Sugar, Alcohol and Your Liver

In my last blog I explained why fatty liver has a new name, MASLD, and why it has far more to do with metabolic health than most people expect. The natural next question is one I hear in clinic all the time: "So what is it in my diet that is doing the damage?"

Some people are convinced it must be sugar. Others quietly worry about the wine. And a quick search online will tell you that what you really need is a liver detox. The honest answer is more nuanced than any of those. No single food is responsible, but some things clearly matter more than others. Let's look at what the evidence shows.

Is Sugar the Problem?
Sugary drinks have the most consistent evidence against them. A 2019 analysis pooled 12 studies involving more than 35,000 people and found that those who drank sugar-sweetened drinks had 39% higher odds of having a fatty liver. The risk rose with the amount: it was 14% higher in people having less than one drink a week, 26% higher at one to six a week, and 53% higher at seven or more.

Studies like these can only show a link, so trials are helpful here. In one six-month trial, 47 adults living with overweight drank a litre a day of either regular cola, milk, diet cola or water. Liver fat rose markedly more in the regular cola group than in any of the others, as did the fat stored around the abdominal organs.

Why drinks in particular? Sugar in liquid form is very easy to consume in large amounts and does little to fill us up. As I described in my last blog, the liver can turn surplus carbohydrate into new fat, and sugary drinks seem to be a particularly efficient way of encouraging it to do so.

Does That Mean All Sugar Is Bad for the Liver?
Not quite, and this is where the headlines tend to go wrong. A meta-analysis of 13 controlled feeding trials in healthy volunteers looked specifically at fructose, the sugar most often blamed. When fructose simply replaced other carbohydrates and total calories stayed the same, there was no effect on liver fat. When it was added on top of the diet as extra calories, in very large amounts, liver fat went up. The authors concluded that the effect may owe more to the excess energy than to the fructose itself.

In other words, context matters. The NHS advises adults to have no more than 30g of free sugars a day, which is roughly seven sugar cubes. Free sugars are those added to food and drinks, plus the sugars in honey, syrups, fruit juices and smoothies. The sugar found naturally in whole fruit, vegetables and milk does not count, and the NHS is clear that we do not need to cut down on these. So, there is no need to fear a piece of fruit. Juice and smoothies are a different matter, and the advice is to keep these to no more than 150ml a day.

The Fat That Surprises People
Sugar gets most of the attention, but saturated fat deserves some too. In a 2018 trial, 38 adults living with overweight were given an extra 1,000 calories a day for three weeks. The extra calories came from saturated fat, unsaturated fat or simple sugars. Liver fat rose in all three groups, but not equally: by 55% with saturated fat, 33% with sugars and 15% with unsaturated fat.

This was a small, short study in which people were deliberately overfed, so it does not tell us what happens on a balanced diet. It does suggest that the type of fat matters to the liver as well as to the heart. The NHS recommends no more than 20g of saturated fat a day for women and 30g for men.

Where Does Alcohol Fit In?

As I mentioned in my last blog, the new terminology recognises that metabolic health and alcohol are not an either/or. Many people have a bit of both, and the evidence suggests that the two do more than simply add together.

A Scottish study published in the BMJ followed more than 9,500 men for a median of 29 years. Among men drinking 15 or more units a week, deaths from liver disease were around three times higher in those of a healthy weight, seven times higher in those who were overweight and almost 19 times higher in those living with obesity, compared with healthy-weight men who did not drink. The researchers concluded that weight and alcohol amplify one another. The study only included men and began in the 1960s, but the pattern is striking.

What about lighter drinking? A Finnish study of more than 8,000 adults with a fatty liver found that 10 to 19g of alcohol a day, roughly one to two and a half UK units, was associated with double the risk of advanced liver disease compared with lifelong non-drinkers. The same study found fewer cardiovascular events among drinkers who had never smoked, which shows how difficult alcohol research can be to interpret. For the liver itself, though, the direction was consistent: the more alcohol, the higher the risk.

