Eating for Better Sleep & Foods that Improve Metabolic Health | Dr. Marie-Pierre St-Onge
In a Nutshell
Sleep restriction increases calorie intake by ~250-400/day via sex-specific hormonal changes (higher ghrelin in men, lower GLP-1 in women) while only raising energy expenditure by ~90 calories, creating net weight gain and insulin resistance. Diet quality directly affects sleep: higher fiber improves deep sleep, while saturated fat and refined carbs reduce it and increase arousals. Eating earlier in the day, aligning with Mediterranean/DASH patterns, and avoiding late large meals optimize both fat oxidation and sleep architecture.
These notes were generated by AI and may contain inaccuracies.
Higher fiber intake was associated with more deep sleep. Higher saturated fat intake was linked to less deep sleep. Greater consumption of refined carbohydrates and simple sugars led to more arousals and reduced deep slow-wave sleep and REM sleep.
Andrew Huberman introduces Dr. Marie-Pierre St-Onge, professor of nutritional medicine at the Institute of Human Nutrition at Columbia University School of Medicine. Her research uniquely examines the bidirectional relationship between sleep and food intake.
Key topics include how modest sleep deprivation increases hunger differently in men and women, the role of sleep in regulating blood sugar, cortisol levels, metabolism, and cardio-metabolic health, and how specific nutrients affect overall health beyond sleep.
Dr. St-Onge explains that sleep affects both what and how much people eat, and food choices affect sleep quality. Population studies show people who sleep too little have higher BMI than those with adequate sleep. The Nurses' Health Study tracked nurses over 14-15 years and found those sleeping 5-6 hours had much higher rates of weight gain compared to those sleeping 7-8 hours.
Dr. St-Onge's first NIH-funded study used a crossover design with participants receiving either 9-hour or 4-hour time in bed for five nights. For the first three days, participants ate identical controlled meals. Appetite-regulating hormones were measured along with neuroimaging of brain responses to food stimuli.
On the final day, participants self-selected food intake. Men showed increased ghrelin (hunger hormone) with sleep restriction. Women showed reduced GLP-1 (satiety hormone). Both groups ate approximately 300 more calories when sleep-restricted compared to adequate sleep conditions.
Neuronal imaging showed upregulation of reward centers in the brain during sleep restriction compared to adequate sleep. Prior studies showing increased ghrelin and reduced leptin with sleep restriction were conducted only in men. When data from men and women were combined in Dr. St-Onge's study, no overall effect appeared on ghrelin because the effect was male-specific.
A metabolic chamber study with women measured oxygen consumption and carbon dioxide production minute-by-minute. Energy expenditure increased approximately 5% (about 90 calories) during sleep restriction because remaining awake is more energetically costly than sleeping. However, this increase did not offset the 300-calorie increase in food intake observed in prior studies.
A follow-up study examined milder sleep restriction of 1.5 hours less than normal (reducing from ~7.5 to 6 hours) sustained for 6 weeks in free-living conditions. Good sleepers verified by actigraphy were assigned to either maintain their sleep or reduce it.
Results showed increased insulin resistance, reduced insulin sensitivity (worse in post-menopausal women compared to pre-menopausal women), and increased blood pressure after 6 weeks of mild sustained sleep restriction.
In the initial 5-night severe sleep restriction study (4 hours per night), cortisol levels showed no difference between adequate and restricted sleep conditions. Glucose and insulin curves were superimposable when participants consumed identical food at identical times and quantities.
Dr. St-Onge suggests the lack of metabolic disruption in the lab setting may reflect the controlled environment where participants faced no external stressors of daily life. The combination of sleep restriction with real-world demands of work, childcare, and daily activities may be necessary to trigger the cardio-metabolic abnormalities observed in population studies.
The 90-calorie increase in energy expenditure during sleep restriction was substantially smaller than the 300-calorie increase in food intake, creating a net positive energy balance. Spontaneous physical activity decreased during sleep restriction, contributing to lower overall energy expenditure in daily life.
Meta-analyses show sleep restriction leads to 250-400 calories of overeating per day. A 2022 study by Neymar Kovven found participants gained 0.5 kg over two weeks when restricted to 5 hours of sleep per night compared to 7.5 hours.
