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Clinical Research

Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention

International Journal of Obesity volume 46, pages 1510–1517 (2022)Cite this article

Subjects

Abstract

Background/Objectives

To examine the association between indices of sleep quantity and quality with dietary adherence, physical activity adherence, and weight loss during a behavioral weight loss intervention.

Methods

Adults (n = 156) with overweight and obesity (40 ± 9 years, 84% female, BMI: 34.4 ± 4.2 kg/m2) participated in an 18-month behavioral weight loss intervention which prescribed a reduced calorie diet (1200–1800 kcal/d) and increased physical activity (300 min/wk). Body weight, indices of sleep (SenseWear armband; SWA), energy intake (EI, 3-day food records), and moderate-to-vigorous physical activity (SWA) were measured at baseline, 6, 12, and 18 months. Linear mixed effects models examined the association between sleep and weight change over time. Additional models were adjusted for covariates including age, BMI, sex, race, ethnicity, study completion, randomization, EI, and physical activity. Secondary analyses examined the association between sleep and adherence to diet and physical activity recommendations.

Results

Mean weight loss was 7.7 ± 5.4, 8.4 ± 7.9, and 7.1 ± 9.0 kg at 6, 12, and 18 months, respectively. Lower sleep efficiency, higher wake after sleep onset (WASO), more awakenings, and higher sleep onset latency (SOL) were significantly associated with attenuated weight loss (p < 0.05). Lower sleep efficiency, more awakenings, and higher SOL remained significantly associated with blunted weight loss after adjustment for covariates (p < 0.05). Later waketime, longer time in bed, longer sleep duration, higher WASO, more awakenings, and higher SOL were associated with lower odds of achieving ≥300 min/wk of moderate-to-vigorous physical activity, adjusted for covariates (FDR p < 0.05).

Conclusions

Future studies should evaluate whether incorporating strategies to improve sleep health within a behavioral weight loss intervention leads to improved adherence to diet and physical activity recommendations and enhanced weight loss.

Clinical trials identifier

NCT01985568

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Fig. 1: 1 Study enrollment and inclusion in analyses.

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Data availability

Deidentified participant data are available upon request. A written request, including hypotheses, methodology, and a statistical analysis plan, should be directed to Dr. Victoria Catenacci (vicki.catenacci@cuanschutz.edu).

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Author information

Authors and Affiliations

  1. Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Seth A. Creasy, Danielle M. Ostendorf, Jennifer M. Blankenship, Daniel H. Bessesen, Edward L. Melanson & Victoria A. Catenacci

  2. Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Seth A. Creasy, Danielle M. Ostendorf, Daniel H. Bessesen & Victoria A. Catenacci

  3. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Laura Grau & Jaron Arbet

  4. Division of Endocrinology, Denver Health Medical Center, Denver, CO, USA

    Daniel H. Bessesen

  5. Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Edward L. Melanson

  6. Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO, USA

    Edward L. Melanson

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  1. Seth A. Creasy
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  8. Victoria A. Catenacci
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Contributions

VAC designed the study, wrote the protocol, and acquired funding and data for this study. SAC, LG, and JA processed and analyzed the data. SAC, DMO, JMB, LG, JA, DHB, ELM, and VAC interpreted the data, generated the tables and figures, and wrote, revised, and approved the final manuscript.

Corresponding author

Correspondence to Seth A. Creasy.

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Competing interests

This study was supported by the National Institutes of Health. VAC obtained funding to collect the data presented in this study (R01 DK097266). SAC obtained funding to perform this secondary data analysis (K01 HL145023). DMO is supported by an NIH Ruth L. Kirschstein Postdoctoral Individual National Research Service Award (F32 DK122652). ELM is supported by resources from the Geriatric Research, Education, and the Clinical Center at the Denver VA Medical Center. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government. All other authors have nothing to disclose.

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Creasy, S.A., Ostendorf, D.M., Blankenship, J.M. et al. Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention. Int J Obes 46, 1510–1517 (2022). https://doi.org/10.1038/s41366-022-01141-z

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