So, what does the guidance say? The NHS advises men and women not to regularly drink more than 14 units a week, spread over three or more days. For reference, a 175ml glass of 12% wine is 2.1 units and a 750ml bottle of 13.5% wine is 10 units. NICE asks clinicians to explain the importance of staying within these limits to people with MASLD.

Liver UK notes that if you have MASLD, drinking alcohol can make liver damage worse. It suggests staying within 14 units with two to three alcohol-free days each week, and stopping completely if you have advanced scarring or cirrhosis. European guidelines go a little further and say that people with a fatty liver should be discouraged from drinking alcohol at all.

My reading of this is that 14 units is an upper limit, not a target, and that for liver health less is better. If you have been diagnosed with MASLD, your GP or liver specialist is the right person to advise on what is appropriate for you.

The Bigger Picture
When you put these studies side by side, a pattern emerges. Excess energy matters, whatever its source. Sugary drinks and saturated fat appear to be the least liver-friendly ways of taking in that excess. Alcohol adds to the load, particularly alongside excess weight.

This is why guidelines focus on the overall pattern of eating, not on single nutrients. European guidelines recommend improving diet quality along the lines of a Mediterranean-style pattern, limiting ultra-processed foods that are rich in sugars and saturated fat, and avoiding sugar-sweetened drinks. They also recommend regular physical activity to reduce liver fat.

Body composition is part of the picture too. For people living with overweight, the same guidelines set out targets: a sustained weight loss of 5% or more to reduce liver fat, 7 to 10% to improve inflammation, and 10% or more to improve scarring. For people of a healthy weight who have MASLD, diet and exercise are still recommended to reduce liver fat.

What About a Liver Detox?
It would be lovely if a tea, a juice cleanse or a capsule could undo all of this, but the evidence is simply not there! Liver UK states that no complementary or alternative medicines have been shown to treat or prevent MASLD, and that they can sometimes harm the liver. 

I have written before about why detox diets don't work, and the liver is a very good example. If you have a liver condition, it is always worth talking to your doctor before starting any supplement.

So, What Actually Matters?
Not one villain, but a handful of everyday habits: how often sugary drinks feature, how much saturated fat and ultra-processed food is in the mix, how much alcohol you drink, and whether your overall pattern of eating and moving is supporting your metabolic health. None of this requires perfection, and none of it requires a detox. In my next blog, I will turn all of this into practical top tips.

Need Some Support?
If you have been told you have MASLD, or you are concerned about your liver or your drinking, your GP should always be your first port of call. Alongside that medical care, personalised nutrition and lifestyle support can help you turn general healthy-eating advice into realistic changes that suit your life. Why not book in a free call?

Fatty Liver Has a New Name
What Is MASLD and Why Does It Matter?

Perhaps a routine blood test showed that your liver enzymes were "a bit raised". Or maybe you had a scan for something else entirely and the report mentioned a fatty liver, almost in passing. Many of my clients come to me with this exact story, usually followed by the same puzzled question: "But I hardly drink, so why is my liver fatty?"

That’s a good question, and the answer explains why the condition has recently been given a new name. What used to be called non-alcoholic fatty liver disease, or NAFLD, is now known as metabolic dysfunction-associated steatotic liver disease, or MASLD. It is quite a mouthful (Liver UK helpfully points out that MASLD is said as one word, rhyming with "dazzled"), but the new name tells us far more about what is actually going on.

Why Did the Name Change?
In 2023, liver specialists and patient groups from around the world agreed on a new set of terms. The old name had two problems. Firstly, "non-alcoholic" described the condition by what it was not, rather than by what was driving it. Secondly, most of the people who took part in the consensus process felt that the words "non-alcoholic" and "fatty" carried stigma.

"Steatotic" simply means that fat has built up inside the liver cells. "Metabolic dysfunction" points towards the cause, which lies in how the body handles and stores energy. The more serious, inflamed form of the condition, previously called NASH, is now called MASH.

The UK is following suit. In July 2026, NICE renamed its guideline to use the terms MASLD and MASH, and the NHS website currently uses both the old and new names. So, if you see NAFLD on one letter and MASLD on another, they are describing the same thing.

