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Obesity (Silver Spring). Author manuscript; available in PMC 2017 January 01. Published in final edited form as: Obesity (Silver Spring). 2016 January ; 24(1): 11. doi:10.1002/oby.21374.
Impact of sleep duration on food intake regulation: Different mechanisms by sex? Marie-Pierre St-Onge, Ph.D, FAHA New York Obesity Research Center, Department of Medicine and Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University
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In this issue of the journal, Broussard and colleagues (1) report findings of elevated ghrelin concentrations after a period of severe sleep restriction in healthy young men. This increase in the food intake-stimulating hormone would explain the greater caloric intake of these men under sleep-restricted conditions relative to their normal sleep duration. Increased food intake, of similar order of magnitude as those reported by Broussard et al., has been observed by others (2, 3) and it is readily accepted that energy intake is increased by approximately 300 kcal/d when sleep is curtailed by 2.5–4 h/night. However, controversy exists with respect to the effects of sleep restriction on regulators of food intake. A recent meta-analysis concluded no effect of sleep restriction on ghrelin, with high heterogeneity among studies (4). Our own interpretation of the findings in this field is similar (5, 6). One source of heterogeneity may be sex. The paucity of studies enrolling sufficient participants of both sexes is striking in sleep research. In fact, most studies enroll men only or too few participants to perform sex-specific analyses. It is further noteworthy that studies enrolling exclusively males, including the report by Broussard et al. (1), report significant effects of sleep restriction on ghrelin concentrations whereas those including women do not. Could it be that sleep restriction affects different food intake regulators in men and women? This is very likely since the end result, increased food intake due to sleep restriction, occurs in both sexes yet ghrelin seems to be elevated only in men.
Author Manuscript
We have proposed the possibility of 2 separate mechanisms, one affecting appetite in men, and one affecting satiety in women, to explain the effects of sleep restriction on food intake. Results by Broussard et al. (1) seem to lend support to our hypothesis: the appetitestimulating hormone ghrelin was increased with sleep restriction whereas the satietypromoting hormone pancreatic polypeptide was largely unchanged. In a similar sleep restriction study conducted by our group, ghrelin was increased in men, whereas glucagonlike peptide 1, a satiety-signaling hormone, was reduced in women as a result of sleep restriction (7). Other factors related to the design of studies assessing the hormonal controls of food intake with sleep restriction may be responsible for between-study differences. One such factor may be the state of energy balance in which participants are maintained during the controlled feeding component of the study (6). Controlled feeding vs ad libitum feeding
Address correspondence to: Marie-Pierre St-Onge, Ph.D, FAHA, 1150 St. Nicholas Avenue, room 121H, New York, NY 10032, Ph 212-851-5578, Fax 212-851-5579, [email protected].
St-Onge
Page 2
Author Manuscript
conditions is another probable explanatory factor. However, the potential sex difference hypothesis needs further exploration and future studies should enroll adequate numbers of both men and women to perform sex-specific analyses. Excluding women from sleep restriction studies is not justified. Further, additional information on other regulators of food intake, such as pancreatic polypeptide and glucagon-like peptide 1, but also cholecystokinin, peptide YY, and glucose-dependent insulinotropic polypeptide, to name a few, is needed. Maybe then can we have more definitive answers on the hormonal mechanisms underlying the increase in food intake resulting from sleep restriction.
Acknowledgments This paper is funded in part by the National Institutes of Health grants R56 HL119945 and P30 DK26687.
Author Manuscript
References
Author Manuscript
1. Broussard JL, Kilkus JM, Delebecque F, Abraham V, Day A, Whitmore HR, et al. Elevated ghrelin predicts food intake during experimental sleep restriction. Obesity. 2016 2. Nedeltcheva AV, Kilkus JM, Imperial J, Kasza K, Schoeller DA, Penev PD. Sleep curtailment is accompanied by increased intake of calories from snacks. The American journal of clinical nutrition. 2009 Jan; 89(1):126–33. [PubMed: 19056602] 3. St-Onge MP, Roberts AL, Chen J, Kelleman M, O’Keeffe M, RoyChoudhury A, et al. Short sleep duration increases energy intakes but does not change energy expenditure in normal-weight individuals. The American journal of clinical nutrition. 2011 Aug; 94(2):410–6. [PubMed: 21715510] 4. Capers PL, Fobian AD, Kaiser KA, Borah R, Allison DB. A systemic review and meta-analysis of randomized controlled trials of the impact of sleep duration on adiposity and components of energy balance. Obesity reviews: an official journal of the International Association for the Study of Obesity. 2015 Sep; 16(9):771–82. [PubMed: 26098388] 5. Chaput JP, St-Onge MP. Increased food intake by insufficient sleep in humans: are we jumping the gun on the hormonal explanation? Frontiers in endocrinology. 2014; 5:116. [PubMed: 25076940] 6. St-Onge MP. The role of sleep duration in the regulation of energy balance: effects on energy intakes and expenditure. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 2013 Jan 15; 9(1):73–80. [PubMed: 23319909] 7. St-Onge MP, O’Keeffe M, Roberts AL, RoyChoudhury A, Laferrere B. Short sleep duration, glucose dysregulation and hormonal regulation of appetite in men and women. Sleep. 2012 Nov; 35(11):1503–10. [PubMed: 23115399]
Author Manuscript Obesity (Silver Spring). Author manuscript; available in PMC 2017 January 01.
