SPEAKER_00 0:00

On this episode, I'm joined by Dr. Marie Pierre Saint-Ange, a professor of nutritional medicine at the Institute of Human Nutrition at Columbia School of Medicine, and director for the Center of Excellence for Sleep and Circadian Research. She unpacks her most recent research published just this past week, showing that restricting sleep for just an hour and a half for those normally getting seven and a half hours of sleep per night causes weight gain. This is a huge discovery which illustrates that just a slight amount of insufficient sleep causes us to gain weight, really driving home the importance of getting good, sufficient sleep about seven and a half hours to improve our weight and overall health. Beyond her recent research, we also go into detail on how and when to eat for better sleep, how sleep impacts your eating behaviors, along with clearing up misconceptions around diet and sleep.

SPEAKER_03 1:26

Good, how are you?

SPEAKER_00 1:27

I'm doing well, thanks. Thanks for joining me today.

SPEAKER_03 1:30

My pleasure.

SPEAKER_00 1:32

Wonderful. Well, I'm excited to get to chat with you. And I was curious if you could tell me just a little bit more about your background and how you got interested in the work you're currently doing.

SPEAKER_03 1:45

Right. So I have a background in nutrition. So I did my bachelor's, master's, and PhD in nutrition at McGill University. The goal of my research then was to uh evaluate various foods, which we call functional foods that could impact cardiometabolic health. So risk of cardiovascular disease and uh obesity, more specifically. Uh, and then I continued my training in obesity research at the New York Obesity Nutrition Research Center at Columbia University, and then got my first faculty position. Uh, and that's where I got introduced to sleep research uh from sleep uh specialists who were interested in uh responding to a grant app, uh a call for grant applications from the NIH to test how sleep could be a causal factor in the development of obesity. And so from my background assessing energy balance and evaluating uh energy intake, energy expenditure uh through the lens of foods and food consumption, I thought this would be a really interesting area to move into and to to explore how sleep could influence energy balance.

SPEAKER_00 3:04

Okay, and so that's interesting. Do you how how does sleep affect energy? And what when you talk about energy, how how do you define energy?

SPEAKER_03 3:17

Yeah, because people think, you know, when we talk, well, when I talk about energy in in the sense of energy balance regulation, it's more the number of calories consumed, calories burnt, not necessarily the sensation of being energetic or having energy to do work. Uh so uh my P for my PhD actually were trying to find ways to to waste energy in a way, right? So that if you're eating one food that produces a greater thermic effect, so that when you when you uh assimilate those calories, it makes you um burn more energy. So when we consume foods, we we don't take in all of the calories that we get from the food. We burn some of it off through the process of digestion and absorption. And the goal from a PhD was to try to find some foods that would be less efficient, that you would keep retain less energy, less calories than uh than uh compared to another food. So um, so in this context, it's more about the number of calories that are burnt off, either through exercise or um through just processing of various foods, that we call the thermic effect of food, uh, in the context of sleep.

SPEAKER_00 4:36

Okay. Okay, and how how one should how should one start to think about their diet when it comes to optimizing for uh better quality sleep?

SPEAKER_03 4:49

Mm-hmm. So I think that it's important to um to view dietary intakes for better sleep as something that's that's that's occurring throughout the day. So not to think about it as one specific food that you consume a few hours before bedtime, like you would a pill, for example, or done or a supplement, right? But to think about this as a whole process across the day to be able to obtain all the nutrients that are needed to um set your body up for better sleep. So regulating your sleep-wake cycle through melatonin production, and also um knowing that these processes relate also to the gut microbiome and gut brain interactions. And so, therefore, a food is not going to instantly, magically, lead to the production of those of those neurotransmitters or hormones that are relevant for sleep onset. So for me, it's consuming a healthful diet across the day, rich in fruits and vegetables, nuts and seeds, um, whole grains. We found that dietary fiber that can be found in fruits and vegetables, nuts and seeds and whole grains uh is quite relevant for better sleep, better sleep depth. So getting more deep sleep at night and having less um light sleep. So those types of foods are would be those two um to favor.

SPEAKER_00 6:21

Okay. Okay, so something like um similar to the Mediterranean diet. Okay.

SPEAKER_03 6:27

And we've also shown, like from population-based studies, where we actually characterize different diet profiles so we could characterize a Mediterranean diet. We've also done uh characterize uh dietary approaches to stop hypertension, looked at it through uh dietary guidelines from for Americans, through the healthy eating index. Uh others have looked at plant um plant-based diet index. So various indices of a healthful diet that represents the same pattern of you know, better, more fruits and vegetables, whole grains and nuts and seeds that are relevant for sleep.

SPEAKER_00 7:03

Interesting. Okay, and um so something that uh that I'm always curious of is how much does when we eat also matter? Like for our circadian health, for our sleep hygiene, for better sleep. Should we be uh also looking at when we eat as well?

SPEAKER_03 7:28

I think that when we eat is also important. Um, there's been a lot more research looking at how when we eat influences uh weight status and cardiometabolic health than there has in terms of uh how it influences sleep specifically. Um there's been so many studies, for example, of time-restricted eating where we're shift, you know, restricting the eating window, uh and how there has been some studies of those looking at uh impact on sleep, but uh the sleep measures are often an afterthought, not necessarily something that's built into the original research. And that's also uh something to keep in mind. But mostly uh studies show that eating earlier in the day is uh associated with better cardiometabolic health, having more regular eating patterns uh associated with better um cardiometabolic health. But I also think that it's important not to think about the timing of eating in the context of of sleep as well, because uh some people may be very sensitive to eating later in the day and how that impacts um their uh gastrointestinal functions and and ability to fall asleep.

