INTRODUCTION

In This Article

What Is Nutrition? How Does Nutrition Affect Sleep? How Does Sleep Affect
Nutrition? How To Improve Sleep and Nutrition

It’s no secret that both nutrition and sleep play a fundamental role in our health,
but the complex and important relationships between them are frequently
overlooked.

Diet and nutrition can influence the quality of your sleep, and certain foods and
drinks can make it easier or harder to get the sleep that you need. At the same
time, getting enough sleep is associated with maintaining a healthier body
weight and can be beneficial for people who are trying to lose weight.

Recognizing the connections between sleep and nutrition creates opportunities

to optimize both in order to eat smarter, sleep better, and live a healthier life.

What Is Nutrition?

Nutrition is made up of the food and other substances1 that allow the body to
have energy and function properly. Human nutrition is composed of
macronutrients, vitamins, and minerals.

Macronutrients2 include carbohydrates, protein and amino acids, fats, fiber, and
water.

Vitamins3 play specific roles in a multitude of bodily processes, and there are
13 essential vitamins.

Numerous minerals4 are needed to power different systems of the body.

Minerals are classified as either macrominerals or trace minerals depending on
how much of them we need.

Proper nutrition requires obtaining a healthy balance of macronutrients and the

necessary intake of vitamins and minerals. Most nutrition comes from food, but
other sources, like drinks and dietary supplements, are contributors as well.
How Does Nutrition Affect Sleep?

“You are what you eat” may be a cliche, but it reflects the fact that nutrition
serves as a backbone for health5, providing the energy we need and other inputs
that make the body function properly. The links between nutrition and obesity,
diabetes, and heart health6 are well-known, but many people are unaware that
their diet can also affect sleep.

What Is the Best Diet for Sleep?

As a general rule, a balanced diet made up largely of a variety of vegetables and

fruits is able to provide the recommended daily intake of vitamins and nutrients,
contributing to better sleep while promoting a healthy weight.

Because both sleep and nutrition are extremely complex and involve multiple
interconnected systems of the body, it is challenging to conduct research studies
that conclusively demonstrate a single diet that is best for sleep. Instead, what
appears most important is that a person gets adequate nutrition without
overconsuming unhealthy foods.

A central role of nutrition is having a high enough intake of a broad range of

vitamins and minerals that enable almost all types of bodily systems and
processes.

Growing evidence indicates that sufficient nutrient consumption is important for

sleep. One large study found a lack of key nutrients, such as calcium,
magnesium, and vitamins A, C, D, E, and K to be associated with sleep
problems7. While this research does not prove cause-and-effect, it supports the
likelihood that diet affects hormonal pathways8 involved in sleep.

High-carbohydrate meals with high glycemic indexes can also affect one’s
energy level and sleep quality. It has been well established that high-
carbohydrate meals often can make you feel drowsy. High-carbohydrate meals
can also impair your sleep quality. In fact, high carbohydrate intake has been
shown to increase the number of awakenings at night and reduce the amount of
deep sleep9 you get. It is not a surprise that frequent consumption of energy
drinks and sugar-sweetened beverages is associated with poor sleep quality.

Many different types of diets can offer this kind of nutritional balance, and
some have been evaluated more closely for how they affect sleep. For example,
the Mediterranean Diet10, which is plant-based while incorporating lean meats
and high-fiber foods, has been found to improve heart health and sleep
quality11.

The Dietary Approaches to Stop Hypertension diet, or DASH diet12, involves

reduced salt and saturated fats along with a focus on whole foods with high
levels of fiber, potassium, and magnesium. The DASH diet was designed to
reduce blood pressure, but research has found that people who closely follow it
tend to report better sleep13.

While the Mediterranean and DASH diets have shown benefits for sleep, other
dietary approaches that balance macronutrients and ensure adequate vitamins
and minerals may have similar effects. Further research will be necessary to
identify the sleep benefits of different diets and to test the comparative effects
of those diets on sleep.

