Moderate sleep and less stress may help with weight loss

The paper, published March 29 in the International Journal of Obesity, was the result of a study funded by the National Institutes of Health's National Center for Complementary and Alternative Medicine.

Nearly 500 participants from Kaiser Permanente in Oregon and Washington took part in the study, which measured whether sleep, stress, depression, television viewing, and computer screen time were correlated with weight loss. Several previous studies have found an association between these factors and obesity, but few have looked at whether these factors predict weight loss.

"This study suggests that when people are trying to lose weight, they should try to get the right amount of sleep and reduce their stress," said lead author Charles Elder, MD, MPH, an investigator with the Kaiser Permanente Center for Health Research in Portland, Ore., who also leads Integrative Medicine at Kaiser Permanente Northwest. "Some people may just need to cut back on their schedules and get to bed earlier. Others may find that exercise can reduce stress and help them sleep. For some people, mind/body techniques such as meditation also might be helpful."

The study involved two phases: during the first phase, participants were asked to lose at least 10 pounds over six months. If they succeeded, they moved to the second year-long phase of the study, which tested a complementary acupressure technique against more traditional weight-maintenance strategies. Findings from phase two are not yet available.

During the study's first phase, all participants attended weekly meetings at which they were weighed and advised to reduce calorie intake by 500 calories per day, adopt a low-fat, low-sugar diet with lots of fruits and vegetables, increase physical activity to 180 minutes a week, and keep daily food records. People who kept more food records and attended more meetings were more likely to lose weight during this phase of the trial.

Participants also were asked to report levels of insomnia, stress and depression, and to record how much time they slept and spent watching television or using a computer. The research team found that sleep and stress levels were good predictors of weight loss, but depression and screen time were not.

People with the lowest stress levels who also got more than six hours, but not more than eight hours, of sleep were most likely to lose at least 10 pounds. In fact, nearly three-quarters of this group moved on to the second phase of the trial, and were twice as likely to be successful as those who reported the highest stress levels and got six or fewer hours of sleep per night.

Participants who qualified for the second phase were divided into two groups: one received monthly guided instruction in the Tapas Acupressure Technique, which involves lightly touching specific pressure points on the face and back of the head while focusing on a problem (i.e., maintaining weight loss). The other group also met monthly with a trained interventionist and a support group, but used more traditional nutrition and exercise techniques to keep weight off. Both groups met for six months and then were followed for another six months to see which group kept more weight off. Results of that phase of the trial should be available in late 2011 or early 2012.

The study authors caution that their findings may not apply to all groups trying to lose weight. The authors also noted that the participants were highly motivated, and that 90 percent had attended at least some college.

These studies are part of ongoing research at Kaiser Permanente to better understand weight loss and the key factors to maintaining optimum weight. Another Kaiser Permanente Center for Health Research study last year found that the more people logged on to an interactive weight management website, the more weight they kept off. Researchers at the Kaiser Permanente Center for Health Research also found that keeping a food diary can double a person's weight loss and that both personal contact and web-based support can help with long-term weight management.

Study authors include: Charles R. Elder, MD, MPH, Christina M. Gullion, PhD, Kristine L. Funk, MS, Lynn L. DeBar, PhD, Nangel M. Lindberg, PhD, and Victor J. Stevens, PhD, all from the Kaiser Permanente Center for Health Research in Portland, Ore.