SPEAKER_00 8:43

Okay, so so earlier is is is likely better like wrapping up your last meal earlier on in the day? Yes. Okay.

SPEAKER_01 8:52

Yeah.

SPEAKER_00 8:52

Okay, and yeah, does that mean could do we know like specifically what's uh what's uh more healthful, more more I don't want to use the word optimal, but it comes for front of mind. Yeah, but like do we know, like, should we be aligning with our circadian rhythm as far as our our diet's concerned, about like try to finish up our last meal before the sun sets or something? Or is how do we know anything about that?

SPEAKER_03 9:23

It's been studied in in different ways, as particularly for in relation to cardiometabolic health. But um in terms of some studies, I've looked at how eating while our metal melatonin levels rise, how that's associated with poor cardiometabolic health. So melatonin levels start to rise a couple of hours before going to bed. And so eating when that's happening is is not uh is not recommended. So eat eating, so then obviously it would be eating before two hours before bedtime. So ideally, you know, give to give ourselves a few hours, usually we talk about three hours as a as something that's reasonable and feasible for most people.

SPEAKER_00 10:07

Okay, interesting. And now when you say that we should be eating things more fruits and vegetables, nuts, and seeds, do we know exactly why that um is healthy for a better sleep? And do we know exactly what's going on there as far as um what the mechanism is?

SPEAKER_03 10:32

Yeah, so we have some um we have some uh supporting information from the animal literature, for example, that uh polyphenolic compounds that are found in fruits and vegetables and see some plant-based products, um, are associated with better sleep, downregulation of arousals that occur in the brain that prevent one from falling asleep. So that stimulates uh brain activity and wakefulness. So those tend to be downregulated with uh higher polyphenolic compound consumption. Similarly, like I mentioned, the gut-brain um communication that downregulates arousal signals uh with these types of foods. So uh foods that would promote a healthier uh gut microbiome that produce more uh short chain fatty acids, for example. We talk mostly for about butyrate, butyric acid being uh relevant for better sleep.

SPEAKER_00 11:34

Okay. And do we do we know what effect does uh meat meat have on our uh our ability to sleep? Uh and or does it do you have, I don't know if your research looks at at that at all, but do we have any understanding on what uh what sort of effect uh meat has?

SPEAKER_03 11:55

Right. So so meat is interesting. Some in some studies, um actually in many studies, there's not particularly um an adverse effect, so relatively neutral, but it depends, in my opinion, the types of meats that we're talking about, because meat could be a source of saturated fats. And in our research, we've shown that saturated fats tend to be associated with uh poorer sleep, so less deep sleep and more light sleep.

SPEAKER_00 12:27

Interesting. And so is that a call for more lean meats, or or how should one think about what's what provides saturated fat, what doesn't? How would how do you look at it?

SPEAKER_03 12:40

Yeah, I look at it as as um favoring more lean meats that would be lower in saturated fats, but also um having a more balanced diet where you have, you know, not a preponderance of animal products, but that can also be important in the context of a healthful diet, right? So I think to have small amounts of meats across the week is um is okay, but not to have large portions and multiple times of very fatty meats.

SPEAKER_00 13:14

Okay, yeah. So maybe what would yeah, what is that?

SPEAKER_03 13:18

Meats provide, you know, complete proteins, they're high in uh tryptophan, that's the building block for uh melatonin synthesis. So I think that's something to keep in mind that protein is important in the in the diet, but not necessarily to um to overdo it and making sure that leaner cuts are are are being better for all sorts of chronic diseases too.

SPEAKER_00 13:44

Okay, and and you know, when think about leaner cuts, it could be a different type of uh meat-based proteins. Do you have suggestions as to uh which like chicken, beef, uh, pork, do we do we know, or do you have a sense of how should one think about red meat or versus like a chicken product, or is one better than the other?

SPEAKER_03 14:13

Firstly, but I'm not sure. I don't think there's been any studies that have compared, right? So one type of meat protein versus another type of meat protein. Um obviously we know that you know chicken breast is leaner than the brown meat of the chicken. Uh, there's certain cuts of beef that are leaner than others. Um, I think the loins tend to be leaner, uh, leaner cuts. So those are types of um meat products to to look at and to to um to prefer.

SPEAKER_00 14:47

Okay. Yeah. So maybe the carnivore diet, meat alone, might not be the most helpful even when it comes to uh to our sleep. You're saying maybe more of a balanced diet. Definitely.

SPEAKER_03 15:01

A lot a lot more balanced than the carnivore diet, yes.

SPEAKER_00 15:04

Because it's gotten a lot of press, you know, it's um in the health podcast world um and all kinds of claims being thrown around thrown around about the benefit of it. Um but and you're but what you're saying is it's it's better to maybe have meat be more of a supplemental type of um uh food rather than your main Yeah.

SPEAKER_03 15:30

Oftentimes, you know, the when we when we look at a plate, the sometimes the vegetable is a garnish. Maybe the meat could be a garnish for the vegetables and the whole grains.

SPEAKER_00 15:40

Okay.

SPEAKER_03 15:40

And that's smaller, in my opinion, smaller portions are are better. Um, and obviously, you know, there's always someone who's gonna come and say, Well, I've done this to my diet and it's done wonders for me. And and I and I think that's perfectly fine and valid for for this person, this particular person. And so everyone has their own um relation to food and how various food products influence them.

SPEAKER_01 16:09

Okay.

SPEAKER_03 16:09

So we talked a lot about personalized medicine, personalized nutrition. You know, I think there's there's room for various uh dietary profiles that that suit different people.

