Sleep and Weight Loss, or Lack Thereof.

Day 27. National Blog Posting Month.

Sleep deprivation is starting to catch up with me.  When I was at the office the other day after baby J had his vaccinations, I got on the scale.

Big mistake.

Since I last weighed myself (about 1 month postpartum), I gained weight.  Ugh.  And I have no one to blame but myself and the baby.

I blame myself because of the damn sweet tooth that I still have.  Now, granted, I’ve always had a sweet tooth, but in the past it was tempered by the exercise I was getting.  Oh, and Hallowe’en. I blame the Hallowe’en chocolate that’s in my house.  We normally get about a hundred kids at Hallowe’en but this year the weather was cold and rainy and we were left with far too much.  So much, in fact, that I would have 3-5 little chocolates every night after dinner.  Those calories add up, dammit!

Forget the fact that I have also started running.  It’s not doing a god-damn thing.  Don’t get me wrong, I am happy to be doing it and I will not quit, but it’s fucking hard this time around.  [Sorry for the language.]  I am running with about 15-20 lbs of extra weight and my legs feel like two lead pipes.

I need to lose some weight, but that’s going to be hard because of the second reason I listed above.

My adorable little baby boy.

He is exclusively breast-fed and is waking up at minimum of thrice a night.  I know, I know, boo hoo, poor me.  I could easily give him a bottle of formula when I go to bed and that might give me an extra hour or two of sleep.  But, I’m not ready to go there just yet.  I am enjoying our breastfeeding relationship and I don’t want to give it up yet.

But lordy lord, this fragmented sleep is wreaking havoc on my metabolism. Meaning that I have NO metabolism right now.  I can’t burn anything, despite the running.  Instincts tell me that a good night’s sleep is important for weight loss.  The better I sleep, the better I feel, and the healthier I eat.  I can even see it in my husband.  When he sleeps well, he eats sensibly throughout the day (ie. less snacking), exercises more efficiently, and keeps his weight stable. Once his sleep is affected (like it is now), eating habits go out the window and he’s too tired during the day to exercise.

Of course, this is all just conjecture on my part.  Is there any evidence to support my theory?

Why yes, in fact there is!

A quick Google search directed me to this WebMd website, http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/lack-of-sleep-weight-gain.

“It’s not so much that if you sleep, you will lose weight, but if you are sleep-deprived, meaning that you are not getting enough minutes of sleep or good quality sleep, your metabolism will not function properly,” explains Michael Breus, PhD, author of Beauty Sleep and the clinical director of the sleep division for Arrowhead Health in Glendale, Ariz.

On average, we need about 7.5 hours of quality sleep per night, he says. “If you are getting this already, another half hour will not help you lose 10 pounds, but if you are a five-hour sleeper and start to sleep for seven hours a night, you will start dropping weight.”

Exactly how lack of sleep affects our ability to lose weight has a lot to do with our nightly hormones, explains Breus.

The two hormones that are key in this process are ghrelin and leptin. “Ghrelin is the ‘go’ hormone that tells you when to eat, and when you are sleep-deprived, you have more ghrelin,” Breus says. “Leptin is the hormone that tells you to stop eating, and when you are sleep deprived, you have less leptin.”

 More ghrelin plus less leptin equals weight gain.

“You are eating more, plus your metabolism is slower when you are sleep-deprived,” Breus says.

A search of Google Scholar led to some more findings:

  • Investigators looked at the association between self-reported usual sleep duration and subsequent weight gain in the Nurses’ Health Study in 1986 and followed over 60,000 women for 16 years. Women who slept 5 hours or less gained 1.14 kg more than did those sleeping 7 hours over 16 years, and women sleeping 6 hours gained 0.71 kg.
  • A systematic review published in 2012 suggested that short sleep duration was independently associated with weight gain, particularly in younger age groups.
  • The Quebec Family Study looked at sleep duration and weight gain. Duration of sleep was characterized as short (5-6 hours), average (7-8 hours) and long (9-10 hours).  The risk of developing obesity was elevated for short and long-duration sleepers as compared with average-duration sleepers, with 27% and 21% increases in risk, respectively.
  • Another study published in the New England Journal of Medicine in 2011 looked at changes in diet and lifestyle and long-term weight gain in a cohort of men and women over a 4 year period.  Not surprisingly, an increased daily consumption of potato chips, sugar-sweetened beverages, unprocessed red meats resulted in an increase in weight while increased daily consumption of vegetables, whole grains, fruits, nuts and yogurt had the opposite effect and resulted in overall weight loss. Interestingly, more weight gain was seen in individuals who slept less than 6 hours and more than 8 hours per night.

So, based on these findings, it would appear that I am NOT going to be successful in losing the pregnancy/baby weight until the little man is sleeping through the night.

Sigh …

Alright then, pass the Chicago Mix.

30 g/day

No, I’m not talking about how much fiber one should have in a day – though, 30 g is about right, I think.  I’m referring to the amount of weight a newborn should gain per day during the first few months of life.

For my American readers – 30 grams = 1 oz.

30g/day was drilled into my head in medical school and particularly so in my Family Medicine training program.  A newborn will typically lose about 10% of his/her birth weight in the first few days of life, but usually by a week of age, the majority of infants will have regained the weight.  I was also taught that this should occur within the first 7 days of life.

So, in my first few years of family practice, I was quite diligent about these milestones.  If a baby hadn’t gotten back to birth weight within a week or wasn’t gaining that magical 30g/day, I would refer to the pediatricians across the hall from my office.  After a few of these referrals, the pediatrician walked over to my office to have a little “chat”.  She’s a lovely woman (she actually sees all my children) who sat me down and told me, that while she appreciated all the consults I was sending her way,  all of the infants were healthy and I was jumping the gun on the referrals.  I explained my reasoning, and she basically told me that “in the real world of clinical practice, most infants will regain their birth weight within 2-3 weeks, and so long as they are gaining weight, don’t focus on the 30g/day rule.”  She reminded me it was more important to assess how the mother was nursing, or how much formula was being given; she reminded me that the hydration status of the infant was more important than the number of grams gained.  Clinically, how does the infant look?  Was the infant having adequate numbers of wet diapers during the day? etc.  It was amazing advice and (sadly for her), my referrals drastically declined.

Yet, when it comes to my own child, I am stuck on that 30g/day rule.  Perhaps it’s because, with my first-born, I had a pathetic milk supply and didn’t recognize that my daughter was hungry and losing weight.  By the time she was 2 weeks old, she had lost about 20% of her birth weight, was just getting enough milk to stay hydrated, but not enough to gain weight.  I had to start supplementing with formula and watching her guzzle back that first 4 oz of formula in about 20 seconds made me realize just how hungry she was.  Cue the gut-wrenching mommy guilt.

I didn’t have to supplement with my second child – we had a great nursing relationship and he gained weight well.  Now, with the third. it seems to be following the same pattern, yet today I decided to take the baby to my office for a weight check only to discover that he’s gaining only about 15 oz/ day.

Cue the mommy guilt again. Oh God, do I not have enough milk for him?  Is he hungry and I’m just not clueing in?  Should I be waking him every 2 hours?  When I relayed my concerns to my husband, he just looked at me and said “He’s fine.”  He’s pooping and peeing appropriately.  He seems satisfied at the breast (unlike the firstborn who was clearly frustrated after a few minutes on the breast).  I am being way too hard on myself, yet I just can’t help it. And to top it all off, the baby now has the cold his older siblings have.

Did I mention he’s only 3 weeks old?

FML.