Diabetics are no strangers to being told what they can and cannot eat. After all, diabetes can be boiled down to a constant struggle to keep one’s blood sugar in check, and the foods that we eat form a very large part of this equation. This often means that diabetics cannot enjoy many of the foods that they like to eat, or at least not without guilt or the need to carefully monitor their insulin and blood glucose levels as a result.
Don’t worry, we come bearing good news – when it comes to snacking before bedtime, a favored indulgence of many, the science might be on your side. There are several factors that appear to suggest that incorporating healthy snacks into your bedtime routine may be of use to some diabetics in controlling their blood glucose levels overnight and the following morning. Read on to see why you might consider speaking to your doctor about including a bedtime snack in your daily routine.
Overnight Glucose Highs and Lows
Rather than simply “turning off” for eight hours when we sleep, our bodies and brains undergo many restorative processes that involve an interplay of metabolic, cognitive, and endocrine factors. In an ideal setting, these processes follow patterns throughout the night that allow us to wake feeling energized and prepared to meet the demands of the day.
One such pattern that is relevant for our discussion describes modulations in our blood sugar levels throughout the night – even in non-diabetic individuals. Generally, blood sugar drops off throughout the early and middle segments of our sleep, before switching gears and ramping up gradually in the early morning, culminating in a peak around the time we wake.
The decline in blood sugar throughout the night is unsurprising, as one would expect blood sugar to drop as the time in a fasted state increases. Less intuitive, though, is the sudden increase in blood sugar that begins typically around 3:00 AM and continues steadily until around 8:00 AM, when most of us wake. This uptick in blood sugar is caused by the dawn phenomenon, or dawn effect, which results from the interaction of several hormones, such as adrenaline and cortisol, that are secreted at certain points in our sleep. These hormones induce the release of glucose from the liver into the bloodstream in order to provide our bodies with useful energy to start the day.
Though not usually a problem for non-diabetics, this pattern can cause hypo- and hyper glycemic episodes during the night for diabetics. Because diabetics’ bodies are less able to regulate blood sugar levels, their blood glucose is more likely to drop excessively low at night. In response, the body will then trigger a rebound-effect, where it releases an excessive amount of glucose from the liver to counter the deficit. This wide variation is difficult for the body to deal with, especially since it cannot produce or adequately respond to its own supply of insulin to remove the spike in glucose from the bloodstream.
Having our blood sugar levels regularly fall outside of a healthy range is problematic for our long term health but can also disrupt the quality of our sleep in the short term. Thus, addressing blood sugar while we sleep is an important part of a holistic diabetes management plan.
Benefits of Eating Before Bed
Having established the problem of nighttime glucose instability, it’s time to explore the potentially helpful role of eating before bed. Several mechanisms exist that might explain how bedtime snacking can generally improve your glucose control.
Avoiding hyperglycemic rebound
Earlier, we discussed how mid-sleep blood sugar lows can exacerbate the dawn phenomenon, spiking blood sugar into hyperglycemic territory later in the morning. One way to pre-empt all of this is to avoid the hypoglycemia in the first place.
Eating a strategic snack at night can trigger just enough of a glucose release to avoid dipping too low overnight. However, this requires finding the correct formula of which foods to eat, and when. Later, we will discuss how to pick foods that are mot likely to stabilize your blood sugar.
Improved appetite control
Many people enjoy a bedtime snack because they otherwise fall asleep feeling hungry. Sleeping on an empty stomach can be uncomfortable for some people, so much so that it can cause disruptions to their sleep. In turn, disrupted sleep can interfere with the regulation of several hormones involved in suppressing appetite throughout the day (leptin and ghrelin, we’re looking at you).
This means that falling asleep hungry can lead to a vicious circle of hunger that will make you more vulnerable to overeating during the day and decreasing your adherence to a diabetes-appropriate diet. So, if eating before bed helps you sleep more soundly, then bedtime snacks may be advisable. However, if you’re feeling hungry before bed, consider that you might not be eating enough during the day, and that eating large portions for your other meals could also address this issue.