SPEAKER_00 16:20

Okay. And is it um is it worth kind of being an experiment for yourself to see what works for you um and what helps you feel you know uh healthy, but also helps you sleep better as well?

SPEAKER_03 16:37

I think so, but I think it's also important to to have uh information from um you know health profiles. So, you know, if you have regular checkups to know, you know, what your glucose levels are, what your lipid profile, your blood pressure, and then to be able to have conversations with the appropriate people to decide on on the better nutrition to have based on your metabolic profile and your health profile. So someone who runs high blood pressure, for example, would benefit for a more plant-based diet, lower in sodium, uh, likely lower in sodium uh for better blood pressure regulation.

SPEAKER_00 17:19

Okay. And for plant-based, is there any specific um preference on which plants we should be consuming more than others? Like I hear a lot of talk about uh leafy greens and green vegetables, but should is that another conversation around just balance around different vegetables or one vegetable um more preferable than the than others?

SPEAKER_03 17:46

I think a variety of colors is is important, right? So there's a lot more um there's a lot more uh polyphenolic compounds benefits to the darker green-orange vegetables. But then, you know, cauliflower, for example, that's white, also has really good uh nutrient profiles, so uh and and polyphenolic profile as well. So I think that having uh a diverse portfolio of um non-starchy vegetables is is recommended.

SPEAKER_00 18:20

Okay. And I I know obviously there's many negative effects of drinking alcohol and and caffeine. Do we do you have any sort of uh any advice for folks for caffeine intake and and alcohol?

SPEAKER_03 18:38

Mm-hmm. So those are two beverages that that people enjoy, right? Um also uh better enjoyed in in moderation for for most people. Uh so caffeine is uh is a good one. It's a you know it's uh a stimulant, it helps with alertness. Um it's uh and it's something that uh really has very few side effects, really, and let's consume very, very high, high amounts, which tends to not not really happen. Um but the sensitivity to caffeine and how that influences sleep is highly individualized, and something that needs to be um really uh re-evaluated within even within an individual as uh as one ages because uh your ability to metabolize caffeine changes over the life course. And something that was uh perfectly fine uh to consume, like a beverage perfectly fine to consume at 4 p.m. in your 20s may not be uh may not be so good to consume at that same time in your 60s, for example. So reevaluating your your relationship with caffeine is is something that should be done to see your level of um tolerance. And then um alcohol is also something that uh should be consumed uh in moderation. We're learning a lot more about um how caffeine influences health status and uh mostly on the negative effects of uh of alcohol in more recent years. So I think to be um mindful of that and also not to overconsume alcohol because although it is a sedative and may help someone fall asleep, as it progresses and and um through your body and and gets metabolized, then towards the end of the night you start to see more arousals and more difficulties with uh with sleep in the earlier hours of the morning.

SPEAKER_00 20:41

Yeah, I feel like the older I get, the uh more you feel those effects.

SPEAKER_03 20:47

Yeah, it tends to be more sensitive, yeah.

SPEAKER_00 20:49

Yeah, yeah. Even just a little, like one drink sometimes can make my sleep totally derail it, I feel.

SPEAKER_02 20:58

Yeah.

SPEAKER_00 21:00

Um okay. And so um I'm always curious, I'm also curious what someone in your position, what your opinions are on the uh the new food pyramid that it was that was trotted out. Do you have any opinions on that?

SPEAKER_03 21:19

Um, well, I must say I I preferred the looks of the previous plate. I really I I think the plate was uh was a nice visual to have. It had a beverage, it showed, you know, the proportions of various types of foods on the on the plate, something that's relatable. Uh the new pyramid um can be a little bit confusing in terms of like which foods should be consumed in which uh quantities because of the way it's it's uh it's shaped and how the foods are are um distributed along this um inverted triangle. Um but yeah, I I think the the The prior version uh was more reflective of how we know diet to influence health.

SPEAKER_00 22:08

Okay. Do you um do you see any other trends involving diet and our sleep and metabolic health? Um, whether it's in uh the general public the eye, the general public's eye, social media that um that you um particularly uh feel is misleading.

SPEAKER_03 22:32

Um I'm sorry, could you repeat that?

SPEAKER_00 22:35

Well, as I was wondering, you know, maybe it's just because of the work that I do. It's my feed in on social media is pretty saturated with folks making health claims. Um, some truthy, some accurate-ish. And I'm always curious to talk with someone like yourself who's doing the hard work and and is studying this topic. If you've seen anything on your radar or in the general public that is uh particularly uh harmful or misleading that that um you that we could debunk. Or do you notice any trends around diet and and sleep in in your field?

SPEAKER_03 23:21

Yeah, so for me, it's when I hear about um eliminating seed oils, where I get I I I find the the reasoning behind that a little troublesome, uh, because we do know that most um most liquid oils are more healthful than than other types of oils. So to me, like all most liquid oils would be advisable to consume. Uh they're high in polyunsaturated fats, they're high in monounsaturated fats, tend to be associated with uh lower risk of heart disease. Um I tend to like put them all in the same basket, right? Of those liquid oils uh being uh being more healthful than oils that uh that tend to be more solid at room temperature. Um but the the concern uh then becomes about it their processing, uh which you know all types of foods need some type of processing um to be to be extractable, right? So uh I I I prefer I I would not advise someone to eliminate seed oils. I don't think there that um that there's reason to be concerned about those. Um I think it's I think it's um it's good like people are talking a lot more about processing and um and have a better desire or bigger desire to consume foods that are more in their original form. I think that that's uh a health trend that's worth uh pursuing. Uh sometimes we we see foods on the shelves and like this looks looks nothing like what it used to be. Uh but sometimes those trends for foods that are uh dubbed healthy tend to also be quite uh processed. So sometimes I I think that there's um there's a bit of uh in inconsistency in the general population about what constitutes uh what's what's considered okay and what's not okay in terms of uh processed foods.

