Nutrition

More Than Just Bedtime Snacking

What follows is a review of the article cited which also reviews other similar studies in the literature.

The August 2006 issue of Diabetes Care includes a study of 714 individuals with either type 1 or type diabetes. This study shows that 9.7% of these individuals ate more than 25% of their daily food intake after “supper” or “dinner”. These individuals were more likely to be obese, to have a hemoglobin A1C of greater than seven, and to have two or more diabetes complications. There was no difference in age, but more females were categorized as having night-time eating syndrome (NES), as were younger, unmarried, and non Caucasian individuals. There was no difference in patients using insulin.

Night-time eating behaviors (NES) is defined as eating 25% of the daily food consumed after the evening meal and/or waking to eat after going to sleep at least three times weekly. The food choices generally tend to be high fat and rich in carbohydrate. NES is considered an eating disorder.

A survey of these individuals showed that this excessive after dinner “snacking” was associated with childhood maltreatment (sexual abuse, coercion, physical abuse, or parental neglect), depression, and eating in response to anger, loneliness, sadness and worry. It is thought that childhood mistreatment can lead to maladaptive interactions with others. Individuals expressing NES were less compliant with diet, exercise, blood glucose monitoring, had sleep disturbances, and had more diabetes complications than patients without such night-time snacking habits.

These night-time eating behaviors are modifiable, however depression is associated with relapse of self-care behaviors such as diet, exercise, taking prescribed medications, and smoking cessation. In individuals who are depressed, eating is often in response to the need to control their emotions

These emotional triggers to excessive eating can lead to elevated blood glucose, obesity, and diabetes complications. In individuals identified with NES, the authors recommend further psychological assessment, support, psychotherapy, pharmacotherapy, strategies for coping with emotions, relaxation training, and diabetes education.

Reference

Morse, S. A., Ciechanowski, P. S., Katon, W. J., & Hirsch, I. B. (2006). Isn't This Just Bedtime Snacking? Diabetes Care, 29(8), 1800-1804.