So, What Exactly Is MASLD?
A healthy liver contains very little fat. MASLD is the term used when excess fat has built up in the liver and there is at least one sign that metabolic health is under strain. Under the international definition there are five of these signs:

• carrying extra weight, particularly around the middle (a waist measurement above 80cm for women or 94cm for men is one of the markers used); 
• raised blood glucose, prediabetes or type 2 diabetes; 
• raised blood pressure; 
• raised triglycerides; 
• and low HDL cholesterol.

If that list looks familiar, that’s because these are the same features we talk about with insulin resistance and heart health, hence the new name.

It is also pretty common. A large review published in 2023 estimated that around 30% of adults worldwide are affected, and the figure was closer to 38% in the most recent studies it included. Liver UK estimates that MASLD affects about one in four adults in the UK, and the NHS notes that many people have it without realising.

"But I Hardly Drink"
Your liver is the body's main processing hub for both fat and sugar, and this is where insulin comes in. When cells become less responsive to insulin, known as insulin resistance, fat tissue releases more fatty acids into the bloodstream and many of these end up in the liver. At the same time, the higher insulin levels that accompany insulin resistance encourage the liver to make new fat of its own from surplus carbohydrate.

That does not mean alcohol is irrelevant. The new classification recognises that metabolic factors and alcohol can both contribute in the same person, and there is now a separate category for exactly that. 

Can You Have MASLD at a Healthy Weight?
Yes. In a large analysis of studies from 24 countries, around 40% of people with the condition were not living with obesity, and almost a fifth were classed as lean. European guidelines note that people of a healthy weight who have MASLD tend to have more insulin resistance, more fat stored around the abdominal organs and less muscle than their peers. Genetics play a part too.

Hormones are relevant too. The NHS lists PMOS (formerly known as PCOS) and being over 50 among the factors that make MASLD more likely. A 2023 analysis of 12 studies found that women who had been through the menopause had around 2.4 times the odds of having a fatty liver compared with women who had not. These were snapshot-style studies, so they cannot prove cause and effect, but for midlife women and those with PMOS it is one more reason to keep an eye on metabolic health.

Why It Is About More Than Your Liver
The NHS describes four stages. Most people only ever have the first, where fat has built up but the liver is not damaged. In a smaller number of people the fat triggers inflammation (MASH), which can lead to scarring (fibrosis) and, eventually, cirrhosis.

The wider picture matters just as much. A meta-analysis of 36 studies involving 5.8 million people found that those with a fatty liver had a 45% higher risk of heart attacks, strokes and other cardiovascular events. Another, covering more than 500,000 people, found just over double the risk of going on to develop type 2 diabetes.

These are observational studies, and researchers are still debating how much of the extra risk comes from the liver itself and how much from the risk factors that travel with it. Either way, cardiovascular disease, rather than liver disease, is the leading cause of death in people with MASLD. That is why a fatty liver deserves to be taken seriously as an early signal about metabolic and heart health.

How Is It Found?
Usually by accident. According to the NHS, MASLD does not usually cause symptoms, although some people notice tiredness, feeling generally unwell or discomfort under the right side of the ribs. It tends to come to light when blood tests or a scan are done for another reason.

It is also worth knowing that normal liver blood tests do not give the all-clear. NICE specifically advises clinicians not to rely on routine liver blood tests to rule the condition out. If your GP suspects MASLD, they will ask about alcohol, check your weight and waist measurement, and may arrange further blood tests or an ultrasound scan. They may also check for scarring, for example with a blood test called the ELF test, which features in NICE guidance.

If you recognise yourself in any of this, or you have type 2 diabetes, PMOS, raised blood pressure or raised cholesterol and have never had your liver checked, it is worth a conversation with your GP.

The Encouraging Part
The NHS is clear that healthy lifestyle changes can reduce the build-up of fat in the liver and help repair damage or stop it getting worse. Unless the condition has progressed, these changes are usually the only treatment needed. Its advice is to eat a healthy, balanced diet, be active for at least 150 minutes a week, lose weight if you are overweight, keep alcohol to no more than 14 units a week and not smoke.