Because of the effects of dietary changes on numerous systems of the body, it’s
important for anyone who is considering starting a new diet to talk with a doctor
or nutritionist who can review their nutrition plan and its benefits and
downsides in their specific situation.

Does an Unhealthy Diet Affect Sleep Disorders?

Some sleeping problems are directly due to sleep disorders. One of the most
serious sleep disorders is obstructive sleep apnea (OSA), which causes impaired
breathing and numerous nighttime awakenings. Obesity is a key risk factor for
OSA, which means that an unhealthy diet that contributes to excess body weight
may cause or worsen this sleep disorder.

Alcohol is known to worsen obstructive sleep apnea as it further impairs airway

muscle tone throughout the night. This leads to increased blockage of the upper
airway during sleep.

How Does Sleep Affect Nutrition?

Sleep is essential for the body to function properly. It allows the brain and body
to rest and recover, and an increasing amount of evidence points to its role in
maintaining proper nutrition and a healthy body weight.

Insufficient sleep has been associated in multiple studies with an elevated risk
of obesity14. Lack of sleep has also been connected to greater waist
circumference15, which is considered to be a worrisome indicator of numerous
cardiovascular problems.

The effect of sleep on weight and body composition may be tied to how it
affects appetite and nutrition.

Multiple studies have found that people who don’t get enough sleep are more
likely to increase their food consumption16 without an equivalent increase in
energy expenditure. Making this worse is that sleep deprivation also appears to
provoke a tendency to select high-calorie foods17 that offer less nutritional
benefit and create a greater risk of weight gain.

Certain hormones are considered to be driving factors behind these poor

nutritional choices associated with sleep deprivation. The normal production of
leptin and ghrelin, hormones that help control appetite and hunger, is thrown off
even after short periods of inadequate sleep18.

Other chemicals in the brain that help guide food choices may also be impacted
by a lack of sleep. In addition, sleep is known to affect concentration, decision-
making, and mood, all of which can play into the types of foods we incorporate
into our daily diet.

Can Sleep Help You Lose Weight?

Getting enough hours of quality sleep can improve dietary decision-making and
contribute to a well-rounded weight loss plan. Studies have shown that people
who are trying to lose weight have better results when they get good sleep19.
Sleeping well can reduce overeating20, and may facilitate more physical
activity by helping you wake up more energetic and refreshed.

How To Improve Sleep and Nutrition

If you want to improve your sleep and nutrition, talking with your doctor is a
good starting point. Your doctor can help identify your barriers to sleep,
including potential sleep disorders, and recommend a nutrition plan that best
suits your needs.

Most people can get better sleep by improving their bedroom environment and
their sleep-related habits. Collectively, this is known as sleep hygiene, and it’s
an important factor in making consistent sleep part of your everyday routine.
Keeping a regular sleep schedule is a major component of sleep hygiene, and
many people find that it can keep them from pushing their bedtime later and
later. Research has found that a late sleep schedule is correlated with a higher
risk of weight gain21, which makes this step a potential benefit for both sleep
and nutrition.

Giving yourself plenty of time to relax and get ready for bed is another element
of sleep hygiene. This includes avoiding foods and drinks, like caffeinated
beverages or spicy foods, that can make it harder to get to sleep. Eating too late
at night, which can throw off sleep, has also been found to be worse for people
trying to lose weight22.

Other sleep hygiene improvements include making sure that your bedroom is
dark and quiet, avoiding screen time for an hour or more before bed, having a
comfortable mattress and bedding, and trying to get daylight exposure and
moderate exercise every day.

There’s a connection between nutrition and sleep.

For example, diets low in fiber and high in saturated fat may decrease the
amount of deep, restorative sleep you’ll get. Excess sugar can cause you to
awaken more frequently. Consuming certain foods and beverages close to
bedtime can also lead to poor sleep.

If you’re having trouble falling and staying asleep, the culprit could be what
you’re choosing to eat and drink.

What to Avoid

Fatty or high-protein foods: Because digestion naturally slows when you

sleep, going to bed too soon after eating a steak dinner or other high-protein
foods can lead to disrupted sleep, since your stomach will feel uncomfortably
full. Foods high in saturated fat have a similar disruptive effect on sleep
patterns.

