Eating for Healthy Sleep

Submitted by Laura Chartrand

Edited by Marcia Bristow MS RDN CSSD CD

Good news for bedtime snackers! Forget what you have heard about disrupting sleep and gaining weight by eating before bedtime.  Studies show that people who go to bed hungry have a harder time falling asleep and may wake during the night.  Weight gain appeared to occur only among people who eat most of their calories in the evening or at night.  So, what does this mean? Eating before bed does not have to cause weight gain and can even improve sleep quality if done mindfully.

Eating certain foods before bed may induce a restful night of sleep. The key is to focus on what and how much you are eating.  Instead of indulging late at night with high calorie foods, it is better to reach for a healthy snack of roughly 200 calories shortly before bed.  This will be enough to keep hunger at bay through the night and is unlikely to disrupt sleep or cause weight gain.

Foods that may help to make you sleepy are rich in protein or in complex carbohydrates; both of which take longer to digest.  They may also contain components like tryptophan and nutrients such as potassium or magnesium, all of which help to promote sleep and relaxation.

Try these pre-bedtime snack ideas (each contains approximately 200 calories):

• 1 cup of low-fat yogurt with 1 tsp honey or ½ sliced banana
• 1 cup of whole wheat cereal with ¾ cup low-fat milk
• ½ of a Turkey sandwich (1 slice whole grain bread, 2 oz low-sodium turkey breast, 1 tbs mustard, ¼ cup spinach)
• About 20 mixed nuts (cashews, pistachio, almonds) 

Foods that may interfere with sleep tend to be high in fat or calories; or, they may contain stimulants. Examples of foods to avoid include items like burgers or french fries; foods or drinks that contain caffeine like chocolate or coffee; and alcoholic beverages such as wine, beer, or mixed drinks. Be wary of hidden sources of caffeine such as soda or energy drinks!

Hungry before bed? Grab a sleep inducing snack and remember to keep it around 200 calories.  Sweet dreams!

References:

1. Baron KG, Reid KJ, Kern AS, Zee PC. Role of sleep timing in caloric intake and BMI. Obesity. 2011;19(7):1374-1381.
2. Bertéus Forslund H, Lindroos AK, Sjöström L, Lissner L. Meal patterns and obesity in Swedish women – a simple instrument describing usual meal types, frequency and temporal distribution. Eur J Clin Nutr. 2002;56:740-747.
3. The University of Maryland Medical Center. (2016, February 4). Insomnia. Retreived from http://umm.edu/health/medical/altmed/condition/insomnia
4. Afaghi, A., O’Connor, H., Chow, C.M. 2007. Am J Clin Nutr. High-glycemic-index carbohydrate meals shorten sleep onset. 85:426-30.

Apple Cider Vinegar for your Health?

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Vinegar was first described as a weight-loss aid over two hundred years ago.¹ Nowadays, many claim that vinegar, and specifically apple cider vinegar, can help you shed pounds, reduce cholesterol, manage blood sugar, and more.  Vinegar is made when the sugar in fruit juice, fruits, or grains is fermented into acetic acid; in apple cider vinegar, the sugar comes from apple cider.² Vinegar’s supposed health benefits come from the fact that it is fermented into acetic acid.  Studies suggest, however, that vinegar’s impact on health is not as significant as some sources would like you to believe.

Few scientific studies have been done in humans to see if apple cider vinegar truly leads to weight loss.  One widely cited experiment found that obese people who took apple cider vinegar every day did lose weight; however, this study is not reliable because it didn’t include many subjects and was carried out by a company that actually produces vinegar.^3,4 More unbiased studies with human subjects will be needed to say for sure whether apple cider vinegar has any influence on weight loss.

Sources also claim that apple cider vinegar can help lower cholesterol levels.  As with weight loss, more research in humans is needed to say whether this is actually true.  Right now, scientific studies on this topic have mixed results, and a lot of the research showing that apple cider vinegar does impact cholesterol levels has been done in mice and rats, not humans.⁵ One study that included humans asked people to take 30 milliliters (about 2 tablespoons) of apple cider vinegar every day.  After four months, there were no significant changes in their cholesterol or triglyceride levels.⁶

One area where apple cider vinegar has shown some promise is in the reduction of blood glucose levels.  A review of eleven scientific studies found that the average blood glucose and insulin levels after eating were lower when the subjects had taken vinegar before eating.  Subjects who used apple cider vinegar consumed about 4 teaspoons of vinegar before meals, and subjects who used white vinegar consumed between 2 and 6 teaspoons.⁷ Researchers aren’t exactly sure why this might happen.  One possible explanation is that vinegar causes your stomach to empty more slowly, so you won’t digest and absorb sugar as quickly.^6,7 This makes sense because vinegar is very acidic, and when your stomach contents are more acidic the sphincter between your stomach and intestines opens less often.  It’s important to note that vinegar’s impact on blood glucose is unpredictable, and therefore it would not be a good idea to try to use vinegar as a way to manage your blood sugar if you have diabetes or to combine vinegar with glucose-lowering medications.

