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March is Nutrition Month® across Canada March is Nutrition Month® across Canada. In celebration of healthy eating, dietitians across Canada unite to organize events and communications to reinforce the importance of nutrition in achieving health and wellbeing. During March, put healthy eating in the spotlight. Make at least one positive change for yourself or make a change that helps the whole family. Choose from Dietitians of Canada "Top Ten" list of healthy eating ideas:
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Sleep and Weight Control Chronic sleep restriction or sleep deprivation is a common phenomenon of modern life. It has been suggested that since 1910 the average total sleep time for humans has decreased from nine hours to seven hours a night. The human body is designed to sleep at night and get seven to eight hours of sleep per night to function normally during the daytime. As North Americans push the limits of human capacity and attempt to cope with the demands of a "twenty-four/seven" society, physicians are seeing the emergence of new epidemics that can be linked to this phenomenon. A tremendous amount of basic research in the fields of sleep, obesity, metabolic and vascular disease is unraveling the relationship of sleep to metabolism and weight control. Clinically, physicians are faced with the outcomes of obesity, metabolic syndrome, Type 2 diabetes and vascular disease. This article discusses these relationships in an effort to help the primary-care physician apply this knowledge to every day clinical practice. What's the background and current state of evidence? In 1999 Spiegel, Leproult and Van Cauter published their findings of a well-designed study exploring the relationship of experimentally induced chronic sleep deprivation to alterations in metabolic function. The results of the study supported the assumption that glucose/insulin regulation and appetite control can be disrupted by chronic sleep restriction. More recent epidemiologic evidence has been presented and published supporting the hypothesis that sleep restriction/disruption is linked to weight control. Hasler et al. published a 13-year prospective study evaluating the relationship of total sleep time to obesity in young adults. The results of this study showed a relationship between chronic sleep restriction and weight gain. At the recent North American Association of the Study of Obesity annual meeting doctors Steven Heymsfield and James Gangwisch presented data from the National Health and Nutrition Examinatinon Survey linking obesity to the number of hours of sleep per day. The data suggests that individuals between the ages of 32 and 59, who reported less than four hours of sleep per night were 73% more likely to be obese and those who reported sleeping six hours per night were 23% more likely to be obese. It is believed that this relationship is related to the neuroendocrinologic control of appetite. The control of appetite and energy metabolism is complex and contradictory at best, but recent work in this area has provided sound biological evidence to support the clinical observation that physicians are seeing more overweight patients with disordered sleeping patterns, poor appetite control, difficulty losing weight and maintaining weight loss. The combined effect of stress the hormones (cortisol and adrenalin) and the secretion/activity of leptin and grehlin leads to the inappropriate, increased consumption of high-calorie dense foods, deposition of visceral adipose tissue and the outcome of insulin resistance. Finally, extensive work in the area of sleep disordered breathing, or sleep apnea, has led to substantial evidence that there is a biological link between the stress associated with obstructive sleep apnea and the development of metabolic and vascular abnormalities associated with insulin resistance. Other work in the area of eating and mood disorders has looked at the relationship of delayed circadian sleep phase and seasonal affective disorder (SAD) to eating behaviour. It is common knowledge that "night owls" have altered eating habits and SAD patients tend to crave high-calorie dense foods late in the day. These findings and common clinical presentations provide evidence to support the assumption that current trends toward an overweight, tired population with high risk for cardiovascular and metabolic disease are linked to stress, mood and sleep behaviour/patterns. Take Home Message
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