SPEAKER_00 25:38

Yeah, it's interesting, right? Because for me, you know, I fall into the trap of looking at something labeled organic or um seems to be labeled in a way that looks more healthy. Um and it certainly costs as if it's going to be more healthy. But I mean, is there any like negative um effect for like consuming frozen vegetables or frozen fruit, like compared to a fresh organic uh produce? Is there is do you is there anything wrong with um going with the fru the frozen variation?

SPEAKER_03 26:24

Actually, sometimes frozen ver variation is probably could be better, right? So if you're not if you don't have access to very fresh fruits and vegetables, um and they're been sitting on the shelf for for a while, uh the a frozen, a frozen option might actually be better because once they're um harvested, they're already you know shifted towards the uh this process of freezing and and preserving. So I think that they could actually be more fresh in the end. So I think that uh that it's important to point out that a healthful diet doesn't have to be the most expensive diet, right? So we can have if you follow what's in season, those types of fruits and vegetables that are usually cheaper than than the ones that have been imported, that are not supposed to be consumed in in this season here in the US. So I think that you know, trying to find more local sources of fruits and vegetables and consuming them in season is is the way to go.

SPEAKER_00 27:36

Okay, yeah, that's that's great, great to know. I feel there's a conflict between our consumer minds or the business of food and what is actually more healthy kind of conflicts, I feel sometimes.

SPEAKER_02 27:51

Yeah, yeah.

SPEAKER_00 27:53

Do you uh do you have a preference on where you grocery shop when you're looking for healthy food? Do you I'm always in the camp of, oh, if I want fresh produce, you know, it's it was worth going to maybe to a Whole Foods or a Sprouts. And then, you know, for everything else, I could maybe go to uh a bigger box store, not that they're not big, but like go to uh my local grocer to pick up more of the uh whatever condiments or whatever I need for the house. But do you have a suggestion or preference to simplify this for folks? Like a lot of people say Aldi is a good store for simplifying things, or what do you choose?

SPEAKER_03 28:38

Yeah, I think it's it's quite localized, right? Everybody has their chain that's in there in their neighborhood. Um I think I just do like like most people, right? But we I there is you know uh a store in my area that that specializes in selling fruits and vegetables. Their fruits and vegetables are always very cheap. I like to go there when I'm really out of uh fruits and vegetables, but I also go to my you know regular grocery chain that's just you know five five minutes down the road uh for for anything else that I need, emergencies and uh and whatnot. But yeah, I and I see what's on sale, what's in season, and that's where I I go.

SPEAKER_00 29:20

Okay.

SPEAKER_03 29:21

It's uh yeah, that's gonna be convenience and and uh freshness, right? Both of them. Yes.

SPEAKER_00 29:28

Yeah, for sure. I um I was wondering if there's any benefit in a multivitamin, in your opinion, when it comes to um comes to our diet. Like, is it worth supplement, either supplements or uh taking a vitamin?

SPEAKER_03 29:46

I think that if you can consume um a complete diet, most people wouldn't need a multivitamin. In some instances, it may be it may be important, it may be um useful, and it could be something that you take for a few weeks and then to just get you back on track and then continue on with uh ordinary foods. But I think that you can get you know all of your micronutrient needs from a healthful diet. Um I know there's some there's some key nutrients that certain groups have difficulty with, you know, the getting enough calcium sometimes for women could be difficult because the requirement is relatively high, and sometimes getting uh sufficient amounts is is more difficult. For women may be difficult also to get enough iron. And that's also relevant for sleep, actually, getting enough uh iron and and some other uh micronutrients. So in this sense, in this instance, sometimes it may be good to have a multi multivitamin, multivitamin mineral supplement.

unknown 30:56

Yeah.

SPEAKER_00 30:57

Gotcha. Okay. Um I've heard a lot of people talk about magnesium for sleep. Um yeah. Is it okay to to supplement with magnesium or is that effective and okay to use?

SPEAKER_03 31:11

I think it's okay to use, it's also, but I also, like I said, prefer you know, obtaining uh minerals from foods. I think that when you start overdoing on on one mineral, it can influence the absorption of other minerals. And so having um your micronutrients come from food sources makes it uh so that you typically don't have these imbalances between between nutrients.

SPEAKER_00 31:41

Okay. Um when you talk about diet and sleep, um, mental health comes top of mind as well. I'm assuming there's a link. There must be. Um everything is connected, but I was curious on your your thoughts on diet involving uh mental health and um and is it kind of like we've been saying like just the more balanced diet's going to help bolster our mental health?

SPEAKER_03 32:13

Yeah, pretty much actually. There's also uh, you know, we were talking about Mediterranean diet dash diet healthy eating index. There's another, there's what we call the mind diet that um favors more berries and more colorful fruits like that for for better um mental health. A colleague of mine, Drew Ramsey, does a lot of work and is a big advocate for uh nutrition for mental health uh in various populations. So I think that's uh that's definitely something that's on the on the radar of uh psychiatrists, psychologists alike.

SPEAKER_00 32:51

That's interesting. And um you brought up uh restricted eating, which is in a way kind of similar to fasting, um just kind of organized or the language maybe a little differently. But um, do you do we know anything about the benefits of fasting, or is there benefits, or does it based on the individual?

SPEAKER_03 33:16

Uh for cardinal metabolic health, sleep, yeah, yeah.

SPEAKER_00 33:20

Yeah, for your yeah, I would say all of those. All of those. Yeah, but and you're what in your fields, I guess, sleep and metabolic health, um, right?