Large doses of apple cider vinegar can make you lose potassium in your urine, so taking it with diuretics can cause your blood potassium levels to become dangerously low.  Taking undiluted apple cider vinegar can also irritate your throat because of its acidity.¹ Instead, use apple cider vinegar in a salad dressing or marinade to add flavor to your foods without adding a lot of calories.  If your goal is to lose weight, reduce cholesterol, or manage diabetes, talk to a Registered Dietitian who can give you an appropriate meal plan.  In all cases, eating within your calorie needs, reducing your intake of foods high in fat and added sugar, and choosing a variety of fruits, vegetables, whole grains, and lean protein is a great way to start!

References:

1.         Kohn JB. Is Vinegar an Effective Treatment for Glycemic Control or Weight Loss? J Acad Nutr Diet. 2015;115(7):1188. doi:10.1016/j.jand.2015.05.010.

2.         Ho CW, Lazim AM, Fazry S, Zaki UKHH, Lim SJ. Varieties, production, composition and health benefits of vinegars: A review. Food Chem. 2017;221:1621-1630. doi:10.1016/j.foodchem.2016.10.128.

3.         KONDO T, KISHI M, FUSHIMI T, UGAJIN S, KAGA T. Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects. Biosci Biotechnol Biochem. 2009;73(8):1837-1843. doi:10.1271/bbb.90231.

4.         Younkin L. Is Apple Cider Vinegar Good for Weight Loss? EatingWell. http://www.eatingwell.com/weight-loss/foods/faq/apple-cider-vinegar/is_apple_cider_vinegar_good_for_weight_loss. Published March 2016. Accessed April 25, 2017.

5.         Samad A, Azlan A, Ismail A. Therapeutic effects of vinegar: a review. Curr Opin Food Sci. 2016;8:56-61. doi:10.1016/j.cofs.2016.03.001.

6.         Panetta CJ, Menk JS, Jonk YC, Brown AJ, Powers MA, Shapiro AC. Prospective Randomized Clinical Trial Evaluating the Impact of Vinegar on High Density Lipoprotein. J Am Diet Assoc. 2010;110(9):A87. doi:10.1016/j.jada.2010.06.321.

7.         Shishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017;127:1-9. doi:10.1016/j.diabres.2017.01.021.

Image source: http://www.prevention.com/eatclean/apple-cider-vinegar-facts

Sweet Without Sugar?

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Have you ever had a craving for something sweet but didn’t want the calories from a sugary snack?  Some people manage this by eating foods made with artificial sweeteners.  Artificial sweeteners are ingredients that provide sweetness without adding calories.  Right now, there are five FDA-approved artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose.¹ They’re usually found in diet soda and sugar-free versions of candy, ice cream, sports drinks, fruit spreads, and juice.²

You might choose a food made with artificial sweeteners to keep your overall calorie intake lower as part of a goal to lose or maintain weight.  Unfortunately, studies have shown that using artificial sweeteners might not really help with weight loss, and could also raise your risk for Type 2 Diabetes and heart disease.^2–4 Eating artificial sweeteners makes it more difficult to regulate the amount of sugar-sweetened foods you eat later because your brain no longer realizes that sugar-sweetened foods actually contain calories.³ It also looks like artificial sweeteners don’t satisfy the “reward center” of your brain the same way regular sugar does, so you’ll still crave sweets after eating an artificial sweetener and may be more likely to overeat and gain weight as a result.² Other studies also suggest that artificial sweeteners change your microbiome, or the bacteria that live inside your intestines.  This change might contribute to Type 2 Diabetes and weight gain.³

Some people react to the controversy around artificial sweeteners by looking to a more natural, calorie-free alternative sweetener: stevia.  Although it seems like stevia first showed up only a few years ago, people have been using it as a sweetener for hundreds of years.⁵ The stevia found in food products is actually the compound Rebaudioside A (Reb A), a highly purified extract from the plant Stevia rebaudiana.  Reb A is the only part of the stevia plant that has been generally recognized as safe by the Food and Drug Administration (FDA).  Stevia leaves, crude stevia extracts, and whole leaf stevia have not been given FDA approval, and can therefore only be sold as supplements.^6,7

