International Circulation: You have shown a link between length of sleep and obesity. Could review the mechanisms behind obesity in sleep-deprived populations?
Dr. Jean-Philippe Chaput: We know that lack of sleep can lead to weight gain via an increase in food intake. Firstly， people eat more because they feel hungrier when they sleep less. There are many changes in key appetite hormones， like an increase in ghrelin levels (an appetite stimulating hormone)， decrease in leptin levels， and an increase in the stress hormone cortisol. All of those changes trigger hunger. Also， people eat more when they sleep less because they have more time and thus increased opportunities for eating. For example， if you sleep four hours per night， you will be awake for 20 hours and will be likely to snack and over-eat. On the other side of the energy balance equation， in terms of energy expended， people feel more tired， have increased fatigue， and are less likely to go to the gym， exercise， or engage in physical activity. All together， lack of sleep， increased food intake， and decreased physical activity creates a positive caloric balance and weight gain over time.
《国际循环》：您向我们解释了睡眠和肥胖之间的关联度。睡眠不足的人群会肥胖，您能给我们评论一下这背后的作用机制吗?
Jean-Philippe Chaput博士：我们知道，睡眠不足的人会通过增加食物的摄入量而导致体重增加。首先，因为他们睡得少，就会觉得饿，因此吃得更多。有许多食欲变化的关键激素，如增加胃饥饿素(一种食欲刺激激素)，瘦蛋白的分泌水平下降，就会增加皮质醇激素的应激性，所有这些改变都会触发饥饿。同时，当人们睡得少，他们就会有更多的时间，从而增加吃的机会，就会吃的更多。例如，如果你每晚睡四个小时，你会醒着20小时，就可能吃零食和暴饮暴食。在能量平衡方程的另一边，能源消耗的越多，人们就会感觉更累，增加了疲劳度，人们就不太可能去健身房锻炼，运动，或者从事体力活动。总之，睡眠不足，就会增加食物的摄入量，并减少身体活动，从而导致了绝对的热量平衡和体重增加。
International Circulation: Could you please explain the concept of “dis-inhibited eating behavior”?
Dr. Jean-Philippe Chaput: We use a questionnaire called the “Three-Factor Eating Questionnaire” which was developed many years ago by Stunkard and Messick. This questionnaire covers three eating behaviors， though I focused on one: disinhibition. This is overeating in response to an external stimulus. For example， if you eat more while watching sports with your friends then you have a high disinhibiting behavior. If you have a high disinhibition eating behavior and are a short sleeper， you are more likely to eat more and gain weight over time. If you are a short sleeper， you have a low disinhibiting behavior. This means that not all short sleepers gain more wait. We need to better characterize our population of short sleepers. Some of them eat more and gain weight， others do not， but those with predisposition towards disinhibitive eating， then yes， obesity is a problem.
《国际循环》：你能解释一下“去抑制饮食行为” 的概念吗?
Jean-Philippe Chaput博士：我们使用一个叫做“三因子饮食问卷”的问卷调查，这是十多年前Stunkard和Messick开发的。这个问卷包括三种饮食行为，虽然我只专注于一个:去抑制。这是因为外部刺激而导致饮食过量的反应。例如，如果你和你的朋友看体育节目，你吃得更多，那么你就有一个高的放纵行为。如果你有一个较高的去抑制饮食行为并且是个睡眠不足者，随着时间的流逝，你就有可能吃的更多，体重也会增加。如果你是一个睡眠不足者，而你有一个较低的放纵行为。这意味着，并非所有的睡眠不足者都会增加体重。我们需要更好地定义我们的睡眠不足人群。他们中的一些人吃更多的而增加体重，而另外一些则不会，但是对于那些倾向于低抑制饮食的人，那么，是的，肥胖是一个问题。
International Circulation: If you are short sleeper and you have a low disinhibitive eating behavior， should you be worried?
Dr. Jean-Philippe Chaput: Much less， I would say. Again， it is not one-size-fits-all and all short sleepers will be different. We are all exposed to the modern， toxic environment with unlimited access to cheap， highly palatable， energy dense food. If you are a short-sleeper and can resist these temptations， you will be fine. However， many short sleepers do not do this.
《国际循环》：如果你是睡眠不足者并且你有一个低的去抑制饮食行为，那么你应该担心吗?
