Dietitians in Nutrition Support: DNS Podcast · Hosted by Christina Rollins, RDN

Nourish, Sleep, and Thrive: Balancing Nutrition Support and Circadian Rhythm

·33 min·3 clips

Night shift workers face higher risks of cardiometabolic disease and cancer due to circadian misalignment.

This episode explores the science of chrononutrition and its application to home nutrition support, featuring host Christina Rollins and researcher Dr. Hassan Dashti. Dr. Dashti is an assistant professor at Massachusetts General Hospital and Harvard Medical School whose NIH-funded work focuses on circadian rhythms, sleep, and nutrition. The conversation examines how meal timing interacts with the body's internal clock to influence metabolism and patient outcomes. Circadian rhythms are endogenous 24-hour cycles that regulate processes like metabolism, body temperature, and melatonin secretion. Dr. Dashti explains that metabolism is optimized during daytime hours and attenuated at night, a pattern governed by gene expression. Night shift work is cited as a key example of circadian misalignment, linked to increased risks for cardiometabolic disease, psychiatric disorders, and certain cancers. Food intake acts as an environmental cue that can reset peripheral clocks in metabolic tissues like the liver and pancreas. Eating at night, when metabolism is less efficient, can lead to delayed metabolic processing and issues like hyperglycemia. Research shows that administering parenteral nutrition (PN) concurrently with sleep severely disrupts sleep patterns for home PN consumers. Studies using devices like Fitbits confirm patients experience significant wakefulness after initially falling asleep. A clinical trial demonstrated that reducing the overlap between PN infusion and sleep improved sleep quality for these individuals. The concern for sleep disruption is greater for long-term home PN patients than for short-term hospitalized patients due to the duration of exposure. Potential risks of this disrupted sleep include daytime fatigue, impaired mood, increased napping, and a higher susceptibility to infections due to impaired immunity. Dr. Dashti notes that while overnight PN is known to disrupt sleep, its direct impact on circadian rhythms in home settings is harder to measure. He emphasizes that sleep is often not a top priority for patients newly discharged on home PN, who are more focused on immediate survival concerns. Practical recommendations include educating patients that daytime cyclic PN is a medically appropriate option that may better align with natural rhythms. Clinicians are advised to proactively ask patients about sleep quality and satisfaction, not just duration. For patients with sleep issues, strategies can include adjusting PN volume, reviewing pump equipment for noise, and revising medication schedules, such as for diuretics. The Oley Foundation website offers a free healthy sleep resource with 36 consumer-tested strategies, available in English and Spanish. Dr. Dashti recently received funding to extend his research on sleep disruption to patients receiving enteral nutrition (EN), anticipating similar findings. Emerging chrononutrition research includes studies on dietary countermeasures for night shift workers and clinical trials on daytime cyclic nutrition support in ICU settings. A key takeaway is for dietitians to collaborate with patients to find the best infusion schedule and to consistently monitor sleep as part of comprehensive care. The tone is educational and conversational, translating complex chronobiology into practical clinical advice. This episode would greatly interest dietetics professionals specializing in nutrition support, particularly those managing home PN or EN patients. Listeners seeking broad nutritional guidance without a clinical focus might find the content too specialized.

As heard by us

A practical look at how nutrition support timing can affect sleep, metabolism, and overall health.

It looks at when nutrition support is delivered and why timing matters for sleep, metabolism, and overall health. Christina Rollins introduces the topic, and Dr.

Read the full review in PlayNext →

Why you'd press play

If you want a focused conversation about timing home PN around sleep, start here.

Read the full recommendation in PlayNext →

Listen to the show on

Apple Podcasts Spotify

Play clips from this episode More from Dietitians in Nutrition Support: DNS Podcast