Although in the past stevia was thought to be connected with fertility problems and birth defects, in 2008 the FDA determined that Reb A is safe after reviewing studies submitted by the companies that produce stevia. While the FDA reviewed these studies and decided that they show Reb A’s safety, it’s difficult to solely rely upon studies that were conducted by the company that makes a product; research without bias holds more credibility.  When a company who can profit from a product funds a study about the safety of that product, the study may be influenced by research or funding bias in which the results are either consciously or unconsciously influenced to show the product in a more favorable light.^8,9

For this reason, when Reb A received FDA approval in 2008 it was important for companies without ties to stevia production to conduct more studies to truly prove stevia’s safety.⁶ Since then, not many studies have been performed in humans and few of them are long-term.  However, some independent studies suggest that eating Reb A does not result in any significant toxicity.  A systematic review by Massachusetts General Hospital found that stevia should be evaluated farther for potential positive impacts on blood cholesterol levels and insulin sensitivity.¹⁰ Other studies suggest that stevia doesn’t lead to the same sugar cravings that other artificial sweeteners are known to cause.^11–13 Since stevia has only been FDA-approved for 9 years, more research is needed to learn about stevia’s long-term health impacts.

The amount of artificial sweeteners and stevia that the FDA considers safe to eat in one day varies depending on your body weight and the type of sweetener.¹⁴ For example, the FDA recommends eating no more than 4 milligrams of stevia per kilogram of your body weight per day, but states that it’s acceptable to eat up to 50 milligrams of aspartame per kilogram of your body weight per day.¹⁵ Since more research is needed to learn about their long-term health impacts, it is best to use them all in moderation.  Limit the amount of artificial sweeteners and stevia you use by choosing unprocessed foods, drinking water or milk instead of diet soda or juice, and satisfying your cravings for sweet foods with fruit instead of candy, desserts, or baked goods.

References:

1.         Strawbridge H. Artificial sweeteners: sugar-free, but at what cost? Harvard Health Blog. http://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030. Published July 16, 2012. Accessed March 15, 2017.

2.         Harvard T.H Chan School of Public Health. Artificial Sweeteners. The Nutrition Source. https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/artificial-sweeteners/. Published September 4, 2013. Accessed March 15, 2017.

3.         Swithers SE. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends Endocrinol Metab. 2013;24(9):431-441. doi:10.1016/j.tem.2013.05.005.

4.         Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016;164, Part B:488-493. doi:10.1016/j.physbeh.2016.04.029.

5.         Stevia: It’s Not Just About Calories. ResearchGate. https://www.researchgate.net/publication/228831065_Stevia_It’s_Not_Just_About_Calories. Accessed March 21, 2017.

6.         Is Stevia Safe? - EatingWell. http://www.eatingwell.com/nutrition_health/nutrition_news_information/is_stevia_safe. Accessed March 22, 2017.

7.         Nutrition C for FS and A. FDA Basics - What refined Stevia preparations have been evaluated by FDA to be used as a sweetener? https://www.fda.gov/AboutFDA/Transparency/Basics/ucm214865.htm. Accessed March 22, 2017.

8.         Six industry-funded studies. The score for the year: 156/12. Food Polit Marion Nestle. March 2016. http://www.foodpolitics.com/2016/03/six-industry-funded-studies-the-score-for-the-year-15612/. Accessed April 22, 2017.

9.         Who pays for science? http://undsci.berkeley.edu/article/who_pays. Accessed April 22, 2017.

10.       Ulbricht C, Isaac R, Milkin T, et al. An evidence-based systematic review of stevia by the Natural Standard Research Collaboration. Cardiovasc Hematol Agents Med Chem. 2010;8(2):113-127.

11.       Anton SD, Martin CK, Han H, et al. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite. 2010;55(1):37-43. doi:10.1016/j.appet.2010.03.009.

12.       Abo Elnaga NIE, Massoud MI, Yousef MI, Mohamed HHA. Effect of stevia sweetener consumption as non-caloric sweetening on body weight gain and biochemical’s parameters in overweight female rats. Ann Agric Sci. 2016;61(1):155-163. doi:10.1016/j.aoas.2015.11.008.

13.       Shivanna N, Naika M, Khanum F, Kaul VK. Antioxidant, anti-diabetic and renal protective properties of Stevia rebaudiana. J Diabetes Complications. 2013;27(2):103-113. doi:10.1016/j.jdiacomp.2012.10.001.

14.       Artificial Sweetener Labeling Initiative. The Sugar Association. https://www.sugar.org/nutritional-advocacy/artificial-sweetener-labeling-initiative/. Accessed March 15, 2017.

15.       Nutrition C for FS and A. Food Additives & Ingredients - Additional Information about High-Intensity Sweeteners Permitted for use in Food in the United States. https://www.fda.gov/food/ingredientspackaginglabeling/foodadditivesingredients/ucm397725.htm#Steviol_glycosides. Accessed April 22, 2017.