28.
Ann Intern Med. 2010 Oct 5;153(7):475-6.

Summary for patients in:

Ann Intern Med. 2010 Oct 5;153(7):I28.

Abstract
BACKGROUND: Sleep loss can modify energy intake and expenditure.

OBJECTIVE: To determine whether sleep restriction attenuates the effect of a reduced-calorie diet on excess adiposity.

DESIGN: Randomized, 2-period, 2-condition crossover study.

SETTING: University clinical research center and sleep laboratory.

PATIENTS: 10 overweight nonsmoking adults (3 women and 7 men) with a mean age of 41 years (SD, 5) and a mean body mass index of 27.4 kg/m² (SD, 2.0).

INTERVENTION: 14 days of moderate caloric restriction with 8.5 or 5.5 hours of nighttime sleep opportunity.

MEASUREMENTS: The primary measure was loss of fat and fat-free body mass. Secondary measures were changes in substrate utilization, energy expenditure, hunger, and 24-hour metabolic hormone concentrations.

RESULTS: Sleep curtailment decreased the proportion of weight lost as fat by 55% (1.4 vs. 0.6 kg with 8.5 vs. 5.5 hours of sleep opportunity, respectively; P = 0.043) and increased the loss of fat-free body mass by 60% (1.5 vs. 2.4 kg; P = 0.002). This was accompanied by markers of enhanced neuroendocrine adaptation to caloric restriction, increased hunger, and a shift in relative substrate utilization toward oxidation of less fat.

LIMITATION: The nature of the study limited its duration and sample size.

CONCLUSION: The amount of human sleep contributes to the maintenance of fat-free body mass at times of decreased energy intake. Lack of sufficient sleep may compromise the efficacy of typical dietary interventions for weight loss and related metabolic risk reduction.

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