Should Everyone Eat Before Bed?
Simply put, it depends. Differing physiologies mean that not every diabetic will have the same needs, and a given patient’s overnight blood sugar levels may or may not need any further intervention. If yours are already in check, then there’s no need to change course. If, however, they are swinging in and out of a healthy range while you sleep, then a bedtime snack may be part of the solution. Therefore, the first step in answering this question is to properly sample your own blood sugar throughout the night to establish a baseline. This will help inform you and your doctor when adjusting your dietary strategy.
Also, bear in mind that any dietary approach will have pros and cons. Eating before bed may be helpful from a diabetes management perspective, but some evidence suggests that it might also impair the overall restfulness and quality of your sleep. Some theorize that late-night meals force your body to divert resources to the digestion process, which distracts it from the process of restoring your brain and body to their full function for the following day. This is not to say that you should or should not engage in bedtime snacking, rather, you should be aware that any dietary choice will involve some form of trade-off that you should consider in your decision-making process. Consulting a doctor or dietician can help you navigate this decision-making process from a place of expertise.
What Makes a Good Snack?
So, you and your doctor and/or dietitian have decided that incorporating a bedtime snack into your daily routine might be a good idea. The next question is – what should you eat? In other words, what factors should you consider when picking a snack to optimize your chances of successfully keeping your glucose within a healthy range overnight?
Timing
Picking the right foods is important, but it’s not he whole story. Other factors, like when you eat a snack in relation to your bedtime, can also influence how effective that snack might be at stabilizing your blood sugar.
Having your snack too early may negate some of the benefits, as the corresponding increase in blood sugar may drop off by the time it would otherwise be useful. In contrast, eating too late can impair your ability to digest the food fully and have the carbohydrates released into your bloodstream by the time you get into bed. The goal is to find the sweet spot between these two extremes.
Of course, the ideal timing will also depend on what you’re eating. Some foods are digested relatively quickly, while others are more of a slow burn. The correct timing will probably vary from person to person and might require a bit of trial and error to get right. You may need to monitor your blood sugar throughout the night until you get the proper snack routine dialed in.
Choosing carbs wisely
Some snacks may be good, but not all snacks are created equal. Foods that are high in simple carbohydrates like refined sugars are liable to cause a quick spike in blood sugar rather than a sustained release overnight. Complex carbohydrates, found in starchy or fibrous foods, are more likely to have this effect. Opting for whole grains or starchy vegetables can help in this regard.
Choosing the right carbs is important, but so is making sure they are paired effectively with fats and proteins. Unaccompanied carbohydrates are colloquially referred to as “naked” carbs, because the lack of accompanying macro-nutrients affects their digestion. Naked carbs are typically digested quickly, leading to rapid releases of sugars into the bloodstream. To smooth the digestion of carbohydrates, try pairing carbs with nuts, eggs, or other healthy sources of fats and proteins.
Portion size
Don’t forget that a snack is not a meal; portion size matters. Start with a conservative amount of food and only increase from there if that amount is not meeting your needs. Eating too much before bed can cause a counter-productive spike in blood sugar that will cause a different set of issues.
Also, make sure that you are factoring in your nightly snacks when considering your other meals throughout the day. If you add a bedtime snack without cutting calories elsewhere during the day, then you might start to gain weight. Given that obesity can reduce positive outcomes for diabetes, this is an important factor to consider.
Recipes and Ideas
Parfait perfection
A yogurt parfait is a quick, easy, and tasty treat to prepare before bedtime. Many brands offer low-sugar Greek yogurts that are high in protein and fat, but make sure you read the nutritional contents of whichever brand you choose and portion accordingly.
Choosing a low-sugar yogurt base allows you to add a sprinkle of your preferred toppings for a kick of sweetness. Dried fruits, berries, and nuts are some of our favorites, as they add a nice flavor without being too sweet and pack a ton of healthy micronutrients and vitamins as a bonus. Add a dash of cinnamon for some extra flavor -yum!