When sleep deprived, GLP-1 levels decrease in women, reducing satiety signals. In men, ghrelin levels rise, increasing hunger. Understanding these hormonal shifts empowers individuals to make conscious choices about eating when tired rather than automatically responding to increased appetite signals.
When considering whether to eat dessert or extra food, people can pause and ask themselves if the desire stems from genuine hunger or from fatigue due to poor sleep the previous night. This awareness allows individuals to either skip unnecessary calories or consciously choose to eat for comfort, recognizing the choice as intentional rather than automatic.
The relationship between food intake and sleep operates bidirectionally. While sleep deprivation affects eating behavior, dietary choices also influence sleep quality and duration. Population studies initially focused on sleep as the driver of dietary changes, but the reverse relationship is equally plausible and important to examine.
Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), researchers paired with Susan Redline to examine how diet quality affects sleep duration and insomnia symptoms. A diet more closely aligned with the Mediterranean diet was associated with better probability of adequate sleep and reduced insomnia symptoms.
In a longitudinal analysis from the Women's Health Initiative, researchers avoided the typical approach of excluding participants with insomnia at baseline. Instead, they categorized women into groups: those with no insomnia at baseline who developed it at three-year follow-up, those whose insomnia resolved, and those with persistent insomnia. Women whose diets aligned more closely with Mediterranean or DASH dietary patterns were less likely to have insomnia at three years.
The DASH (Dietary Approaches to Stop Hypertension) diet was developed to reduce blood pressure through increased intake of fruits, vegetables, nuts, seeds, and low-fat dairy products with a more plant-based profile. The DASH diet improved outcomes regardless of salt content, outperforming typical American diets higher in saturated fat and sugars.
Estimates suggest anywhere from one in seven Americans have tried GLP-1 medications. These medications reduce appetite, and snack food companies are reportedly struggling with decreased sales, though alcohol companies face different market dynamics.
In population-based studies, researchers adjust for covariates including race, occupation, socioeconomic status, existing illnesses, depression, and physical activity levels. However, factors like social interactions are typically not well captured or adjusted for in these analyses.
In a controlled inpatient study with nine-hour time-in-bed opportunity, participants first received a controlled diet then self-selected their food. When eating the self-selected diet, participants consumed nearly 450 more calories and 33% more saturated fat with slightly less protein and marginally more carbohydrates.
Sleep duration did not differ between controlled and self-selected diet conditions. However, when participants self-selected their diet, time to fall asleep increased by over 70% and slow-wave sleep decreased by approximately 20-23% compared to the controlled feeding condition.
Higher fiber intake was associated with more deep sleep. Higher saturated fat intake correlated with less deep sleep. Greater consumption of refined carbohydrates and simple sugars was linked to increased arousals during sleep, defined as transitions from deeper to lighter sleep stages without full awakening.
The researcher personally prefers to finish the last meal at least three hours before bedtime. Eating earlier supports cardiometabolic health overall. Eating too close to bedtime causes increased body temperature, which interferes with the cooling process necessary for sleep onset.
Going to bed significantly later than usual disrupts alignment with personal circadian rhythms, making quality sleep more difficult. Shift workers experience this misalignment chronically, attempting to sleep during daytime hours when melatonin should be low rather than elevated, compounded by environmental factors like light and noise.
Naps should not occur too close to bedtime to avoid dissipating sleep pressure needed for nighttime sleep. If napping is necessary, recommendations include keeping naps short at 30 minutes to no more than one hour, scheduled early enough in the day to allow sleep pressure to rebuild. Persistent need for naps despite adequate sleep opportunity warrants investigation into nighttime sleep quality issues.
A recent paper in Nature examined biological clocks and aging across different organs. The optimal range for aging was 6.5 to 7.5-8 hours of sleep. Sleep duration below this range showed U-shaped curves indicating negative effects, with some variation by sex and specific organs. Women generally showed slightly longer optimal durations for certain organs.
Women tend to sleep slightly longer than men across the lifespan but report poorer sleep quality. More women than men report insomnia symptoms, including difficulty falling asleep and maintaining sleep. Women show greater sensitivity to poor sleep effects on metabolic outcomes, with blood pressure elevations occurring at lower sleep apnea thresholds compared to men.
