People who got regular, uninterrupted sleep did better at sticking to their exercise and diet plans when trying to lose weight, according to preliminary research presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions 2023.
The symposium presents the most recent findings in population-based health and wellness, as well as their implications for healthy lifestyles and cardiometabolic function.
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“Focusing on getting good sleep — getting seven to nine hours of regular waking hours a night, as well as staying refreshed and alert throughout the day — can be an important behavior that helps people stick to their physical activity and diet modification goals,” he said. Christopher E.
Kline, Ph.D., is an associate professor in the Department of Health and Human Development at the University of Pittsburgh. “Our previous study reported that better sleep health was associated with significantly greater loss of body weight and fat among participants in a year-long, behavioral weight loss program.”
The researchers examined whether good sleep was related to health by how well people adhered to various lifestyle modifications prescribed in a 12-month weight loss program. The weight loss program included 125 adults (mean age 50 years, 91% female, 81% white) who met criteria for overweight or obesity (body mass index of 27-44) without any medical conditions requiring medical supervision of their diet. . or physical activity.
At the start of the program, at 6 months and 12 months, sleep, waking activity and rest habits were measured through a patient questionnaire, a sleep diary and 7-day readings from a wrist-worn device. These measures were used to score each participant as “good” or “poor” on six measures of sleep: regularity; satisfaction; vigilance; time; efficiency (percentage of time spent in bed actually sleeping); and duration. An overall sleep health score of 0–6 was calculated for each participant, with one point for each “good” measure of sleep health, with higher scores indicating better levels of sleep health.
Adherence to the weight loss program was measured by percentage of group intervention sessions; percentage of days on which each participant ate between 85–115% of their recommended daily calories; and changes in daily duration of moderate or vigorous physical activity. At the start of the study, the participants’ average sleep health score at 6 months and 12 months was 4.5 out of 6. Participants self-reported their calorie intake each day using a phone app, and researchers measured participants’ physical activity with a waist-worn accelerometer at one week at the start of the study, at 6 months and at 12 months.
After adjusting sleep health scores for age, gender, race and whether or not there was a bed-sharing partner, the researchers found that better sleep health was associated with higher rates of attendance at group interval sessions, adherence to calorie intake goals and improvement. Time spent performing moderate-vigorous physical activity. They found:
Participants attended 79% of group sessions in the first six months and 62% of group sessions in the second six months.
Participants met their daily calorie intake goals 36% of the time in the first six months and 21% in the second six months.
Participants increased their total daily time spent in moderate-vigorous activity by 8.7 minutes in the first six months, however, their total time decreased by 3.7 minutes in the second six months.
Reductions in group session attendance, calorie intake and time spent in moderate-vigorous activity were expected over the second six months, Kline said. “When someone continues on a long-term behavioral weight loss intervention, it is common for adherence to weight loss behaviors to decrease,” he said.
Additionally, while there was a correlation between better sleep health scores and an increase in physical activity, it was not strong enough to be statistically significant, meaning the researchers could not rule out the results being due to chance.
“We hypothesized that sleep would be associated with lifestyle modification; however, we did not expect to see associations between sleep health and our three measures of lifestyle modification,” he said. “Although we did not intervene in sleep health in this study, these results suggest that optimizing sleep can lead to better lifestyle modification.”
Limitations of the study include that it did not include any intervention to help participants improve their sleep, that the study sample was not recruited based on participants’ sleep health characteristics, and that the overall sample population had relatively good sleep health at baseline. The sample was also predominantly white and female, so it is unclear whether these results generalize to more diverse populations.
“One question of interest for future research is whether we can increase adherence to lifestyle modifications — and, ultimately, weight loss — if we improve a person’s sleep health,” Kline said.
A second question for researchers is how to time such an intervention to improve sleep.
“It remains unclear whether it is best to optimize sleep prior to trying to lose weight. In other words, physicians should, or should, tell their patients to focus on getting better and more regular sleep before they begin trying to lose weight. Try to improve their sleep while modifying your diet and activity level?” Cline said.
Improving sleep health is something everyone can do to improve their heart health and is a key component of the American Heart Association’s 8 Essentials of Life. Sleep was added in 2022 as the eighth component of optimal heart health, which includes eating healthy, being physically active. Be active, don’t smoke, get enough sleep, maintain a healthy weight, and control cholesterol, blood sugar, and blood pressure levels. According to a 2023 statistical update from the American Heart Association, heart disease kills more people in the United States each year than all forms of cancer and chronic lower respiratory disease combined.
“There are over 100 studies linking sleep to weight gain and obesity, but this was a great example of how sleep isn’t just linked to weight, it’s linked to the things we do to help manage our own weight. Because sleep controls hunger and cravings, your metabolism and affects your ability to regulate metabolism and make healthy choices in general,” said Michael A. Grandner, PhD, MTR. Grandner is director of the University of Arizona’s Sleep and Health Research Program, director of the Behavioral Sleep Medicine Clinic at Banner-University Medical Center in Tucson, Arizona, and co-author of the Association of Life’s Essentials 8 Cardiovascular Health Score. .
“Studies like this really show that all of these things are connected, and sometimes sleep is something that we can start to control that can help open up other pathways to health.”
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