An important thing that can help you stick to your physical activity and dietary goals.

Preliminary research presented today suggests that individuals who consistently experience uninterrupted sleep tend to adhere better to their weight loss diet and exercise regimens.

Preliminary research presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle, and Cardiometabolic Health Scientific Sessions 2023 found that people who said they got regular, uninterrupted sleep did a better job of sticking to their exercise and diet plans while trying to lose weight.

Christopher E. Kline, Ph.D., an associate professor in the department of health and human development at the University of Pittsburgh, said that focusing on achieving good quality sleep for seven to nine hours per night and waking up refreshed and alert could be a critical habit that helps individuals maintain their physical activity and dietary modification goals. 

The expert added that a previous study conducted by his team found a positive correlation between better sleep quality and a greater loss of body weight and fat among participants enrolled in a year-long behavioral weight loss program.

The purpose of this study was to determine whether a person’s ability to stick to the numerous lifestyle changes recommended in a 12-month weight reduction program was correlated with their quality of sleep.

125 persons (average age 50, 91% female, 81% white) without any medical issues needing medical monitoring of their diet or physical activity were enrolled in the weight-loss program.

Using patient questionnaires, a sleep journal, and seven-day readings from a wrist-worn device that recorded sleep, waking activity, and rest, sleep patterns were assessed at the start of the program, at 6 months, and at 12 months.

Each participant was given a “good” or “poor” rating based on their results in six categories of sleep quality: consistency, contentment, alertness, timing, efficiency (the proportion of time in bed spent sleeping), and length.

Each participant received a composite sleep health score ranging from 0 to 6, with one point awarded for each “good” indicator of sleep health. Higher scores denoted greater levels of sleep health.

Weight loss program adherence was assessed by tracking how many group intervention sessions each participant attended, how many days each participant consumed 85–115% of their daily calorie recommendation, and how much time each participant spent engaging in moderate or vigorous physical activity each day.

At the beginning of the research, six months into it, and a year afterwards, participants’ average sleep health score was 4.5 out of 6. At the beginning of the trial, at 6 months, and at 12 months, participants self-reported their daily calorie consumption using a smartphone app, and researchers monitored their physical activity using a waist-worn accelerometer for one week at a time.

The researchers discovered that better sleep health was linked to higher rates of attendance at group interval sessions, adherence to caloric intake goals, and improvement in time spent engaging in moderate-vigorous physical activity after adjusting the sleep health scores for age, gender, race, and whether or not a partner shared the bed.

They discovered:

• In the first six months, participants attended 79% of group meetings, whereas in the second six months, 62% of participants attended group sessions.
• In the first six months and the second six months, participants reached their daily calorie intake targets on 36% and 21% of days, respectively.
• In the first six months, participants’ total daily time engaged in moderate-vigorous exercise rose by 8.7 minutes; but, in the following six months, participants’ total time fell by 3.7 minutes.

According to Kline, the second six-month period saw a decline in group session attendance, calorie intake, and time spent engaging in moderate-vigorous exercise. It’s natural for the adherence to weight reduction activities to diminish as one continues in a long-term behavioral weight loss strategy.

There was also a link between higher sleep health ratings and more exercise, but it wasn’t strong enough to be statistically significant, so researchers can’t be sure it wasn’t just a coincidence.

“We had hypothesized that sleep would be associated with lifestyle modification; however, we didn’t expect to see an association between sleep health and all three of our measures of lifestyle modification,” he points out. “Although we did not intervene on sleep health in this study, these results suggest that optimizing sleep may lead to better lifestyle modification adherence.”

The sample was not selected based on participants’ sleep health characteristics, and the total sample population had pretty excellent sleep health at baseline, which are both limitations of this research. Since the sample was predominantly composed of white and female individuals, it is difficult to determine whether or not these findings are applicable to communities that are more demographically diverse.

Christopher E. Kline raised some interesting questions for future research. Firstly, he wonders whether improving a person’s sleep health could increase adherence to lifestyle modifications, ultimately leading to greater weight loss. Secondly, the researchers would need to investigate the timing of such an intervention to optimize sleep health.

He acknowledges that it is uncertain whether it is preferable to optimize sleep before or during weight loss attempts. He wonders whether clinicians should advise their patients to prioritize obtaining better and more consistent sleep before embarking on a weight loss program or if they should focus on improving sleep quality while simultaneously modifying their diet and activity levels.

Michael A. Grandner, a co-author from the University of Arizona, noted that there are more than 100 studies linking sleep to weight gain and obesity. This study, however, was a remarkable example of how sleep quality is not only connected to weight itself, but also to the behaviors people adopt to manage their weight.

Grandner suggested that this could be because sleep affects various factors that drive hunger and cravings, metabolism, and the ability to make healthy choices.

He added that studies like this demonstrate the interconnectedness of these factors and how improving sleep quality could potentially lead to other avenues of better health.

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