A scientific statement from the American Heart Association on multi-dimensional sleep health recommends clinicians ask patients an open-ended question about their sleep rather than focusing solely on sleep duration. Sleep health encompasses regularity, quality, satisfaction, nighttime experiences, and daytime alertness and vigilance following sleep.
Snoring often leads to sleep apnea testing when a partner notices loud snoring. Apnea always involves some form of breathing interruption followed by a gasping or arousal sound. Many people discover they have apnea only after using sleep monitoring devices or apps that record snoring during sleep.
Nose strips can reduce snoring by opening the nostrils, but they do not address the throat closure that causes obstructive sleep apnea. Weight loss is typically the first-line treatment for individuals with excess weight. CPAP therapy is effective though many find it uncomfortable; lower body weight may allow for lower pressure settings that improve comfort.
People who snore, wake unrefreshed, or feel sleepy during the day should speak with their doctor. Polysomnography conducted in a lab is the gold-standard test, but at-home sleep testing is also available and can be prescribed easily. CPAP machines cannot be purchased directly on Amazon because the required pressure settings must be professionally determined.
CPAP devices are not inexpensive. When used correctly they improve daytime wakefulness, cognitive function, longevity, and metabolic health, creating positive reinforcement for continued use.
Kefir was studied as a fermented dairy product for its potential effect on cholesterol synthesis via short-chain fatty acids. In a study conducted at McGill, men with mildly elevated cholesterol consumed two cups (500 ml) daily for one month versus regular milk. The study measured cholesterol production at baseline and endpoint and found no effect.
Fermented foods such as sauerkraut, kimchi, and full-fat Bulgarian yogurt are generally supported for gut microbiome health. While the kefir study focused narrowly on cholesterol, other outcomes such as glycemic control or gut inflammation were not measured.
Functional foods provide health benefits beyond basic nutrition. Structure-function claims (for example, dairy calcium supporting bone health) differ from approved health claims (for example, oat fiber reducing cholesterol). Research on medium-chain triglycerides formed part of doctoral work exploring functional ingredients.
Industry-sponsored research tested coffee mannooligosaccharides extracted from spent coffee grounds. Participants received sachets containing either the active compound or placebo. The study measured body composition and found a statistically significant effect on adipose tissue loss in men but not in women. The product was not marketed further because of the sex-specific result.
The compound is not available commercially, and brewing coffee does not deliver meaningful amounts of it.
Ginger was selected for study after McCormick offered spices for research. A crossover trial compared ginger powder dissolved in warm water versus plain hot water. The thermic effect of food was measured over six hours using a metabolic hood that quantified oxygen consumption and carbon dioxide production. Ginger significantly increased the thermic effect of food, likely via the capsaicin receptor.
Small dietary additions that raise energy expenditure relative to intake can help offset the gradual weight gain many adults experience over decades.
Low-sugar fermented foods have been shown to reduce inflammatory markers more consistently than increased fiber intake. In crossover research, some individuals experienced large increases in inflammation when fiber intake rose, whereas the fermented-food condition produced average reductions. Different types of fiber may produce different responses, and gradual habituation from low baseline intakes (for example, 6 g to 25 g) is important.
Histamine-containing foods can cause symptoms such as sleepiness or gut discomfort in sensitive individuals. DAO enzyme supplements are sometimes used to aid histamine digestion.
In a metabolic chamber study, participants followed identical 10-hour eating windows that began either one hour or five hours after waking. The same foods and quantities were provided. Meals consumed later in the day produced significantly less fat oxidation than the same meals eaten earlier.
Shifting the majority of caloric intake to the first two-thirds of the waking day (for example, 8 a.m.–6 p.m. versus 12 p.m.–10 p.m.) favors greater fat oxidation. Cultural meal timing varies widely, yet studies in Spain show that earlier lunch timing improves weight-loss outcomes even in late-eating societies.
Approximately 95 % of the muscle-protein-synthesis benefit from adequate daily protein can be achieved with two meals, with or without a snack. The 30-gram-per-meal ceiling is not a strict physiological limit; up to 100 g can be assimilated under certain conditions such as prior exercise. Avoiding large or late dinners remains advisable for metabolic health.
