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Epidemiology and Population Health

High sleep variability predicts a blunted weight loss response and short sleep duration a reduced decrease in waist circumference in the PREDIMED-Plus Trial

International Journal of Obesity volume 44, pages 330–339 (2020)Cite this article

Subjects

Abstract

Background

Whether short sleep duration or high sleep variability may predict less weight loss and reduction in measures of adiposity in response to lifestyle interventions is unknown. The aim of this study was to compare the 12-month changes in weight and adiposity measures between those participants with short or adequate sleep duration and those with low or high sleep variability (intra-subject standard deviation of the sleep duration) in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a primary prevention trial based on lifestyle intervention programs.

Methods

Prospective analysis of 1986 community-dwelling subjects (mean age 65 years, 47% females) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus trial was conducted. Accelerometry-derived sleep duration and sleep variability and changes in average weight, body mass index (BMI), and waist circumference (WC) attained after 12-month interventions were analyzed.

Results

The adjusted difference in 12-month changes in weight and BMI in participants in the third tertile of sleep variability was 0.5 kg (95% CI 0.1 to 0.9; p = 0.021) and 0.2 kg/m2 (0.04 to 0.4; p = 0.015), respectively, as compared with participants in the first tertile. The adjusted difference in 12-month changes from baseline in WC was −0.8 cm (−1.5 to −0.01; p = 0.048) in participants sleeping <6 h, compared with those sleeping between 7 and 9 h.

Conclusions

Our findings suggest that the less variability in sleep duration or an adequate sleep duration the greater the success of the lifestyle interventions in adiposity.

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Acknowledgements

The authors especially thank the PREDIMED-Plus participants for their enthusiastic collaboration, the PREDIMED-Plus personnel for their outstanding support, and the personnel of all associated primary care centers for their exceptional effort. Centros de Investigación Biomédica en Red: Obesidad y Nutrición (CIBEROBN), Centros de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP) and Centros de Investigación Biomédica en Red: Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM) are initiatives of Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Food companies, Hojiblanca and Patrimonio Comunal Olivarero, donated extra-virgin olive oil and Almond Board of California, American Pistachio Growers, and Paramount Farms donated nuts.

Funding

The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, ISCIII through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (three coordinated FIS projects led by JS-S and JV, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926), the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-PLUS grant to Jordi Salas-Salvadó, the European Research Council (Advanced Research Grant 2013–2018; 340918) grant to MÁM-G, the Recercaixa grant to JS-S (2013ACUP00194), the grant from the Consejería de Salud de la Junta de Andalucía (PI0458/2013; PS0358/2016), the PROMETEO/2017/017 grant from the Generalitat Valenciana, the SEMERGEN grant and FEDER funds (CB06/03), OC is granted by the JR17/00022, ISCIII. CP is supported by a postdoctoral fellowship granted by the Autonomous Government of Catalonia (PERIS 2016–2020 Incorporació de Científics i Tecnòlegs, SLT002/0016/00428). None of the funding sources took part in the design, collection, analysis or interpretation of the data, or in the decision to submit the manuscript for publication. The corresponding authors had full access to all the data in the study and had final responsibility to submit for publication.

Author contributions

CP, MB, and JS-S: designed the research. CP, MB, AD-L, MAM-G, DC, MF, JV, DR, JAM, JL-M, RE, AB-C, FA, JAT, FJT, LS-M, VM, JL, CV, XP, JV, LD, MD-R, ER, IA, JB-L, AG-A, NB, HS, ET, AA-G, and JS-S: conducted the research. CP, MB, and JS-S: analyzed the data. CP wrote the article. CP and JS-S are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors revised the manuscript for important intellectual content and read and approved the final manuscript.

Author information

Authors and Affiliations

  1. Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain

    Christopher Papandreou, Mónica Bulló, Andrés Díaz-López, Nancy Babio & Jordi Salas-Salvadó

  2. Institut d’ Investigació Pere Virgili (IISPV), Reus, Spain

    Christopher Papandreou, Mónica Bulló, Andrés Díaz-López, Nancy Babio & Jordi Salas-Salvadó

  3. Consocio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain

    Christopher Papandreou, Mónica Bulló, Andrés Díaz-López, Miguel A. Martínez-González, Dolores Corella, Olga Castañer, Dora Romaguera, Alfredo J. Martínez, Napoleón Pérez-Farinós, Jose López-Miranda, Ramon Estruch, Angel Alonso-Gómez, Josep A. Tur, Francisco J. Tinahones, Luis Serra-Majem, Jose Lapetra, Clotilde Vazquez, Xavier Pintó, Emilio Ros, Itziar Abete, Javier Barón-López, Ana Garcia-Arellano, Jose V. Sorli, Nancy Babio, Estefania Toledo, Montse Fitó & Jordi Salas-Salvadó

  4. University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain

    Christopher Papandreou, Mónica Bulló, Andrés Díaz-López, Nancy Babio & Jordi Salas-Salvadó

  5. Department of Preventive Medicine and Public Health, University of Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain

