Abstract
Ever more evidence associates short sleep with increased risk of metabolic diseases such as obesity, which may be related to a predisposition to non-homeostatic eating. Few studies have concurrently determined associations between sleep duration and objective measures of metabolic health as well as sleep duration and diet, however. We therefore analyzed associations between sleep duration, diet and metabolic health markers in UK adults, assessing associations between sleep duration and 1) adiposity, 2) selected metabolic health markers and 3) diet, using National Diet and Nutrition Survey data. Adults (n = 1,615, age 19–65 years, 57.1% female) completed questions about sleep duration and 3 to 4 days of food diaries. Blood pressure and waist circumference were recorded. Fasting blood lipids, glucose, glycated haemoglobin (HbA1c), thyroid hormones, and high-sensitivity C-reactive protein (CRP) were measured in a subset of participants. We used regression analyses to explore associations between sleep duration and outcomes. After adjustment for age, ethnicity, sex, smoking, and socioeconomic status, sleep duration was negatively associated with body mass index (-0.46 kg/m2 per hour, 95% CI -0.69 to -0.24 kg/m2, p < 0.001) and waist circumference (-0.9 cm per hour, 95% CI -1.5 to -0.3cm, p = 0.004), and positively associated with high-density lipoprotein cholesterol (0.03 mmol/L per hour, 95% CI 0.00 to 0.05, p = 0.03). Sleep duration tended to be positively associated with free thyroxine levels and negatively associated with HbA1c and CRP (p = 0.09 to 0.10). Contrary to our hypothesis, sleep duration was not associated with any dietary measures (p ≥ 0.14). Together, our findings show that short-sleeping UK adults are more likely to have obesity, a disease with many comorbidities.
Highlights
Metabolic syndrome is defined as central obesity plus at least two of the following: raised blood pressure, raised fasting plasma glucose (! 5.6 mmol/L or treatment for diabetes), raised triglycerides (! 1.7 mmol/L or treatment for hypertriglyceridemia), and reduced HDL cholesterol (< 40 mg/dL for males, < 50 mg/dL for females, or treatment for low HDL cholesterol levels)
Consistent with our predictions, sleep duration was negatively associated with BMI and waist circumference, and positively associated with HDL cholesterol levels
We hypothesized that shorter sleepers would have impaired glucose metabolism and thyroid function, as well as Energy Carbohydrate (g) Carbohydrate (% total energy) Fat (g) Fat (% total energy) Protein (g) Protein (% total energy) Alcoholb Fibre (g) Sugar (g) NMES (g) Trans-fatty acids (g) Saturated fatty acids (g) Sodium (g) Fruits (g) Vegetables (g)
Summary
Approximately 4.5 million people in the UK have diabetes, and it was estimated that in 2015 about 415 million 20–70 year old adults had diabetes worldwide. Large epidemiologic studies have consistently linked short sleep to type 2 diabetes, (central) obesity and metabolic syndrome [10,11,12,13], and some of the mechanisms contributing to associations between short sleep and metabolic diseases are beginning to be understood [14]. Among these mechanisms, short sleep may affect dietary choices, predisposing individuals to selection of energy-dense, rewarding foods and nonhomeostatic eating [15]. We hypothesized that short sleep would be associated with 1) less healthy dietary habits, 2) obesity, 3) dysglycemia, 4) dyslipidemia, 5) metabolic syndrome, 6) impaired thyroid function, and 7) higher systemic inflammation
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