Spicy foods: Spicy foods can cause painful heartburn that could make it
difficult to lie down comfortably, which makes it harder to fall asleep.
Heartburn can also worsen the effects of obstructive sleep apnea (OSA), as the
backed-up acid can create more irritation in your airway. Some spicy foods can
raise your body temperature, forcing your body to work harder to cool down
enough to fall asleep; feeling too warm in bed may also disrupt your sleep
patterns throughout the night.
Caffeine: Drinking caffeine late in the day has long been known as a potential
sleep disrupter for many people, since it’s a stimulant designed to keep you
alert. But be aware that caffeine can be hidden in other foods as well, such as
chocolate and even ice cream, so check the ingredients. 

Alcohol: Winding down with a glass of wine or a beer at dinner can be a

pleasurable experience, but not so much when you’re getting ready to sleep.
Once the effects of alcohol wear off, you’ll likely find yourself waking
suddenly and struggling to go back to restful sleep. Alcohol can also worsen
OSA symptoms. 

Go ahead and enjoy flavorful foods and drinks, but note that fatty and high-
protein foods and alcohol close to bedtime can affect your sleep, so consume
them in moderation. And cutting off caffeine in the afternoon is a good idea
since caffeine’s effects can last up to six hours, and sometimes even longer if
the beverage is high in caffeine.

 What to Choose Instead

If you need a snack before bedtime, consider complex carbohydrates such as

oatmeal or whole-wheat toast, which digest easily. 

Healthy eating habits overall will encourage healthier sleeping patterns.

Consuming a high-fiber diet with fresh fruits, vegetables, whole grains, and
low-fat proteins—while avoiding foods with added sugars—is ideal. Look for
foods high in B vitamins; B vitamins are believed to help regulate melatonin.
Foods rich in B vitamins include fish, lean poultry and meat, legumes, eggs, and
dairy.

A healthy diet can also help you lose weight, which can in turn lead to better
sleep and make you less likely to suffer from daytime fatigue, insomnia, and
OSA. 

The takeaway? Good eating habits can go hand in hand with getting a good
night’s sleep for a healthier you. 
HARMFUL CULTURAL PRACTICES DURING PERINATAL PERIOD
AND ASSOCIATED FACTORS AMONG WOMEN OF HILDBEARING
AGE IN SOUTHERN ETHIOPIA: COMMUNITY BASED CROSS-
SECTIONAL STUDY

Although the maternal mortality ratio has decreased by 38% in the last decade,
810 women die from preventable causes related to pregnancy and childbirth
every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone.
The lives of women and newborns before, during, and after childbirth can be
saved by skilled care. The main factors that prevent women from receiving care
during pregnancy and childbirth are harmful cultural practices. The aim of this
study was to assess the level of harmful cultural practices during pregnancy,
childbirth, and postnatal period, and associated factors among women of
childbearing age in Southern Ethiopia.

A community-based cross-sectional study design was conducted in the Gurage

zone, among representative sample of 422 women of reproductive age who had
at least one history of childbirth. A simple random sampling technique was used
to recruit participants. Data were collected by six experienced and trained data
collectors using a pretested structured questionnaire with face to face
interviews. Harmful cultural practices are assessed using 11 questions and those
who participate in any one of them are considered as harmful cultural practices.
Descriptive statistics were performed and the findings were presented in text
and tables. Binary logistic regression was used to assess the association between
each independent variable and outcome variable.

Harmful cultural practices were found to be 71.4% [95%CI, 66.6–76.0]. The

mean age of study participants was 27.6 (SD ± 5.4 years). Women with no
formal education [AOR 3.79; 95%CI, 1.97–7.28], being a rural resident [AOR
4.41, 95%CI, 2.63–7.39], having had no antenatal care in the last pregnancy
[AOR 2.62, 95%CI, 1.54–4.48], and pregnancy being attended by untrained
attendants [AOR 2.67, 95%CI, 1.58–4.51] were significantly associated with
harmful cultural practice during the perinatal period.

