Sleep less and get fat


An important study conducted at the Eastern Virginia Medical School in Norfolk, Virginia showed that people who sleep less tend to weigh heavier than those who sleep more.

The clinical investigation, which included 1,000 subjects, reported that “total sleep time decreased as the body mass index (a measure of weight based on height) increased.”

Whether this means that heavier individuals tend to sleep less, and vice versa, or having enough sleep makes it easier for people to control and maintain their normal weight, was not clear.

The authors of this study warn that “this does not establish a cause-and-effect relationship between restricted sleep and obesity (but) future investigations demonstrating success in weight loss via extensions of sleep would help greatly to establish such a relationship.”

“We’ve put so much emphasis on diet and exercise that we’ve failed to recognize the value of good sleep,” said Fred Turek, a physician at Northwestern University in Chicago, who wrote a related editorial in a recent issue of the Archives of Internal Medicine, where the study was published.

Some earlier researches have shown sleep deprivation to cause a decline in an appetite-suppressing protein hormone called leptin, and an increase in another hormone (ghrelin) that causes a craving for food. In addition, neuropeptides in the brain governing sleep and obesity appear to overlap.

In another study involving more than 8,000 adults, researchers found that those who sleep only six hours a day had a 23 percent risk of getting obese; five hours, 50 percent; and for those who sleep less than four hours a day, 73 percent, compared to those who sleep eight to nine hours a day.

“It is now critical to determine the importance of lack of sufficient sleep during the early formative years in putting our youth on a trajectory toward obesity … a trajectory that could be altered if sleep loss is indeed playing a role in this epidemic,” Turek’s editorial said.

The alarming rise in obesity, especially among children —  a subject we have written about in this column the past several years — is now an epidemic in many developed countries, especially in the United States, where “super-sizing” of hamburgers, French fries, high-calorie, high-sugar beverages, and other high-carbo-junk-food items, have dominated the fast food chains. As “admirers and followers” of trends in food and fashion in the United States, Filipinos are now facing the same overweight and obesity dilemma in the Philippines.

What is alarming is not the negative aesthetic effect of obesity or of being overweight, but their multitude of dangerous implications on the health and longevity of the victims. Insufficient sleep has been shown in other previous studies to lead to a “cascade of metabolic, cardiovascular, and general medical disorders,” but the lay public has somehow not made the connection yet. Hopefully, this recent study will help convince people that enough sleep (minimum of eight hours a day, which does not have adverse effects or possible complications anyway) is essential, not only in weight control, but in maintaining our health and well-being, and in warding off illnesses in general.

As we have stated before, obesity increases the risk, not only for cardiovascular diseases and diabetes, but also for cancer.

Those with Obstructive Sleep Apnea (OSA) — who snore and do not breathe for a long time, depriving themselves and their organs of oxygen — do not sleep well, waking up tired and without energy, are candidates for a Sleep Study. Sleep apnea also raises the risk for cardiovascular and metabolic illnesses and cancer.

Once the diagnosis of OSA is confirmed by the Sleep Study, the standard of care, the best treatment today, is the use of a CPAP (Continuous Positive Airway Pressure) during bedtime. This stops snoring, allows the person to sleep better and longer, waking up refreshed and full of energy — recharged! The CPAP also minimizes heart attack and sudden death during sleep. The use of the CPAP is a lot more comfortable than people think. Hundreds of millions are on CPAP therapy. Adequate quality sleep is indeed vital.

However, I would like to state that adequate sleep is only one-fifth of the total equation for a healthier, happier, more productive, and longer life. The other four are (1) a healthy diet that is high-fiber, high-grain, low-fat, low-cholesterol, low-carbohydrate, low-salt; (2) daily exercises; (3) stress management and relaxation; and (4) abstinence from tobacco and strict moderation in alcohol intake.

***

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: scalpelpen@gmail.com

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