SPEAKER_03 33:32

So you want to make sure that you're so hunger is not a good state to be in if you're trying to fall asleep, right? Those signals that um that uh stimulate appetite also stimulate arousal and wakefulness, right? So they go hand in hand. Uh you want to to to be alert when you're trying to get food, and when there's you know, when you're resting, there's no food, right? So those types, those types of things, they tend to go together. Um, so so you don't want to go to bed hungry, um, but you also don't want to go to bed too full. So that's that's something that that you can play with in terms of where we're talking about uh you know how long it to take, how long to to leave between uh last meal and bedtime, for example. That's one where you can uh experiment and see what's what works for you. Um but um in terms of uh cardiometabolic health and weight management, you know, I know there's there's been quite a bit of research with alternate day fasting or five two types of diets where two days a week you only consume one small meal, maybe 500 calories, and then the rest of the days you can eat as much as you'd like. And those tend to be useful for weight management, also useful for uh cardiometabolic risk factors, but that's usually associated with the weight loss that goes along with it. Um, and maybe difficult to uh to keep up for a prolonged period of time for most people.

SPEAKER_00 35:13

Okay, yeah, that's interesting because I've always kind of figured that we should go to bed hungry.

SPEAKER_03 35:20

Yeah, but not too hungry.

SPEAKER_00 35:22

Not too hungry, okay.

SPEAKER_03 35:23

Not too hungry.

SPEAKER_00 35:26

Okay, that's good to know. And um, I'm assuming this similar um opinions on you know diet most optimal diet for our um for a healthy weight. I'm assuming you would you would recommend a similar type of diet, like uh um fruits, vegetables, seeds, um, type of Mediterranean type of diet.

SPEAKER_03 35:54

Yes, because it helps you to feel fuller. There's more bulk, it's more uh more substantial, uh with fewer calories. So it's in that sense, it's helpful to if you're trying to lose weight. So it's it's not very satisfying when your, I don't know, 600 calories come in a small package like this, right? If you get a nice big plate for 600 calories, it's a lot more satisfying. It takes you longer to eat it. You're better prepared to have the satiety signals, you know, um tell you that you've had enough than eating a small amount for the same calories.

SPEAKER_00 36:39

Okay, feeling satiated is um it's an interesting um sensation that if you're not self-aware, if you've got if you're having struggles with eating, I feel um when I'm in the season of life where that's the case that I'm consuming things quickly. Like, you know, I don't know if there's anything to that, but um, what are some of the signals one should look for? It's just this this sensation of feeling fulfilled with your your meal, your food. Okay.

SPEAKER_03 37:09

Yeah, feeling like you've had enough. And sometimes, you know, your mind has to kind of work with with you as well, right? So, you know, just knowing that okay, this is enough. I've had enough, I need to stop, or take a break from eating and say, okay, let me just wait it out. And if in 15 minutes, I still want it, I'm still hungry, I still feel like I should eat something else, then I'll go back to it, right? So that kind of can be some strategies, or you know, something's very appealing, very appetizing. You really, really, really, really would like it, but you want it, but you you know you're not hungry. At least having a if people are able to do that, a bite and calling it a day satisfies the sweet tooth or that hunger, if you will, and then uh and then be done.

SPEAKER_00 38:05

Yeah, that pause for me at least is really helpful to kind of gauge where my hunger level is at.

SPEAKER_03 38:15

Yeah. And you know, when I talk about this in terms of like insufficient sleep and how poor sleep plays into appetite and food intake regulation, I always I always tell people to kind of take a step back and say, okay, why am I choosing this food right now? Uh is it because I'm tired or is it or is it because I'm really hungry and this is really what I want? Or, you know, what are what's what's the reasoning for for this, right? If you know you had a poor night's sleep, if you know you're exhausted, it's like, am I reaching for something because I just want to get this burst of energy that you'll get if you eat something at this moment, or or is it something other than that? You know, and if you think that maybe I just need to pick me up because I'm tired, well, maybe a cold glass of water could be helpful also as an arousal signal.

SPEAKER_00 39:10

Okay. Okay, that's that's helpful. I I do find, yeah, poor night's sleep, there's just this diminished willpower. Is that what's going on? Is it just like our brain's not functioning uh in a way that could um that you're you could resist as easy these temptations?

SPEAKER_03 39:31

We've found some of that in our research where you know things that are appealing become more appealing in the context of sleep restriction compared to adequate sleep. So the reward networks of your brain tend to be more uh engaged in context of sleep restriction. Uh, whereas when you're well rested, those cognitive centers were that tell you, you know, okay, this is a more sensible thing to do. Choose this instead, those tend to be better when you're well rested, right? But not so much when you're when you're sleep deprived. So I think, you know, every I think everybody knows in a way that you don't make the best choices if you're sleep deprived. You tend to be more impulsive, a little more moody, a little more aggressive. And I think it translates to any decision in your life, including food and exercise.

SPEAKER_00 40:26

Okay. And so um so your work points to that is definitely the case that that lack of sleep or poor sleep um is definitely having an effect on our ability to uh uh control our behaviors in a healthy way.

SPEAKER_03 40:44

Exactly. Yeah.

SPEAKER_00 40:45

Okay.

SPEAKER_03 40:46

And my research mostly in relation to to food intake.

SPEAKER_00 40:50

Okay, okay. Great. And um, and what else are you working on? Um anything on the horizon that you're excited about, emerging that's coming up?