In this study we found that low maternal education, rural residence, lack of
antenatal care and lack of trained birth attendant were independent risk factors
associated with women employing harmful cultural practices during the
perinatal period. Thus, strong multi-sectoral collaboration targeted at improving
women’s educational status and primary health care workers should take up the
active role of women’s health education on the importance of ANC visits to
tackle harmful cultural practices.

THE EVOLUTION OF CULTURAL ADAPTATIONS: FIJIAN FOOD

TABOOS PROTECT AGAINST DANGEROUS MARINE TOXINS

The application of evolutionary theory to understanding the origins of our

species' capacities for social learning has generated key insights into cultural
evolution. By focusing on how our psychology has evolved to adaptively extract
beliefs and practices by observing others, theorists have hypothesized how
social learning can, over generations, give rise to culturally evolved adaptations.
While much field research documents the subtle ways in which culturally
transmitted beliefs and practices adapt people to their local environments, and
much experimental work reveals the predicted patterns of social learning, little
research connects real-world adaptive cultural traits to the patterns of
transmission predicted by these theories. Addressing this gap, we show how
food taboos for pregnant and lactating women in Fiji selectively target the most
toxic marine species, effectively reducing a woman's chances of fish poisoning
by 30 per cent during pregnancy and 60 per cent during breastfeeding. We
further analyse how these taboos are transmitted, showing support for cultural
evolutionary models that combine familial transmission with selective learning
from locally prestigious individuals. In addition, we explore how particular
aspects of human cognitive processes increase the frequency of some non-
adaptive taboos. This case demonstrates how evolutionary theory can be
deployed to explain both adaptive and non-adaptive behavioural patterns.

EATING SOUP WITH NAILS OF PIG: THEMATIC SYNTHESIS OF

THE QUALITATIVE LITERATURE ON CULTURAL PRACTICES
AND BELIEFS INFLUENCING PERINATAL NUTRITION IN LOW
AND MIDDLE INCOME COUNTRIES

The perinatal period, i.e. pregnancy, childbirth and early infancy, is a significant
transition period where the biological and the social strongly intersect. In low
and middle-income countries the disease burden arising from the perinatal
period, is still substantial. The perinatal period is also a crucial window of
opportunity for reducing undernutrition and its long term adverse effects.
We explored qualitative research conducted in low resource settings around the
perinatal continuum over the past two decades, with a particular focus on the
‘cultural’ realm, to identify common themes influencing maternal and infant
nutrition. We systematically searched electronic databases from 1990 to 2014,
including MEDLINE, EMBASE, PsycINFO, Scopus and Cumulative Index to
Nursing and Allied Health Literature, using relevant search terms including
traditional beliefs, practices, pregnancy, childbirth, developing countries etc.
Adapted Consolidated Criteria for Reporting Qualitative Health Research and
Critical Appraisal Skills Programme criteria were used to determine quality of
studies. We synthesised the literature thematically, enabled by NVivo 10
software.

Most studies showed cultural support for breastfeeding, although most

traditional societies delayed breastfeeding due to colostrum being considered
‘dirty’. A range of restrictive practices through pregnancy and the post- partum
period were revealed in Asia, Latin America and Africa. There was a strong
cultural understanding of the healing power of everyday foods. A wide range of
good foods and bad foods continued to have currency through the perinatal
continuum, with little consensus between groups of what was beneficial versus
harmful. Cross-cutting themes that emerged were 1) the role of the
woman/mother/wife as strong and good; 2) poverty restricting women’s
nutrition choices; 3) change being constant, but the direction of change
unpredictable.