Obesity (Silver Spring). Author manuscript; available in PMC 2017 January 01. Published in final edited form as: Obesity (Silver Spring). 2016 January ; 24(1): 11. doi:10.1002/oby.21374.
Impact of sleep duration on food intake regulation: Different mechanisms by sex? Marie-Pierre St-Onge, Ph.D, FAHA New York Obesity Research Center, Department of Medicine and Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University
Author Manuscript Author Manuscript
In this issue of the journal, Broussard and colleagues (1) report findings of elevated ghrelin concentrations after a period of severe sleep restriction in healthy young men. This increase in the food intake-stimulating hormone would explain the greater caloric intake of these men under sleep-restricted conditions relative to their normal sleep duration. Increased food intake, of similar order of magnitude as those reported by Broussard et al., has been observed by others (2, 3) and it is readily accepted that energy intake is increased by approximately 300 kcal/d when sleep is curtailed by 2.5–4 h/night. However, controversy exists with respect to the effects of sleep restriction on regulators of food intake. A recent meta-analysis concluded no effect of sleep restriction on ghrelin, with high heterogeneity among studies (4). Our own interpretation of the findings in this field is similar (5, 6). One source of heterogeneity may be sex. The paucity of studies enrolling sufficient participants of both sexes is striking in sleep research. In fact, most studies enroll men only or too few participants to perform sex-specific analyses. It is further noteworthy that studies enrolling exclusively males, including the report by Broussard et al. (1), report significant effects of sleep restriction on ghrelin concentrations whereas those including women do not. Could it be that sleep restriction affects different food intake regulators in men and women? This is very likely since the end result, increased food intake due to sleep restriction, occurs in both sexes yet ghrelin seems to be elevated only in men.
Author Manuscript
We have proposed the possibility of 2 separate mechanisms, one affecting appetite in men, and one affecting satiety in women, to explain the effects of sleep restriction on food intake. Results by Broussard et al. (1) seem to lend support to our hypothesis: the appetitestimulating hormone ghrelin was increased with sleep restriction whereas the satietypromoting hormone pancreatic polypeptide was largely unchanged. In a similar sleep restriction study conducted by our group, ghrelin was increased in men, whereas glucagonlike peptide 1, a satiety-signaling hormone, was reduced in women as a result of sleep restriction (7). Other factors related to the design of studies assessing the hormonal controls of food intake with sleep restriction may be responsible for between-study differences. One such factor may be the state of energy balance in which participants are maintained during the controlled feeding component of the study (6). Controlled feeding vs ad libitum feeding
Address correspondence to: Marie-Pierre St-Onge, Ph.D, FAHA, 1150 St. Nicholas Avenue, room 121H, New York, NY 10032, Ph 212-851-5578, Fax 212-851-5579, [email protected].
St-Onge
Page 2
Author Manuscript
conditions is another probable explanatory factor. However, the potential sex difference hypothesis needs further exploration and future studies should enroll adequate numbers of both men and women to perform sex-specific analyses. Excluding women from sleep restriction studies is not justified. Further, additional information on other regulators of food intake, such as pancreatic polypeptide and glucagon-like peptide 1, but also cholecystokinin, peptide YY, and glucose-dependent insulinotropic polypeptide, to name a few, is needed. Maybe then can we have more definitive answers on the hormonal mechanisms underlying the increase in food intake resulting from sleep restriction.
Acknowledgments This paper is funded in part by the National Institutes of Health grants R56 HL119945 and P30 DK26687.
Author Manuscript
References
Author Manuscript
1. Broussard JL, Kilkus JM, Delebecque F, Abraham V, Day A, Whitmore HR, et al. Elevated ghrelin predicts food intake during experimental sleep restriction. Obesity. 2016 2. Nedeltcheva AV, Kilkus JM, Imperial J, Kasza K, Schoeller DA, Penev PD. Sleep curtailment is accompanied by increased intake of calories from snacks. The American journal of clinical nutrition. 2009 Jan; 89(1):126–33. [PubMed: 19056602] 3. St-Onge MP, Roberts AL, Chen J, Kelleman M, O’Keeffe M, RoyChoudhury A, et al. Short sleep duration increases energy intakes but does not change energy expenditure in normal-weight individuals. The American journal of clinical nutrition. 2011 Aug; 94(2):410–6. [PubMed: 21715510] 4. Capers PL, Fobian AD, Kaiser KA, Borah R, Allison DB. A systemic review and meta-analysis of randomized controlled trials of the impact of sleep duration on adiposity and components of energy balance. Obesity reviews: an official journal of the International Association for the Study of Obesity. 2015 Sep; 16(9):771–82. [PubMed: 26098388] 5. Chaput JP, St-Onge MP. Increased food intake by insufficient sleep in humans: are we jumping the gun on the hormonal explanation? Frontiers in endocrinology. 2014; 5:116. [PubMed: 25076940] 6. St-Onge MP. The role of sleep duration in the regulation of energy balance: effects on energy intakes and expenditure. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 2013 Jan 15; 9(1):73–80. [PubMed: 23319909] 7. St-Onge MP, O’Keeffe M, Roberts AL, RoyChoudhury A, Laferrere B. Short sleep duration, glucose dysregulation and hormonal regulation of appetite in men and women. Sleep. 2012 Nov; 35(11):1503–10. [PubMed: 23115399]
Author Manuscript Obesity (Silver Spring). Author manuscript; available in PMC 2017 January 01.