SPEAKER_03 41:00

Yeah, so we have a paper that's uh that's about to be released, and it's been a long time in the works actually, um showing how uh restricting sleep by an hour and a half in people who usually get at least seven and a half hours of sleep per night, uh, but maintaining this insufficient sleep for six weeks leads to weight gain. So this is huge because we have shown that restricting sleep to very small amounts. So my initial research was uh restricting sleep to four hours in bed. So this is not a lot of time in bed, uh, and doing that for five days leads people to overeat compared to having spending nine hours in bed where you can get a full night's sleep. But what we didn't know was what would happen if you're just shit reducing sleep to what happens in the general population very frequently, right? Sleeping six hours per night. Because the the idea for for the study was that you know, people don't maintain four hours of sleep uh long term. And when we're looking at associations between uh insufficient sleep and weight or other cardiometabolic risk factors, it's because people are not sleeping enough by this much, right? By an hour or so, but doing this for years, which which can be sustained, right? So uh we recruited people who have adequate sleep, sleeping at least seven hours. So usually in my lab they sleep seven and a half hours, um and and asking them to reduce their sleep by an hour and a half for six weeks for one in one condition, and then in the other condition, we asked them to maintain their adequate sleep, and we found uh increase in weight, an increase in waist circumference from uh reducing sleep by an hour and a half for six weeks. And it was similar to what we what others have found with more severe sleep restriction for two weeks, for example. And so it's kind of nice to see that um all of the data converge towards you know accumulating uh more sleep debt, right? So whether it's by small and small amounts for a long period of time or large amounts over short periods of time, all lead to to similar weight gain.

SPEAKER_00 43:29

Okay, and and so that time frame where you're in asleep that you looked at went from adequate sleep defined as eight hours or seven and a half?

SPEAKER_03 43:42

We measured sleep with a with the risktigraphy. And so over the six week period, they slept about seven and a half hours per night. Wow, and compared to the sleep restriction, that was about six.

SPEAKER_00 43:55

Got you. Okay. Which I believe I would imagine most folks. Folks would be, um, if they're being honest, probably get about six hours. Um I don't know about most folks, you know better than I do. Are the numbers are they getting worse? Are they getting worse?

SPEAKER_03 44:12

I feel like my sleep's getting worse, but um Well, so I think that the numbers are relatively stable now, with usually you know, about what we find about a third of the population not getting at at least or not reporting sleeping at least seven hours per night. Maybe um and typically uh as we age, people tend to report shorter sleep and more dis more sleep difficulties. So so maybe that's why you maybe think that uh that your sleep is getting worse.

SPEAKER_00 44:44

Yeah, for sure. I'm getting old. That's just happening.

SPEAKER_03 44:47

Not saying that you're getting old, but everyone's getting older, right? So you're sleeping younger relative to 10 years ago, right?

SPEAKER_00 44:53

Yeah, yeah. And um, did they report why that is? Is it just because more responsibilities, more stress, less sleep kind of thing?

SPEAKER_03 45:02

Or yeah, we we don't always ask those same questions at the same time, right? You just look at snapshots of people at various times in their lives and uh and see that. But yeah, typically, you know, there's there's so many factors that influence um how much we sleep, how well we sleep. Uh, we recently um or last year published a paper uh that I chaired for the American Heart Association on multi-dimensional sleep health, where we uh explain how there are various forces that act on sleep health, right? They could be personal choices, personal uh factors, but also social, societal, environmental factors that all play a role in in shaping how well we sleep. It's you know 100 degrees today here and tomorrow too. Some people may have you know difficulty uh sleeping tonight if they don't have AC, for example, right? So those environmental factors are definitely uh relevant, uh, but also other uh socioeconomic, sociodemographic factors that play a role.

SPEAKER_00 46:10

Yeah, it's all uh similar to like pain research with the bio-psychosocial model. There's I feel it's all comes into play.

SPEAKER_01 46:19

Yeah.

SPEAKER_00 46:20

So yeah, that's wow, that's a call for getting at least seven and a half hours of sleep on the regular, and that usually means you said being in bed for about nine hours to fall asleep for most people.

SPEAKER_03 46:35

Uh, you may not need that much. So for us, uh in the research that we did, we gave people a nine-hour time in bed opportunity to make sure that they actually got all the sleep they needed, that they wouldn't be uh cut short. If it if it takes you uh some time to fall asleep, and then there's some wake times during the night. If you're asleep, if you're in bed for eight hours, you might get cut short based on what your your needs are. So I think it's important that people give themselves um adequate time in bed to be able to get the sleep that they need. And it may be seven for for someone, maybe 7:30 could be 6:30, right? But to but to be able to recognize what's appropriate for you and and how um how you feel during the next day based on how you slept the night before.

SPEAKER_00 47:24

Okay. And do we understand how what caused exactly the weight gain from those who missed out on just an hour and a half of a normal sleep? Um, is it are you following their behavior after, like, oh, they reached for the ice cream? Or is it is it just a hormonal or uh some sort of chemical effect that just no matter what, if you get that sort of sleep, you're going to gain weight. Is it a caloric consideration or is it more um just the sleep?

SPEAKER_03 47:55

Yeah. So in this specific study, um, this was all conducted out patients. So participants were at home following their own, you know, diet, physical activity level, their own, you know, doing their own behaviors that we assessed where we um manipulated the sleep and verified based on um their adequate sleep condition. So we don't have much uh in terms of very accurate measures of energy intake, for example, that we were able to get in our prior study in the lab, and others have been able to get also from in-lab studies where we actually observe people weigh the food that they're consuming, and we know exactly what they ate. When we do that, we know that people eat more in the context of sleep restriction compared to adequate sleep. Um here we know that if you change your weight, if you have a weight increase, there's an imbalance, right? So probably ate a little more, exercise a little less. And actually, we do know that they were more sedentary because we had uh ectigraphy measures, so we were able to affect uh their levels of physical activity and they spent more time sedentary, even after adjusting for the number of hours a week uh when they were in sleep restriction.