This topic was the focus of a PhD dissertation. The principal investigator received a grant to study medium chain triglycerides after prior work had been conducted. The study used purified MCT oil, a liquid oil containing only 8-carbon and 10-carbon chain fatty acids. These chain lengths are uncommon in typical food sources, so the oil was purified and extracted before being given to participants.
A functional oil was created that also contained flax seed oil to increase omega-3 fatty acid content. Plant sterols were added because cholesterol reduction and cardiovascular disease risk reduction were a major research focus at McGill. The goal was to evaluate impact on energy expenditure because medium chain triglycerides are metabolized differently than long chain triglycerides (12, 14, 16 carbons and above). Medium chain triglycerides travel directly to the liver and are metabolized there, resulting in more rapid burning compared to long chain triglycerides that circulate peripherally and deposit in adipose tissue.
Two separate studies were conducted in men and women. Both studies showed an increase in thermic effect of food with medium chain triglycerides, meaning participants burned slightly more calories from meals containing MCT compared to meals containing standard fat.
The first study was conducted in women. The design attempted to match saturated fat content because medium chain fatty acids are by default saturated. Beef tallow was used as the saturated fat-matched control. Participants were not pleased with the diet. The beef tallow was incorporated into real foods such as mashed potatoes. Half of the total fat in the diet came from either the medium chain triglyceride source or beef tallow, representing approximately 20 percent of total fat intake.
MCT oil has a known laxative effect. Some participants initially experienced gastrointestinal discomfort described as gargling from the stomach, but this resolved after a few days. The study lasted four weeks and no participants dropped out due to gastrointestinal issues.
Beef tallow is solid at room temperature, so food would gel on the plate as it cooled. Some women reported headaches from the smell of the beef tallow.
The MCT condition produced a statistically significant increase in thermic effect of food of approximately 45 to 60 calories per meal. While this represents a small absolute change, repeated across three meals per day it contributed to measurable changes in body composition, including improvements in weight status and lean mass to fat mass ratio.
A follow-up weight loss study used purified MCT oil compared to olive oil. Greater weight loss occurred with MCT consumption. The recommendation for typical use is approximately one to two tablespoons of MCT per day substituted in place of other oils rather than added on top of existing intake.
Ginger and MCT effects on weight loss were discussed as potentially additive because they may work through different mechanisms. This led to discussion of the portfolio diet designed by David Jenkins for maximal cholesterol reduction. The original portfolio diet included four components: soy protein, nuts, plant sterols, and soluble fiber. A head-to-head comparison showed the portfolio diet produced cholesterol reduction equivalent to statin medication.
The diet has been expanded to be more flexible, now including legumes and monounsaturated fats such as olive oil. Public health challenges with the diet include public perception of soy, tendency to overeat nuts, and unfamiliarity with plant sterols.
The amino acid protein foraging hypothesis suggests people eat until they obtain sufficient amino acids. Animal proteins such as chicken breast or eggs tend to be more satiating than grains and nuts, raising questions about how to achieve cardiometabolic health while managing hunger without relying on GLP-1 medications.
Plant-based diets with higher food volume can promote satiety because large volumes of low-calorie-density foods are difficult to overconsume. Adding nuts can prolong satiety through protein and healthful fats. Animal products are considered important for health when consumed in appropriate portion sizes without overemphasis relative to plant-based foods. Plant-based products are associated with better heart health outcomes, reduced type 2 diabetes risk, lower cancer risk, and reduced metabolic disease risk.
Foods that are easiest to overeat include combinations of starch and fat or starch, sugar, and fat. These combinations trigger brain and gut signals that promote continued consumption. Reducing white foods including white flour, white rice, and white pasta is recommended. Bread that dissolves quickly in the mouth indicates high processing.
Portion sizes in the United States are substantially larger than in Canada. Many people never considered taking restaurant leftovers home in Canada, but large portions in the US often require doggy bags or result in food waste.
When moving from Canada to the United States, differences were noted in bread formulation, with US bagged bread containing more additives and sugar. Yogurt in the US was also sweeter than the identical brand in Canada. Food formulation varies by country to appeal to local taste preferences. The United States has historically favored sugar and fat combinations, contributing to substantial health consequences.
A study examined whether snack chips fried in corn oil could alleviate cardiovascular risk factors when substituted for low-fat or high-fat snacks. The research was funded by Frito-Lay at the time they changed their frying oil to corn oil for products including Doritos, Fritos, Cheetos, and Titos. The previous oil type was not specified but was not tallow.
