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ACSM’s Health & Fitness Journal

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Adequate sleep and proper nutrition are essential to maintaining proper physical, mental, emotional, social, occupational, and academic health and wellness. In fact, Healthy People 2020 has identified both nutrition and sleep health as primary health indicators. The goal of the nutrition indicator is to promote health and wellness, as well as reduce chronic disease risk, through the consumption of healthful diets. The sleep health indicator includes improving public knowledge regarding the effects of inadequate sleep on multiple indicators of wellness, including productivity, quality of life, and safety.


Young adults, 18 to 25 years of age, typically require approximately 8 hours of sleep per night to feel well rested and to function optimally throughout the day. Much of what is known about young adult sleep needs is based on research in college students, who often report only getting between 6 and 7 hours of sleep per night (1). These same students face specific and numerous challenges toward getting sufficient sleep, including academic demands, social pressures, technology overload, irregular schedules, and noisy residence halls (10). As college graduates segue into the workforce, many of these challenges still exist. One challenge of particular note is related to shift work, which creates sleep deprivation and workday drowsiness, resulting in higher rates of vehicular and workplace accidents (6,11). Regardless of the context in which young adults spend their days, many naturally go to sleep later at night and get up later in the morning (3). Combining this natural inclination for getting to sleep later with the demands of early wake times required for school and/or work also may contribute to inadequate sleep and increased risk of negative physical and mental health outcomes. The most common negative outcomes include increased risk of mood disorders, decreased ability to fight infection, and increased risk of chronic conditions such as obesity and diabetes (3).


Poor dietary quality also is a risk factor for future chronic diseases including obesity, diabetes, and coronary heart disease (2). Living away from home as a young adult is an important transitional period during which formerly simple decisions and responsibilities such as budgeting, meal planning, and dietary choices become more daunting. As it is, less than 1% of adolescents aged 11 to 19 years, most of whom are living at home, met the five components of a healthy diet score (higher intakes of fruits, vegetables, fish, and fiber-rich whole grains and lower intakes of sodium and sugar-sweetened beverages) and 90% were classified with having a poor diet (12). And looking at the next stage of life, a meta-analysis of five large-scale cohort studies with more than 5,700 participants aged 18 to 39 years reported that only 7% met at least four of the five healthy eating components as set by the American Heart Association (9). Looking specifically at college students, there is a strong tendency to have diets high in solid fats, sodium, and added sugars, while also low in fiber (4). Complicating all of this poor nutrition is that some research has found that poor sleep can decrease the ability to make healthy food choices (7).




Approximately 75% of teens have smart phones (8) and the number of mobile phone apps increases every day. Of the 40,000 plus health-based apps available on the U.S. Apple iTunes® store, more than 50% get downloaded less than 500 times and only five apps make up 15% of all the health-based apps downloaded (5). The willingness of young adults to use their mobile phones makes mobile apps an ideal way to engage them in general, with the promotion of healthy behaviors a prime area to target (13). Although still an emerging area of research, there is some promise (13) related to how technology can enhance traditional behavior change methods.

One of the challenges for practitioners in helping clients change behavior is obtaining accurate information about individual levels of sleep and daily diet composition. Without this critical baseline information, it is difficult to have a conversation about practical changes and/or to show progress. Although there is the ironic twist in that using technology tends to negatively impact sleep and diet, there also are numerous advantages to positively influence both. The following are descriptions of a few powerful and highly rated apps and devices that may be useful in tracking sleep and diet:

  1. SleepBot: SleepBot integrates a smart alarm and sleep cycle tracker. After turning on the app, you place your phone on your mattress and it collects information about your sleep cycles, movements, and noises throughout the night. These data are downloaded and converted into easy to understand graphs, which also can be emailed or texted to anyone designated by the original user. SleepBot also tracks your sleep cycle and helps you to wake up gently and efficiently each morning during your lightest cycle of sleep. No more groggy mornings!
  2. MyFitnessPal: This free exercise and fitness app helps to keep track of daily food and beverage intake and calculates all of your daily nutrients, calories, and vitamins. The app analyzes patterns and identifies the foods that you need to eat more or less of in a given day.
  3. Fitbit: This wearable device tracks food intake, sleep, activity, exercise, and weight. It can sync with a smartphone and monitors long-term progress toward goals for all aspects that it tracks. Progress reports to identify trends, motivational messages to help improve compliance with goals, and connecting with other friends using Fitbit are additional features that round out this particular device.