SPEAKER_00 49:17

Okay. Is it um was it a large study where there's a lot of participants?

SPEAKER_03 49:23

We had over 90 participants in the study. A wide uh variety of demographics or yeah, we had men and women, all uh racial ethnic groups.

SPEAKER_00 49:35

Great. And and sounds like a more of um a real-world scenario being outside the lab.

SPEAKER_03 49:40

Exactly, exactly.

SPEAKER_00 49:42

Okay, yeah, interesting. And um and so monitored activity and but didn't monitor their food intake, but we could assume that they've uh consumed those who gained weight more than those who didn't. Okay, okay. Great. And um did you monitor their sleep? How how do you monitor how long they were asleep? Did you give them aura rings or no?

SPEAKER_03 50:08

We did uh wrist ectigraphy.

unknown 50:10

Okay.

SPEAKER_03 50:10

So we had the wrist watch, yeah. That uh research grade ectig that we used for that. So accelerometers on the wrist.

SPEAKER_00 50:21

Okay.

SPEAKER_03 50:22

And then you did that for six weeks in both cases, adequate sleep and sleep restrictions. So we knew night by night exactly how much sleep people were getting.

SPEAKER_00 50:32

Were the were you able to see that there's a similar trend within the six weeks based on the individual? I feel like a lot of folks go through seasons of life quickly where it's like, oh, this week I got bad sleep, next week is great sleep, following week, you know, did you how do you kind of map out the entirety of that time frame and make um conclusions?

SPEAKER_03 50:59

So this is uh this is a a research intervention, right? So the intervention was sleep. Okay so when people sign up to participate in the study, they agree to continuing adequate sleep for six weeks, and they agree to having their sleep reduced by an hour and a half for six weeks. So when they came and met with my research assistant, we first of all evaluated their sleep before the study for two weeks to make sure that they actually had adequate sleep. So we didn't want to start restricting sleep and people who were already sleeping too little. So that was the first step, right? Uh and then from the data that we got from this screening period, we told our participants, okay, for the next six weeks, you're going to need to keep adequate sleep. So on average, you go to bed at this time, you wake up at this time based on what we see from screening. Is that something that you can continue to do for six weeks? And then we set the bedtimes, wake times for them to get the adequate sleep. If they were uh going to be in a sleep-restricted situation, we said, okay, well, we would like you now to get one and a half hours less of sleep than what you usually get, but to do that by delaying your bedtimes. Can we set your wake time at this time and then go backwards and shift your bedtime to an hour and a half later so you can have shorter sleep? And then that was how we kind of negotiated in a way the right bedtimes with our study participants for them to get the target sleep durations that we were going for in the study. And we met with them most weekly and we verified their um their sleep data on a weekly basis because we figured maybe, you know, as they get more sleep deprived, they're going to be more efficient, they're going to fall asleep faster. And then what we set out to be an hour and a half sleep restriction is going to be a little less if they're falling asleep faster. And then we readjust the the bedtimes to make to make sure that they continue on this uh reduced sleep schedule.

SPEAKER_00 53:12

Interesting. Yeah, it's fascinating. If it's feels like there's so many other, there's a lot of variables to try to control for, like a lot of there's a lot of confounding variables potentially with like mental. I feel like a lot of folks, it's most it's a lot of emotional and um yeah, mental considerations when it comes to sleep, like they'll, you know, and it's just it seems like it'd be difficult to to study in a way or get folks to um adhere to a program, you know.

SPEAKER_03 53:47

Yeah, yeah. So our participants were very um very compliant actually with the with the study protocol. When you sign up for to do something, I think that people want to to work with you and and do well. Of course, if we're talking about what people actually do unrestrained, not in the context of a stud of a research intervention like ours, you sure sleep will be quite different across days, across weeks. Um, sometimes you go to bed, you know, at this you're you're you have a good stretch where you're going to bed and waking up at the same time every day. And then there's another period of time where you know things are late because it's laid out longer and uh later at night, and you don't go to bed as as early as in the you know in the winter, for example. Uh so there's a lot more variability across across the year within people. But when you're participating in the research like the one we had, you know, you really have to follow a specific protocol. And I think that people were very honest with I mean, we could actually track uh with our wrist technicography, you know, that people were honest with us and and following our instructions.

SPEAKER_00 55:01

Okay, and and so in conclusion in that study, the um one a slight um restriction in sleep, just an hour and a half less sleep um than seven and a half hours, right? Yeah, so it would be about six hours of sleep uh regularly within a six-week time frame had uh significant outcome on weight gain then? Yeah. Okay. Waist circumference, uh weight gain measured by waist circumference, or is that body composition?

SPEAKER_03 55:42

We did so weight on a scale, but also uh weight measured using magnetic resonance imaging. We were also interested in looking at uh body composition, fat mass, lean mass. So, but in both both ways of uh of evaluating mass, we found an incre similar increase in um in weight.

SPEAKER_00 56:02

Okay, yeah, it's terrifying. That's that's all it takes. And then you imagine half a kilo, half a kilo over six weeks, but all it was was through restricting sleep.

SPEAKER_03 56:16

And it was over a six-week period.

SPEAKER_00 56:18

So consists like every night on a six-week period. Yeah, yeah. Okay, and um, yeah, that's I can imagine the downstream negative effects of that.