    Miguel A. Martínez-González & Estefania Toledo

  6. Department of Preventive Medicine, University of Valencia, Valencia, Spain

    Dolores Corella & Jose V. Sorli

  7. Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

    Olga Castañer, Helmut Schröder & Montse Fitó

  8. Nutritional Epidemiology Unit, University of Miguel Hernandez, Isabial-Fisabio, Alicante, Spain

    Jesus Vioque

  9. Consorcio CIBER, M.P. Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain

    Jesus Vioque, Aurora Bueno-Cavanillas, Miguel Delgado-Rodriguez & Helmut Schröder

  10. Instituto de Investigación Sanitaria Illes Balears (IdISPa), University Hospital of Son Espases, Palma de Mallorca, Spain

    Dora Romaguera

  11. Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain

    Alfredo J. Martínez & Itziar Abete

  12. Madrid Institute for Advanced Studies (IMDEA) Food Institute, Madrid, Spain

    Alfredo J. Martínez, Lidia Damiel & Itziar Abete

  13. Department of Nursing, School of Health Sciences, University of Malaga-IBIMA, Malaga, Spain

    Napoleón Pérez-Farinós & Javier Barón-López

  14. Lipids and Atherosclerosis Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain

    Jose López-Miranda

  15. Department of Internal Medicine, Hospital Clınic, Institut d’Investigacions Biomediques August Pi Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain

    Ramon Estruch

  16. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain

    Aurora Bueno-Cavanillas

  17. IBS.GRANADA Instituto de Investigación Biosanitaria de Granada, Granada, Spain

    Aurora Bueno-Cavanillas

  18. Department of Cardiology, University Hospital Araba, Vitoria, Spain

    Angel Alonso-Gómez

  19. Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain

    Josep A. Tur

  20. Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, University of Malaga-Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain

    Francisco J. Tinahones

  21. Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain

    Luis Serra-Majem

  22. Research Group on Gene-Environment Interactions and Health, University of Leon, Leon, Spain

    Vicente Martin

  23. Biomedicine Institute (IBIOMED), University of Leon, Leon, Spain

    Vicente Martin

  24. Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain

    Jose Lapetra

  25. Department of Endocrinology and Nutrition, University Hospital Fundación Jimenez Díaz, Madrid, Spain

    Clotilde Vazquez

  26. Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Xavier Pintó

  27. Endocrinology and Nutrition Department, Hospital Clinic Universitari, Barcelona, Spain

    Josep Vidal

  28. Institut d’Investigacions Biomediques August Pi Sunyer (IDIBAPS), Barcelona, Spain

    Josep Vidal

  29. Consorcio CIBER, M.P. Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

    Josep Vidal

  30. Emergency Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain

    Lidia Damiel & Ana Garcia-Arellano

  31. Department of Health Sciences, University of Jaen, Jaen, Spain

    Miguel Delgado-Rodriguez

  32. Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain

    Emilio Ros

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  1. Christopher Papandreou
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  2. Mónica Bulló
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  7. Jesus Vioque
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  8. Dora Romaguera
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  9. Alfredo J. Martínez
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  10. Napoleón Pérez-Farinós
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  11. Jose López-Miranda
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  13. Aurora Bueno-Cavanillas
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  14. Angel Alonso-Gómez
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  15. Josep A. Tur
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  16. Francisco J. Tinahones
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  17. Luis Serra-Majem
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  18. Vicente Martin
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  19. Jose Lapetra
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  20. Clotilde Vazquez
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  21. Xavier Pintó
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  22. Josep Vidal
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  23. Lidia Damiel
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  24. Miguel Delgado-Rodriguez
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  25. Emilio Ros
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  26. Itziar Abete
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  27. Javier Barón-López
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  28. Ana Garcia-Arellano
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  29. Jose V. Sorli
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  30. Nancy Babio
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  31. Helmut Schröder
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  32. Estefania Toledo
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  33. Montse Fitó
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  34. Jordi Salas-Salvadó
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Corresponding author

Correspondence to Jordi Salas-Salvadó.

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JS-S reports serving on the board of and receiving grant support through his institution from International Nut and Dried Fruit Council; receiving consulting personal fees from Danone, Font Vella Lanjaron, Nuts for Life, and Eroski; and receiving grant support through his institution from Nut and Dried Fruit Foundation and Eroski. ER reports grants, non-financial support, and other fees from California Walnut Commission and Alexion; personal fees and non-financial support from Merck, Sharp & Dohme; personal fees, non-financial support, and other fees from Aegerion and Ferrer International; grants and personal fees from Sanofi Aventis; grants from Amgen and Pfizer and; personal fees from Akcea, outside of the submitted work. XP reports serving on the board of and receiving consulting personal fees from Sanofi Aventis, Amgen, and Abbott laboratories; receiving lecture personal fees from Esteve, Lacer, and Rubio laboratories. MD-R reports receiving grants from the Diputación Provincial de Jaén and the Caja Rural de Jaén. LD reports grants from Fundación Cerveza y Salud. The other authors declare that they have no conflict of interest.

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Papandreou, C., Bulló, M., Díaz-López, A. et al. High sleep variability predicts a blunted weight loss response and short sleep duration a reduced decrease in waist circumference in the PREDIMED-Plus Trial. Int J Obes 44, 330–339 (2020). https://doi.org/10.1038/s41366-019-0401-5

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