Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity
Open accessAbstract
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. PRIMARY FUNDING SOURCE: National Institutes of Health.
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More recent investigations found leptin unaffected or elevated.
“leptin was unaffected [30], [32], [66] or elevated [20], [29], [31].”
From Impact of Five Nights of Sleep Restriction on Glucose Metabolism, Leptin and Testosterone in Young Adult Men (2012) · cites this paper as [66]
In a controlled-feeding weight loss study, participants lost an equivalent amount of weight in both sleep conditions, but in the sleep restriction condition they lost more fat-free mass and less fat mass than with an 8-hour sleep opportunity.
“Because of the controlled-feeding nature of the study, participants lost an equivalent amount of weight in both sleep conditions. However, in the sleep restriction condition, participants lost more fat-free mass and less fat mass than when the same weight loss treatment was performed with an 8-hour sleep opportunity.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [73]
Lack of sleep may attenuate the efficacy of dietary interventions for fat loss.
“These results indicate that lack of sleep may attenuate the efficacy of dietary interventions for fat loss [117].”
From Sleep and metabolic function (2012) · cites this paper as [117]
In overweight and obese middle-aged adults on moderate caloric restriction, 14 nights of 5.5 h versus 8.5 h sleep opportunity decreased the proportion of weight lost as fat by 55% and increased fat-free mass loss by 60%.
“At the end of the 2 weeks of sleep curtailment, the proportion of weight lost as fat was decreased by 55%, and the loss of fat-free body mass was increased by 60%.”
From Sleep and metabolic function (2012) · cites this paper as [117]
In the caloric-restriction study, leptin declined with weight and adiposity loss without a significant independent effect of sleep loss, so negative energy balance most likely overrode the effect of sleep duration.
“For example, in the study that submitted the subjects to caloric restriction, leptin levels declined in parallel with the loss of weight and adiposity without a significant independent effect of sleep loss: The negative energy balance most likely overrode the impact of sleep duration [117].”
From Sleep and metabolic function (2012) · cites this paper as [117]
Studies in adults have shown that insufficient sleep can impair one's ability to lose fat mass-associated weight.
“studies in adults have shown that insufficient sleep can impair one's ability to lose fat mass-associated weight.82”
From Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and meta-analysis of prospective studies (2018) · cites this paper as [82]
Partial sleep deprivation does not affect 24-hour GH levels in lean or obese individuals, but six 4-hour nights change GH nocturnal secretory patterns to a biphasic pattern.
“Partial sleep deprivation did not affect 24-h levels of GH in lean or obese individuals,101,109,118 but six 4-h nights changed GH nocturnal secretory patterns: sleep deprivation was associated with a biphasic pattern compared to the usual single large GH peak at sleep onset.102”
From Interacting epidemics? Sleep curtailment, insulin resistance, and obesity (2012) · cites this paper as [118]
Short sleep duration is cross-sectionally and prospectively related to increased body weight and body weight gains, and lack of sleep seems to compromise the efficacy of weight loss dietary intervention.
“Accordingly, short sleep duration, per se, is cross-sectionally and prospectively related to increased body weight and body weight gains (see [57] for review) and lack of sleep also seems to compromise the efficacy of weight loss dietary intervention [105].”
From Homeostatic and Circadian Control of Food Intake: Clinical Strategies to Prevent Overconsumption (2013) · cites this paper as [105]
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“…hunger (i.e., especially for energy dense foods), decrease physical activity, increase partitioning of body energy to body fat, (i.e., particularly abdominal or visceral fat), reduce insulin sensitivity, and preferentially promote fat mass accumulation relative to lean mass accumulation [37].”
Background
- Authors
- Nedeltcheva, A. V., Kilkus, J. M., Imperial, J., Schoeller, D. A., & Penev, P. D.
- Affiliations
- University of Wisconsin System (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2010-10-05
- Volume
- 153
- Issue
- 7
- Pages
- 435-441
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- PMC
- PMC2951287
- OpenAlex
- W2003713262
- Cited by
- 397
- References
- 27
- Citations by year
- 2026: 15 · 2025: 17 · 2024: 17 · 2023: 26 · 2022: 24 · 2021: 26 · 2020: 27 · 2019: 20 · 2018: 29 · 2017: 17 · 2016: 20 · 2015: 32 · 2014: 29 · 2013: 27 · 2012: 42
- FWCI
- 40.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1s10rr004999-01)
- National Institute on Aging (P01-AG11412., P01AG011412)
- National Heart, Lung, and Blood Institute (R01HL089637)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60DK020595)
- National Center for Research Resources (CTSA-RR 04999, UL1RR024999)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep restriction, insufficient sleep, caloric restriction, weight loss, adiposity, fat-free mass loss, fat loss, energy expenditure, substrate utilization, hunger, neuroendocrine adaptation, metabolic hormones, overweight adults
- MeSH terms
- Adult, Energy Metabolism, Female, Hormones, Humans, Hunger, Male, Obesity, Sleep Deprivation, Weight Loss, Cross-Over Studies, Caloric Restriction, Adiposity
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