Jean-Philippe Chaput博士：我想说的是，这种担心少多了。并且，这不是放之四海而皆准的，所有的睡眠不足者情况都是不同的。我们都生活在现代，面临有毒环境，被不计其数的便宜而又特别美味的，高能量的食品所包围。如果你是一个睡眠不足者并能抵抗这些诱惑，你就会没事的。然而，许多睡眠不足者却做不到。
International Circulation: If have a patient who sleeps 4-5 hours a night and is not obese， what kind of advice would you have for them?
Dr. Jean-Philippe Chaput: Good sleeping habits are good for overall health. We talked about obesity today， but this is just one aspect. We should promote sleep for all of the benefits of sleep. This is the same for physical activity. These are all in the package for good health. It does not just prevent chronic disease， but will also， by sleeping well， our overall well being improves. We have to address the barriers or root causes of this problem. These vary per person， some work too much， others watch television into the night， still others can drink too much coffee. For some people， it will be difficult to change but simply telling people to sleep more will not work. That is the same with physical activity. Telling people to move more or eat less is impossible， people are free to do what they want. However， if we report that lack of sleep is poor for health and we can make a couple of lifestyle changes， then we will see improvement. My best advice is to be more active. By being more active， your sleep quality and quantity will improve. I would start with physical activity.
《国际循环》：如果你有一个病人，每晚只能睡4– 5个小时，并且他并不肥胖，你会给他们什么样的建议?
Jean-Philippe Chaput博士：良好的睡眠习惯有益于身心的整体健康。今天我们谈论肥胖，但是这仅仅是健康的一个方面。为了享有良好睡眠的益处，我们应该促进睡眠。体能活动亦是相同的。这些都是身体健康所必须的。保证身体的健康，不只是预防慢性疾病，而且也要通过保持好的睡眠来改善我们的总体福祉。我们要清楚地了解产生这些问题的壁垒或根源。这些人，每个人的情况均有不同，一些工作疲劳过度，其他人看电视到深夜，还有一些人可以喝了太多的咖啡。对于一些人来说，只是简单地告诉他们要增加睡眠，不要工作过度，是很难使他们改变的。体能活动也是一样。告诉人们多运动，或者是少吃，也是不可能的，人们可以自由地做他们想要做的事情。然而，如果我们报告称，缺乏睡眠不利于健康，我们可以通过改变几个生活方式而达到健康的目的，那么我们将会看到人们具有明显改进。我最好的建议就是要生活的更加活跃。更加活跃，你的睡眠质量和数量将会提高。我也将开始体能活动。
International Circulation: Have we seen effects of sleep quality and quantity on conditions other than obesity or weight gain? Especially when it comes to heart factors， what have we seen?
Dr. Jean-Philippe Chaput: Short sleep duration and poor sleep quality are associated with an increased risk of type 2 diabetes， an increased risk of CVD， and mortality. People die younger when they sleep less.
《国际循环》：睡眠的质量和数量除了会引起肥胖或体重增加外对身体还有哪些影响?尤其是当涉及到心脏的影响因素时，我们看到了哪些问题?
Jean-Philippe Chaput博士：短睡眠持续的时间和糟糕的睡眠质量增加了2型糖尿病和心血管疾病的风险，并且提高了死亡率。如果一个人睡的越少，那么他们的寿命越短。
International Circulation: If I am generally healthy， exercise frequently， but lack sleep， do I still need to make a change?
Dr. Jean-Philippe Chaput: It is one factor among many. Health is about eating well， moving， sleeping well， managing stress， not smoking， etc. Of course we are not perfect， we all have bad habits. Overall， if need to aim for more good habits than bad. For some people， they have bad genes. Bad genes， plus bad environment can lead to poor results. Sleep should be part of the health care package， but again it is only one factor. One thing is not more important others. If it is not possible to change your sleep patterns， but you eat well and exercise， you should be fine.
《国际循环》：如果我通常身体健康，运动也很频繁，但是缺乏睡眠，我在生活习惯上是否还需要做出改变?
Jean-Philippe Chaput博士：这是健康的诸多的影响因素之一。健康是关于吃好，睡好，运动，调整压力，不吸烟等等。当然，我们人无完人，我们都有不好的习惯。总的来说，相比坏习惯，我们更需要向好的习惯看齐。对于一些人来说，他们先天不足。不良的基因，加上恶劣的环境可以导致糟糕的结果。 睡眠应该是关爱身体健康的一部分，但是，这也仅仅是其中一个影响因素。这件事和许多其他因素一样，同等重要。如果你不可能改变你的睡眠模式，但是你可以合理饮食并且积极锻炼，那么你应该是健康的。
[下一页] [1] [2] [3]