Nutritional-medicine researcher Dr. Marie-Pierre St-Onge of Columbia studies the bidirectional relationship between sleep and food. She lays out her lab's causal work: in a controlled crossover study, severe sleep restriction (~4 hours for five nights) raised ghrelin in men and lowered the satiety hormone GLP-1 in women, drove ~300 extra calories of intake, and upregulated brain reward centers — yet left cortisol, glucose, and insulin unchanged. A follow-up of milder, sustained restriction (six weeks at ~6 hours) did raise insulin resistance and blood pressure, worse in post-menopausal women, implicating free-living food choices and reduced spontaneous activity rather than sleep alone. On the reverse arrow, diets closer to the Mediterranean and DASH patterns predicted better sleep and less insomnia, while higher fiber correlated with more deep sleep, saturated fat with less, and refined carbs/sugar with more arousals. St-Onge recommends eating earlier (most calories in the first two-thirds of the day, last meal ~3 hours before bed) for both sleep and cardiometabolic health, and reviews her functional-foods work (a null kefir-cholesterol study, coffee mannooligosaccharides that aided weight loss only in men, ginger and MCT oil raising the thermic effect of food). The conversation closes on the seed-oil debate, plant- vs animal-based diets, the portfolio diet matching a statin for cholesterol reduction, and a defense of industry-funded nutrition research alongside the difficulty of publishing null results.
St-Onge describes her first NIH-funded controlled crossover study: severe sleep restriction raised the hunger hormone ghrelin in men and lowered the satiety hormone GLP-1 in women, drove ~300 extra calories, and upregulated brain reward centers.
In severe five-night restriction, cortisol, glucose, and insulin were unchanged; a follow-up six-week mild restriction study did raise insulin resistance and blood pressure (worse in post-menopausal women), suggesting metabolic harm in the real world comes from compounded food choices and inactivity.
Metabolic-chamber work showed energy expenditure rises ~5% (~90 calories) during sleep restriction because staying awake is energetically costly, while reduced spontaneous daytime activity in free-living conditions tips the balance toward weight gain.
St-Onge's cohort and inpatient work links Mediterranean- and DASH-aligned diets to better sleep and less insomnia, and finds higher fiber predicts more deep sleep, saturated fat less, and refined carbs/sugar more arousals.
St-Onge recommends eating earlier — last meal ~3 hours before bed, most calories in the first two-thirds of the day — for cardiometabolic health, citing reduced fat oxidation with later meals; she also gives napping guidance (short, early).
Women sleep slightly longer but report worse sleep and more insomnia and are more metabolically sensitive to poor sleep; St-Onge urges open-ended sleep questions from clinicians and outlines apnea detection (testing) and treatment (weight loss, CPAP).
St-Onge walks through her functional-foods research: a null kefir-cholesterol study, coffee mannooligosaccharides that aided weight loss only in men, ginger raising the thermic effect of food via the capsaicin receptor, and MCT oil raising thermogenesis and aiding fat loss.
Discussion of the portfolio diet matching a statin for cholesterol reduction, the case for plant-based volume plus moderate animal protein for satiety and heart health, and a nuanced take on seed oils (smoke points, processing) where St-Onge favors any liquid oil.
St-Onge defends industry-sponsored nutrition research as honestly conducted with publication rights protected by contract, and both discuss the field-wide difficulty of publishing null results and the need for more NIH nutrition funding.
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