This is an incredibly common question that my clients approach me with a and one that actually has a great of personal relevance to me.
Let me explain…
I dealt with a fair amount of transient digestive issues in my youth, the vast majority of which I was able to resolve through generally healthier eating and some enhanced vigilance of how certain behaviours impacted my GI tract.
One such behaviour, which with time I learned to be quite detrimental, was my penchant for not allotting sufficient time between my last meal of the day and lying down for bed.
With time I was able to observe with myself that the vast majority of stomach pain I dealt with was largely related to eating too closely to bed time.
While this is a purely anecdotal account, I knew that this was a topic of great value and one that I always wanted to explore more closely.
Now many of my clients, and the public at large, are concerned with the question of the optimal meal-to-bed timing primarily as it concerns to weight management.
That’s obviously not what today’s article is about and I am always happy to let them know there may be much more salient concerns at play when it comes to this topic.
Today’s post takes a closer look at the available evidence surrounding meal-to-bed timing and its potential association with negative digestive health consequences.
The vast majority of studies that have looked at this particular metric have done so in the context of GERD – Gastroesophageal reflux disease.
So let’s take a second to explore what that’s all about.
What Is GERD?
GERD, sometimes also known as acid reflux, is a weakening of the lower esophageal sphincter which increases the likelihood of the stomach contents rising back up into the esophagus.
The esophagus, for those who understandably may not know, is the tube that connects your throat and your stomach.
Recent prevalence estimates suggest that up 1 in 4 North Americans suffer from GERD – this is no small number.
Additionally, the last decade has seen a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30–39 years.
The most common symptom is heartburn, which is a burning sensation in the middle/upper part of your abdomen that could potentially be easily confused with a “stomach ache”.
In 2005, a study by a group of Japanese researchers published in the American Journal Of Gastroenterology was the first to provide some level of evidence that those who had a shorter interval between dinner and bed-time (3 hours or less) had a higher risk of suffering from GERD symptoms.
Since then, a pair of studies published looking at the same metrics have come to similar conclusions.
a 2007 paper out of the American Journal Of Gastroenterology
a 2013 paper out of the Journal of Gastroenterology and Hepatology
Why Is Lying Down Before Bed Bad For GERD?
“[M]any of the physiologic changes that occur with sleep favor the development of GERD. These changes include… [a] marked decrease in acid clearance owing to loss of gravitational effects in the supine position…”
Nicholas Diamant MD Motility Online 2006
In other words, when you are upright gravity and your digestive system are both pushing in the same direction, when you lie down, the aren’t.
For some, this could be a much larger issue if there is a large amount of food sitting in your stomach or upper GI tract ( ie: when you eat right before bed).
Are you one of those people? A closer examination of your symptoms and habits will help you to find out.
Long-Term Consequences Of Eating Before Bed
A 2016 study out of the Medicine ( Baltimore) journal found that eating too close to bed ( <3 hours) and being sedentary after dinner ( ie: not going for a walk) were independently and synergistically linked to an increase in gastric cancer risk, especially among people over the age of 55.
And while this particular topic area is not necessarily flooded with studies and evidence, I think I’ve presented a reasonable enough case that the length of your dinner-to-bed window is at least worthy of your thought and consideration.
The goal of today’s article is to encourage you guys to think more closely about your eating habits as they relate to how quickly to proceed to lying down or going to sleep and whether or not that may be causing you stomach pain.
From a practice perspective, I know that increased awareness around this issue has made an immense difference in my quality of life, and that of my clients as well.
If you are diagnosed with GERD or dealing with transient/unidentified stomach pain upon waking, you may benefit from increasing the window of time between your last bite and bed/nap time.
Three hours may be unrealistic or excessive for most people, but that does not mean you can’t extend that window within your practical limitations.
Until next time,
Andy De Santis RD MPH