November 2012 Question 3
The authors remark that, "partial sleep deprivation infers prolonged wakefulness, and in addition to physiologic effects on appetite, another cause of increased energy intake may be more time exposure to palatable foods." How would you counsel a client that has a bad habit of nighttime snacking?
posted by Unknown @ 3:25 PM
15 comments
15 Comments:
This is something that we have been dealing with at Proctor with a night eating syndrome client over the past few weeks. We have told him to try and break the cycle of eating at night by putting notes up on his door to remind him not to eat after a certain time. I would also counsel them that they are most likely looking for food to get the seratonin like effects of eating so they can go to sleep. I would promote relaxation techniques, eating a better breakfast and lunch with more mild dinner and a late snack, and encourage sufficient protein intake at night to make a more hearty meal to last. I would also promote regular physical activity so that the person is more relaxed and able to sleep without needing to eat at night.
When talking with patients at the wellness center, I always encouraged them to try and balance meals throughout the day and make sure to include a good protein source at breakfast, lunch, and dinner. I also encouraged a mid-morning and afternoon snack if needed. Educating clients about balancing intake throughout the day and how this can promote satiety at the end of the day is important. This sometimes means educating the patient/client about protein-rich foods and snacks that are nutrient dense.
I would first ask what the client's usual eating schedule is as well as why they feel the need to snack. I would recommend different tactics to a person who eats dinner at 5pm and then feels the need to snack before bed at 11pm due to hunger versus someone who eats a late dinner and just wants to snack. As Nate and Alana mentioned, I would counsel to balance their intake throughout the day and would recommend appropriate late night snacks. An article I referenced before recommends pairing tryptophan–containing foods with carbohydrates to promote better sleep such as half a turkey sandwich or a small bowl of whole–grain, low–sugar cereal. If the client were eating out of habit rather than hunger, I would steer the counseling to ways to distract from mindless eating.
Angela brings up a very good idea about pairing tryptopha containing foods with carbohydrates in order to promote relaxation and sleep. I have not thought of recommending that as a late night snack before to clients but it would make good practical sense and could improve their sleeping habits.
I would not try to cut out the night-time snack necessarily but would focus on making it low-calorie and as nutrient dense as possible. As far as I know, there is nothing inherently wrong with night-time snacking unless these snacks are poor choices and in large portions. So I would focus on how to choose healthy snacks with my client.
If a client had an issue with nighttime snacking I would like to have him/her provide me with a food recall for a few weekdays and well as weekend days. This way I would be able to see what the client’s eating patterns are. Generally nighttime snackers do not eat consistently throughout the day so education in this area would be my first step. I would want to include foods that provide satiety such as fiber or protein rich meals/snacks. Also, I would like to know what the client considers to be a lot of snacking at night because each person’s interpretation of the amount of food consumed may be different.
I also thought Angela's idea of recommending foods with tryptophan as a late night snack would be a good idea. I think that would be an interesting study to see if there was any correlation. Also, Nate's comment about relaxation techniques is something I did not think of that I think could be really effective.
I would tell my client that they can still have snack at night because if I try to take that away, that's all they will want. I would try to counsel them on good nighttime snack options but I would have them ask themselves if they are eating because they are bored or if they are eating because they are really hungry. I think many people eat at night because they have nothing else to do and many times they are sitting in front of the TV where mindless snacking is so common.
I agree with Nate that eating enough protein at night is crucial in order to promote satiety in clients. I also think promoting physical activity is important. It might be nice to suggest exercising at night if the client is bored and finding themselves in front of the TV with their snacks.
The most important thing I would want to find out is why they snack at night. If they are hungry, I would discuss ways to alter meals throughout the day to decrease evening hunger. If they are eating out of habit, I would discuss some ways to break that habit and find some more relaxing, healthy techniques to get into before bedtime.
Amy, I agree that unless nighttime snacking is showing to be a problem in their weight-loss, healthy snacking any time of day isn't necessarily a problem. Helping them choose between nutrient dense and calorie dense foods may be the necessary action.
I agree with Emily and Amy that snacking at night is not always a problem and should not be discouraged for all clients. I would rather a client have a nutrient-dense snack before bed versus waking up in the middle of the night because of hunger and rading the kitchen at 2 AM.
I would suggest that the person try to move their evening meal a little later so that they still feel full later in the evening. Encouraging an afternoon snack to help with having a later meal in the evening and including a balanced meal may help. I would explain the importance of including protein in their meal to prolong satiety. I would also try to find out if the person was eating at night because they were hungry or if they were just bored. Finding the root of why the person eats at night will help to find a solution for decreasing evening snacking.
I think Amy makes an excellent point- there is nothing wrong with nighttime snacking as long as the person needs the calories and they are making good choices. A food recall or diary will help to see what they are eating throughout the day and how many calories they are consuming. All the person may need from you is better choices for snacks.
I agree with several of you who mentioned encouraging physical activity to promote better sleep. Each person may not react the same way, but often any intense activity should be avoided right before bed time. It might be helpful for the client to try a few different times of day to see what works best for them.
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