The study used a crossover design with three arms: low-fat high-carbohydrate snack, high-fat high-saturated-fat snack, or corn oil chips. Each participant completed all three conditions for 25 days, consuming two snacks per day on a rotating schedule among four different chip varieties.
The corn chip condition produced the best lipid profile and lower lipoprotein(a), an additional cardiometabolic risk factor. When saturated fat is replaced with seed oils such as corn oil, cardiometabolic risk factors typically improve. However, concerns exist about processing effects when fats are combined with carbohydrates and heated, potentially creating compounds detrimental to health.
Different oils have different smoke points and should be used appropriately. Flax seed oil should not be heated to high temperatures. All liquid oils at room temperature are acceptable, and moderation applies to all fats including butter. Olive oil has a lower smoke point than seed oils such as peanut oil, making the latter more suitable for frying. Fried food consumption itself is a separate dietary consideration.
Industry-sponsored studies do not necessarily create conflicts of interest for investigators. Researchers draft the research question, collect data, analyze results, and publish findings independently. Some industry-funded studies have produced null results that were still submitted for publication despite lack of significant effects.
Companies typically include contractual rights to publish, as there would be no purpose in conducting research without the ability to disseminate findings. One null-result paper required submission to five different journals before potential acceptance because findings showing no effect are less exciting to publishers.
Dr. St-Onge emphasizes that persistence is critical in research, noting that many scientists abandon projects when initial results are not promising. She points out that issues with negative or null results are not unique to industry-funded studies, as NIH-sponsored research has also documented cases of scientific misconduct where principal investigators falsified data in published papers.
She states that if a researcher is not honest, the funding source does not matter, since misconduct occurs across both industry and government-funded work. The motivation for conducting science should be discovering real answers rather than other incentives.
Companies fund research to determine whether their products provide health benefits that can be marketed. If no benefit is found, companies may redirect the product toward different applications. Dr. St-Onge notes that while NIH and NSF funding is highly competitive and limited, industry funding allows research on specific foods or products that would otherwise be difficult to access.
There is growing discussion at NIH about creating incentives for publishing negative or null results, recognizing their value in steering people away from ineffective approaches. Increased federal interest in nutrition research is evident through revisions to dietary guidelines and related initiatives.
Dr. St-Onge advocates for more federal funding for nutrition research to reduce potential bias concerns. She notes that public skepticism tends to focus more on food industry funding than pharmaceutical research, despite drug companies conducting most of their R&D internally.
Scientific fraud involving fabricated data is considered very rare. However, publication bias against null results means many findings never reach the public. Dr. St-Onge stresses the importance of creating lab cultures where graduate students and postdocs feel comfortable reporting that results show no meaningful effect.
She describes teaching students to distinguish between numerical differences and statistically significant differences, using an example where values of 25 versus 27 with a standard deviation of 10 are not meaningfully different. The ideal scenario occurs when students are initially skeptical of their own results and require convincing that findings are genuine.
Nutrition remains a contentious field partly due to its importance in daily life and partly due to unnecessary conflicts. When interacting with students, postdocs, and the public, common questions focus on what to eat, what to avoid, and inquiries about specific dietary fads or products. Peptides have recently gained significant attention as a trending topic.
Dr. St-Onge prefers obtaining nutrients through whole food choices rather than supplements, finding this approach more pleasurable. She acknowledges that some individuals may require supplementation but encourages striving to meet nutritional needs through complete foods.
Regarding fiber, she notes increasing medical recommendations for supplemental fiber such as psyllium husk. While fiber supplements address intake gaps, whole fruits and vegetables provide additional benefits including polyphenols and non-nutrient compounds that support gut health and may enhance fiber's effects.
The discussion concludes with recognition that encouraging good sleep should be paired with guidance on eating patterns and food choices that support quality sleep, which in turn promotes better dietary decisions. Dr. St-Onge describes a vicious cycle where poor sleep leads to poor eating, which further impairs sleep, and advocates instead for a healthful cycle where good sleep enables good food choices that support continued better sleep.
Dr. St-Onge's research program is noted for integrating multiple areas and identifying their intersections, contributing to understanding of both sleep and metabolic health.
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