European guidelines add that, for people living with overweight, a sustained weight loss of 5% or more is the target recommended to reduce liver fat. New medicines for more advanced disease are also being assessed for NHS use, and these are a matter for your GP or liver specialist.

What you will not find in any of this guidance is a liver detox, a cleanse or a miracle supplement. What matters is the everyday pattern of how we eat, move and live, and that is exactly what I will be covering in the rest of this month's blogs.

Need Some Support?
If you have been told you have MASLD, or you are concerned about your liver, your GP should always be your first port of call for testing, diagnosis and monitoring. Alongside that medical care, personalised nutrition and lifestyle support can help you turn general healthy-eating advice into realistic changes that suit your life. Why not book in a free call?

Top Tips: 8 Evidence-Based Habits for Better Sleep

If your sleep is not brilliant, you have probably been given plenty of advice already.

Go to bed earlier. Put your phone away. Buy blackout curtains. Stop drinking coffee. Meditate. Take magnesium. Don't eat after 6pm. Get up at 5am. Somehow relax more.

Before long, getting a good night's sleep can start to feel like another full-time job.

The good news is that you do not need a perfect 27-step bedtime routine. Sleep is influenced by what happens throughout the whole day, and some habits appear to matter considerably more than others.

Here are eight evidence-based places to start.

1. Give Your Body Clock Some Regularity

It is tempting to focus entirely on getting eight hours of sleep, but researchers are increasingly interested in another aspect of sleep health: regularity.

Going to sleep and waking at wildly different times from one day to the next can create a mismatch between our behaviour and our internal circadian clock.

A 2025 systematic review involving 59 studies found fairly consistent associations between greater sleep-timing irregularity and poorer cardiometabolic and mental health outcomes. Some large prospective studies have also linked highly irregular sleep with greater mortality risk, even after taking sleep duration into account.

This suggests that sleep health is about more than simply accumulating a certain number of hours.

If you want one practical anchor, focus on your wake-up time. Try to get up at roughly the same time most days rather than continually shifting your schedule backwards and forwards.

2. Get Outside During the Day
Your brain needs clues about what time it is, and light is one of the most powerful signals it receives.

Light reaching the eyes is detected by specialised cells that communicate with the suprachiasmatic nucleus, the brain's central circadian clock. This helps coordinate rhythms in alertness, body temperature, hormone secretion and sleep.

Bright daytime light, particularly earlier in the day, helps reinforce the difference between biological day and night. By contrast, spending much of the day in relatively dim indoor light and then exposing ourselves to bright light late into the evening can blur those signals.

Get outside. Have your morning coffee in the garden. Walk to the station. Take a short walk after breakfast. Step outside during your lunch break.

Outdoor daylight is generally much brighter than normal indoor lighting, even on a cloudy British day. And you gain the added benefits of moving your body at the same time.

3. Move Your Caffeine Earlier
This is one of the changes most worth experimenting with if you struggle to sleep. Caffeine blocks the action of adenosine, one of the chemicals involved in building sleep pressure during the day.

A systematic review and meta-analysis found that caffeine reduced total sleep time by around 45 minutes on average. It also increased the time taken to fall asleep, increased waking during the night and reduced deep sleep.

The researchers estimated that a coffee containing around 107mg caffeine would need to be consumed approximately 8.8 hours before bedtime to avoid reducing total sleep time.

It does not mean everyone needs an 8.8-hour caffeine curfew. Run your own experiment. If you normally have coffee at 3pm, try moving your last caffeinated drink to lunchtime for a couple of weeks and see what happens.

And remember that caffeine can also come from tea, cola, energy drinks, chocolate and pre-workout supplements.

4. Exercise, But Don't Worry Too Much About the Perfect Time
Regular physical activity is one of the most useful lifestyle habits for health generally, and there is good evidence that exercise can also support sleep.

A large 2026 systematic review and meta-analysis included 200 randomised trials involving more than 23,000 adults and found improvements in subjective sleep quality with exercise.