SPEAKER_03 56:30

Yeah, well, we also published from that study dead on um blood pressure, insulin sensitivity, uh, inflammation, immune factors. Uh so blood pressure was increased, um, insulin resistance was increased, insulin sensitivity was decreased, there's uh higher higher inflammation from uh from sleep restriction, more oxidative stress, reduced anti uh antioxidative, uh antioxidative uh uh responses from sleep restriction.

SPEAKER_00 57:08

Okay, and and we don't know could could you also have these negative effects while consuming the same exact food? Like just from the sleep uh uh variable alone, we've you found these markers, right?

SPEAKER_03 57:24

Or or do we could we somehow in the context of free living situations, so contributions of uh pretty much anything, right? Then we didn't control their diet, so we could have, and we know people tend to choose less healthful diet, so it could be a contribution of uh making more unhealthy food choices.

SPEAKER_00 57:48

Okay. All right. Well, it's uh interesting and a big um a big finding to make sure that we're getting sufficient enough sleep. It's um it's challenging. Do you think it's I know you kind of brought up the numbers and it's not necessarily more prevalent now. I just feel like maybe it's on my radar more, but um it seems like a very big problem. Like we've kind of gotten more into interested in monitoring our sleep with the rings and the watches and the whoops and uh and you name it, and also it just feels as if it's more mainstream, as if we're having conversations like this more frequently. Is it a bigger problem or just more are we just more aware?

SPEAKER_03 58:37

Well, I think it depends on what the time frame is in terms of like the a bigger problem. I mean, obviously it, I think it is a bigger problem than you know, 60 years ago. Uh, is it a bigger problem now than 10 years ago? Um I don't I'm not sure that the the prevalence of short sleep has changed that much in the past 10 years, but it's still not it's still too high, right? And I and I think the more we know about the adverse health effects of insufficient sleep, and when I mean insuff, when I talk about insufficient sleep, I'm not just talking about duration, but also poor quality sleep, sleep disturbances in sleep, irregularity or variability uh in sleep duration. So though those aspects of of sleep are relevant for health. And I think the more we learn about how um insufficient sleep influences health uh and um and well-being, I think it's more and more important to make sure that people get good sleep.

SPEAKER_00 59:43

Yeah, and I've had many conversations on here about different ways one could accomplish that. Seeming it seems like cognitive behavioral therapy is a big component of uh if you're struggling with sleep for mental health reasons, diet, exercise, um, and different habits to help you figure out your personal individualized uh preferences to help get better sleep. But is there anything is there anything that um aside from those factors? I mean, it seems like everything contributes to your sleep. So if one's trying to improve this, like they should probably, if they're continuously struggling for a long stretch of time, it might be time to actually go seek out some help because it's it is having like this major negative effect on the on our health if we don't get sufficient sleep.

SPEAKER_03 1:00:46

Correct. I think it's important to to bring it up with the healthcare provider uh at at uh at various visits. Uh when we um when we published our our scientific statement on uh multidimensional sleep health and risk of cardiovascular disease, we actually made recommendations for clinicians to ask their patients about their sleep and said, just please ask, how's your sleep? That's it. You don't need to you don't need to ask about one specific aspect of sleep, just ask about sleep and let the patient tell you what is relevant to them. Right? Because you might be asking, you know, how many hours of sleep do you get at night? But maybe that's not the problem. Maybe they're getting a sufficient number of hours of sleep, but they're waking up, they're still sleepy. Then that's that can reveal some some underlying problems. So I think that's um that's quite important to have this conversation and to to be able to seek appropriate treatment if uh if sleep disorders are are uncovered.

SPEAKER_00 1:01:48

Great. And do you find the doctors are pretty compliant or receptive?

SPEAKER_02 1:01:54

I hope they are.

SPEAKER_00 1:01:55

I hope nice. Okay. Well, is there anything else that you want to that excites you about your findings with this new study coming? And um anything else in this field that you are excited about or intrigued with on the horizon that you wanna?

SPEAKER_03 1:02:15

Yeah, so for me, it's I I'm I I'm excited by the fact that um we're really showing that there's a psych, there's a cycle of sleep and and diet that's relevant for health. So that you know how you sleep at night influences your food intake, but also how you eat during the day influences your sleep at night. We're showing across multiple studies now that um not getting adequate sleep is a risk factor for multiple chronic disorders. I think now we need to be able to do studies in people who have poor sleep to find ways to get them to sleep better to see how that improves then their health outlook.

SPEAKER_00 1:03:00

Okay. Well, wonderful. I um I learned a lot. I know I I threw a lot of kind of rapid fire type of questions at you today. And uh I appreciate you being a good sport about that, but also going very into depth about your most recent work, which is exciting. And um and if folks want to find you or support support you, do you want me to point them to uh a website or anything? Do you have anything that you want me to um to to point people to if they want to support you?

SPEAKER_03 1:03:33

Yeah, they could uh they could email or they could uh look up our Center of Excellence for Sleep and Socating Research at Columbia University. Can email me directly also.

SPEAKER_00 1:03:43

Wonderful. Well, I learned a lot today, and I uh I appreciate you being so great at communicating in a way that I could understand um about sleep and um diet and and metabolic health. And so I uh I appreciate your time and your your work and I I'd love to chat with you again sometime soon.

SPEAKER_03 1:04:06

That would be great. Thank you.

SPEAKER_00 1:04:08

All right, take care.

SPEAKER_03 1:04:09

You too. Thanks for having me.

SPEAKER_00 1:04:11

Thanks for tuning in. If you found my conversation with the Dr. Marie Pierre Saint-Ange to be helpful, informative, if it got you thinking, please share the podcast with a friend, like, subscribe, and leave a review. You can find me on all social media platforms, especially on Instagram at Yoga With Jake, and on my website, yoga with Jake.com. Until next time, take care of it.