A rich and diverse repertoire of cultural practices and beliefs influenced

perinatal nutrition. Results from this synthesis should influence public health
policymakers and practitioners, to tailor contextually specific, culturally
responsive perinatal nutrition interventions to optimise health and wellbeing of
mother-infant dyads. Ideally these interventions should build on culturally
sanctioned life affirming behaviours such as breastfeeding, promoting post-
partum rest and recovery, while modifying the potentially harmful aspects of
other cultural practices in the perinatal period.
 CULTURAL INFLUENCES ON INFANT FEEDING PRACTICES

All different cultures, whether in a tropical village or in a highly urbanized and

technologically sophisticated community, contain some practices and customs
which are beneficial to the health and nutrition of the group, and some which
are harmful. No culture has a monopoly on wisdom or absurdity.” Jellife D.
Child Nutrition in Developing Countries: A Handbook for
Fieldworkers. Washington, DC: United States Public Health Service; 1968
Healthy infant feeding practices, including exclusive breastfeeding and delayed
introduction of complementary foods, are promoted by health clinicians as well
as by numerous national and international organizations. However, mothers
base their infant feeding decisions on an array of factors, including their
experiences, family demands, socioeconomic circumstances, and cultural
beliefs.

As the number of children from immigrant families in the US increases, more

pediatric clinicians are working not only with families of color who...

THE PROBLEMATIC MESSAGES OF NUTRITIONAL DISCOURSE: A

CASE-BASED CRITICAL MEDIA ANALYSIS

Nutritional science has assumed a fundamental importance in shaping food

meanings and practices in the developed world. This study critically analysed
the content of one weekly nutrition column written by a nutritional expert in a
popular New Zealand magazine, from a social constructionist perspective, to
investigate how nutritional advice constructs food, food practices and eaters.
The analysis identified a range of ways in which the nutrition information
communicated in the articles was potentially problematic for readers. The
articles advocated eating for health with recommendations based on nutritional
science, but depicted nutritional information as inconclusive, changeable and
open to interpretation. Fear-based messages were used to motivate making
'healthy' food choices, through linking 'unhealthy' food choices with fatness and
chronic ill health. Unhealthy foods were portrayed as more enjoyable than
healthy foods, social occasions involving food were constructed as problematic,
and exercise was defined only as a way to negate food consumption. Healthy
eating was portrayed as a matter of personal choice, obscuring the situational
factors that impact on food choice and health. We conclude that the nutritional
advice analysed in this study constructs a way of understanding food that, if
internalised by eaters, may evoke anxiety, confusion and dissatisfaction around
food and eating.

MIASMATIC CALORIES AND SATURATING FATS: FEAR OF

CONTAMINATION IN ANOREXIA

This paper draws on ethnographic material to challenge the taken-for-granted

relationship between anorexia and fear of fat. While popular understandings
assume anorexia to be an extension of everyday dietary guidelines and a fear of
weight gain from foods high in fats and calories, I argue that it is fear of
contamination rather than fear of fat per se that is at issue. Through a critique
and extension of Mary Douglas' structuralist typology and Julia Kristeva's
embodied theory of abjection, I demonstrate that it is the qualities of certain
foods, and in particular their amorphous natures, that render them
contaminating. Saturating fats and invisible calories are considered dangerous
by people with anorexia because they have the ability to move, seep, and
infiltrate the body through the interplay of senses. Foods that transgress
conceptual and bodily boundaries are thus to be avoided at all costs, for they
have the potential to defile and pollute. In light of the low recovery rates for
those with anorexia within Australia (and internationally), the findings of this
paper have significant implications for the understanding and treatment of this
disorder.

REDUCING HARMFUL TRADITIONAL PRACTICES IN ADJIBAR,

ETHIOPIA: LESSONS LEARNED FROM THE ADJIBAR SAFE
MOTHERHOOD PROJECT

This paper assesses the impact of the Adjibar Safe Motherhood Project and
derives lessons of value to future interventions.

Amongst the participatory qualitative methods used were 15 group discussions,

eight semi-structured interviews, a number of opportunistic informal
discussions and observation.The information gathering was complemented by a
detailed review of project documents. Field visits for data collection took place
over a six day period in March 2005.