Today, most young adults highly value their access to daily technology; however, the same priority is not always given to healthy eating and sufficient sleep. The question then becomes, “As a practitioner working with young adults, what can I do with this information to help promote better sleep and healthy eating?” First, practitioners can focus an eye toward using behavior therapy and health promotion strategies to help clients change their behaviors. Information from the mobile apps can be used to identify patterns that compromise health, and practitioners can work together with the clients to problem solve strategies that will fit into their lifestyles. For example, helping clients to focus on food preparation, scheduled meals, and healthy options when eating at restaurants can guide better nutrition. Likewise, using sleep hygiene strategies such as avoiding technology and blue light an hour before bed, engaging in relaxing activities, and finding ways to manage worry often result in better sleep. Finally, when working with a population of young adults who often view themselves as invincible, discussing the importance of healthy eating and adequate sleep as a way of enhancing their health today, and in the future, can help motivate change. This may be even more likely when technology is incorporated into the plan, because this is a method of communication young adults are inherently comfortable with. Ultimately, helping people change their behavior begins with knowledge of what they currently are doing, followed by helping to motivate them to make small changes in their everyday lives.


1. Adams SK, Kisler TS. Sleep quality as a mediator between technology-related sleep quality, depression, and anxiety. Cyberpsychol Behav Soc Netw. 2013;16(1):25–30.

2. Camhi SM, Katzmarzyk PT. Tracking of cardiometabolic risk factor clustering from childhood to adulthood. Int J Pediatr Obes. 2010;5(2):122–9.

3. Hagenauer MH, Perryman JI, Lee TM, Carskadon MA. Adolescent changes in the homeostatic and circadian regulation of sleep. Dev Neurosci. 2009;31(4):276–84.

4. Hirshberg SM, Fernandez PM, Melanson KJ, Dwiggins JL, Dimond ES, Lofgren IE. Dietary sugars predict chronic disease risk factors in college students. Top Clin Nutr. 2011;26:324–34.

5. Patient Apps for Improved Healthcare: From Novelty to Mainstream. October 2013. IMS Institute for Healthcare Infomatics. Parsippany (NJ); 2013. pp. 6–27.

6. Institute of Medicine (US) Committee on Sleep Medicine and Research, Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19960/. doi: 10. 17226/11617.

7. Kruger AK, Reither EN, Peppard PE, Krueger PM, Hale L. Do sleep-deprived adolescents make less-healthy food choices? Br J Nutr. 2014;111(10):1898–904.

8. Lenhart A, Page D. Teens, Social Media & Technology Overview 2015: Smartphones Facilitate Shifts in Communication Landscape for Teens. Pew Research Center; April 2015. http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015/. Accessed January 2017.

9. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4):586–613.

10. Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health. 2010;46(2):124–32.

11. National Center on Sleep Disorders Research and National Highway Traffic Safety Administration Expert Panel on Driver Fatigue and Sleepiness [Internet]. Drowsy Driving and Automobile Crashes. [cited 2017 January 16]. Available from: https://www.healthypeople.gov/2020/tools-resources/evidence-based-resource/drowsy-driving-and-automobile-crashes.

12. Shay CM, Ning H, Daniels SR, Rooks CR, Gidding SS, Lloyd-Jones DM. Status of cardiovascular health in US adolescents: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2005–2010. Circulation. 2013;127(13):1369–76.

13. Zhao J, Freeman B, Li M. Can mobile phone apps influence people’s health behavior change? An evidence review. J Med Internet Res. 2016;18(11):e287.


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