But when should you exercise? For years, people with poor sleep were routinely told not to exercise in the evening. The research is more nuanced.

A new 2026 systematic review comparing morning with evening exercise included 25 studies. Overall, it found no clear advantage of morning over evening exercise for most sleep outcomes. So, if the only time you can exercise is at 6pm, there is probably no need to abandon it because somebody told you all evening exercise is bad for sleep. But if a hard 9pm HIIT class leaves you buzzing at midnight, however, listen to your own response.

The best exercise time is likely to be one that you can maintain and that works with your sleep.

5. Notice What Alcohol Does to Your Sleep
Alcohol can be deceptive. A drink may make you feel relaxed or drowsy, which makes it very easy to conclude that it helps you sleep. But feeling sedated is not the same as having normal, restorative sleep.

A 2025 systematic review and meta-analysis of 27 studies found that alcohol disrupted normal sleep architecture, including delaying REM sleep and reducing the amount of REM sleep. These changes were found even following relatively low amounts of alcohol and became greater as alcohol intake increased. 

If you regularly wake during the night, feel hot or restless, or wake feeling unrefreshed after drinking, try comparing alcohol-free and drinking nights. Your own pattern can be surprisingly revealing.

6. Give Your Evening Meal Time to Settle
Research into chrononutrition, or how food timing interacts with our circadian rhythms, is developing, but there is not yet enough evidence to justify rigid meal-time rules for everyone. Studies of time-restricted eating and sleep have also produced inconsistent findings. 

There are, however, simple practical considerations.

A very large meal immediately before lying down may leave you uncomfortably full and can be problematic if you experience reflux or indigestion. Look at the pattern across your whole day.

If breakfast is tiny, lunch is eaten at your desk and you arrive home ravenous, it is hardly surprising if most of your food ends up being eaten in the evening.

Aim for satisfying meals containing protein, fibre-rich carbohydrate, vegetables and healthy fats, rather than relying on an arbitrary rule such as "no food after 6pm". Just try and finish your meal around 3 hours before going to bed.

7. Create a Wind-Down Signal, Not a Perfect Routine
Your brain cannot necessarily switch instantly from answering emails, watching an exciting television programme or sorting out tomorrow's problems to being ready to sleep.

An evening transition can help. A bit like the bedtime routine that we put together for babies and children. That might mean dimming some lights, having a shower or bath, reading, stretching, listening to music or practising a relaxation exercise, having a cup of sleepy tea.

So, choose an evening routine that feels calming and achievable. You do not need to perform it perfectly for your body to sleep.

8. Know When to Stop Trying to Fix It Yourself
This may be the most important tip of all. If you occasionally have a poor night's sleep, that is normal.

If you have been struggling for months, sleep problems are affecting your ability to function during the day, or you are becoming increasingly anxious about sleep, another supplement or stricter bedtime routine may not be the answer.

It is also important to investigate possible underlying causes. Speak to your GP if persistent sleep problems are affecting daily life. Seek medical assessment if you have symptoms suggesting sleep apnoea, such as loud snoring, pauses in breathing, gasping or choking during sleep, frequent waking or severe daytime tiredness.

Restless legs, pain, menopause symptoms, anxiety, depression, some medications and other medical conditions can also interfere with sleep.

Poor sleep is not always a sign that you are doing bedtime badly.

Start with One Thing
Perhaps the biggest mistake we make with sleep is trying to optimise everything at once.

Instead, choose one change. 

Then give yourself enough time to see whether it actually makes a difference.

Because sleep is not something we can force. Often, the most useful thing we can do is create the conditions that allow our biology to get on with it.

Need Some Support?
Sleep, energy, stress, food and lifestyle habits often overlap. If you are struggling to work out which changes are actually relevant to you, personalised nutrition and lifestyle support can help you look at the bigger picture. Why not book a free health review?

Autumn Chicken, Squash & Chickpea Traybake

This is a simple autumn traybake featuring chicken, butternut squash, chickpeas and seasonal greens – perfect for an easy midweek dinner with plenty of protein, fibre and colourful plants. And bonus - there is not much washing up afterwards!