The project was effective in raising awareness about maternal health, and the
social, economic and health consequences of various harmful traditional
practices (HTPs). It has also mobilised the community to monitor and report
HTPs and has strengthened referral systems for counselling, support and
treatment. A number of effective strategies were identified as having
contributed to project success.These are presented using the framework offered
by the Ottawa Charter for Health Promotion which presents five areas of public
health action: developing personal skills; strengthening community action;
building healthy public policy; re-orienting health services; and, creating
supportive environments.

This evaluation contributes to and strengthens the expanding body of literature

about effective development practices to reduce HTPs. It demonstrates that
addressing HTPs takes time and long term investment; both are necessary to
enable better understanding of the social and cultural reasons for HTPs before
attempting to address them, and to build the community trust necessary to
overcome the natural resistance to challenging such deeply entrenched
practices. The project also highlighted the importance of developing a multi
pronged strategy based on engagement with a broad range of stakeholders and
supportive legislation.

HARMFUL POSTPARTUM BELIEFS AND PRACTICES OF

MOTHERS IN INDIA: RAPID EVIDENCE SYNTHESIS

The World Health Organization (WHO) states that the postpartum period begins
immediately after childbirth and lasts for around six weeks (approximately 42
days).(1) Dr. Sakeena K., District Medical Officer (DMO), Malappuram,
Kerala, along with an action group of obstetricians (OB’s), expressed concern
over certain undesirable practices being encouraged by these lay health
workers/attendants focussing on issues such as nutrition and breastfeeding The
DMO proposes to change the harmful behaviours and practices through the
design of training modules for mothers and LHWs/attendants. The primary
outcomes of interest relate to breastfeeding, diet and nutrition and some
newborn care practices. Some of the harmful postpartum practices reported in
the literature include delayed initiation of breastfeeding, unhygienic cord care
practices, giving prelacteal feeds, restriction on certain foods, and unsafe
practices related to personal hygiene. The DMO requested the rapid evidence
synthesis team the George Institute for Global Health (TGI) India to conduct a
rapid review of evidence on common harmful postpartum practices across India.
Rapid Evidence Synthesis (RES) is an emergent research approach undertaken
to provide synthesised information in shorter timeframes for decision making.
The objective of this RES was to identify and summarise the harmful practices
followed by mothers and to a certain extent encouraged by lay health workers in
different regions and settings across India. It is important to explore and
understand the prevalent harmful practices across India to provide a
comprehensive picture of the commonalities in relatively similar settings.
Tailored strategies to discourage harmful practices in one setting or region in
India may be transferable to other regions.

BETWEEN SCYLLA AND CHARYBDIS. NUTRITIONAL EDUCATION

VERSUS BODY CULTURE AND THE BALLET AESTHETIC: THE
EFFECTS ON THE LIVES OF FEMALE DANCERS

A key objective of this empirical study was to investigate whether improved

education for dancers about nutrition has made a positive change to the body
culture of the ballet world and lifestyle of female dancers. The issues were
foreshadowed by sociological theories of the body, performance nutrition, and
disordered eating. An interpretive, critical research approach was used to
maximise the 'insider perspective' of the researcher, with over 20 years
experience of the training and professional ballet culture. A small-scale
qualitative research project aimed to capture 'thick description' and authentic
accounts of the human realities of ballet culture from the inside. Interview and
questionnaire responses were gathered from student-dancers, professional
dancers, teachers/managers, and medics at a UK vocational ballet school and a
company fed, to some extent, from that training school. Findings were collated
with experiential observations in the daily workplace, retrospective participant
observation through personal diaries and documentation including some
biographies and autobiographies of professional dancers. The findings indicated
that there is still a gap between the rhetoric of nutritional education and the
reality of the ballet world's aesthetic and practices. 'Cult-like', authoritarian
behaviour and 'docile' submissive attitudes were apparent and contributed to
problems with self-esteem, body image and eating disorders. Whilst dancers in
training were better informed, pressures related to the body inside the profession
dominated attitudes and behaviour. The recommendations include a re-appraisal
of the ballet aesthetic and body culture in the management of the profession and
more empowerment of dancers to encourage them to question, critique and
improve the culture of their art form rather than merely accept its ideals and
demands.