It also fits nicely with this month’s sleep theme. Chicken, chickpeas, pumpkin seeds and yoghurt are good sources of tryptophan, an essential amino acid used in the pathway that produces serotonin and subsequently melatonin, which is involved in regulating our sleep-wake cycle.

Chicken and chickpeas also provide vitamin B6, which is needed for the conversion of 5-HTP to serotonin. 

This meal also gives you a satisfying combination of protein, fibre-rich carbohydrate, healthy fats and a variety of plant foods, making it a great everyday autumn dinner. Plus, it’s delicious! And perfect for those darker evenings.

Serves 4

Ingredients

• 500g skinless chicken thigh, cut into large chunks
• 600g butternut squash, peeled and cut into chunks
• 1 x 400g tin chickpeas, drained and rinsed
• 1 large red onion, cut into wedges
• 200g cavolo nero or kale, tough stalks removed and roughly chopped
• 2 garlic cloves, finely chopped
• 2 tbsp extra virgin olive oil
• 8 to 10 fresh sage leaves, roughly chopped
• 1 tsp smoked paprika
• Zest and juice of 1 lemon
• 20g pumpkin seeds
• Black pepper

To serve:

• 150g thick Greek yoghurt
• Small handful fresh parsley, finely chopped
• Squeeze of lemon
• Black pepper

Method

• Heat the oven to 200°C fan.
• Place the squash and red onion in a large roasting dish. Add 1 tbsp of the olive oil, half the sage and the smoked paprika. Season with black pepper and toss everything together. Roast for 15 minutes.
• Meanwhile, mix the chicken with the remaining olive oil, garlic, lemon zest and remaining sage.
• Remove the tray from the oven and add the chicken and chickpeas. Toss gently with the vegetables and return to the oven for 20 to 25 minutes, until the chicken is completely cooked through and the squash is tender.
• Add the cavolo nero or kale for the final 5 to 7 minutes, turning it through the vegetables until softened.
• Mix the Greek yoghurt with a squeeze of lemon, parsley and black pepper.
• Squeeze the remaining lemon juice over the traybake, scatter over the pumpkin seeds and serve with a spoonful of lemony yoghurt.
• Enjoy!

Make it even more October
For pudding, try warm cinnamon pears with Greek yoghurt and pumpkin seeds.

Simply slice ripe British pears and poach gently with a splash of water and a pinch of cinnamon until soft. Serve warm with thick Greek yoghurt and a scattering of pumpkin seeds.

And if you're interested in more easy, nutritious recipes, why not head to the Recipe Index to see what else you can cook?

Can What You Eat Really Affect Your Sleep?

Magnesium before bed. Two kiwi fruit. Tart cherry juice. Turkey because it contains tryptophan. No carbs after 6pm.

Social media has no shortage of foods, drinks and supplements promising the perfect night’s sleep.

It is easy to see the appeal. If you are lying awake at 2am, the idea that adding one particular food to your evening routine might solve the problem is often more appealing than hearing that sleep is influenced by a complicated combo of biology, lifestyle, environment and health.

But can what you eat really affect how well you sleep?

The answer is probably yes, but not quite in the way Instagram would have us believe.

Sleep and Diet Influence Each Other
One of the difficulties with sleep research is that the relationship between food and sleep works in both directions.

What we eat may influence sleep, but how well we sleep can also affect what and how much we eat. Experimental research suggests that inadequate sleep can increase energy intake and alter eating behaviour.  Think about the morning after a terrible night’s sleep. You may be more likely to reach for another coffee, crave quick-energy foods, and have less motivation to cook.

So, if people who eat a healthier diet also sleep better, we cannot automatically conclude that the food caused the better sleep. Perhaps people who sleep well also find it easier to eat well, exercise regularly and drink less alcohol.  Often, the relationship probably works both ways.

Does Your Overall Diet Matter?
Increasingly, researchers are looking beyond individual “sleep foods” towards whole dietary patterns. One of the most studied is the Mediterranean diet, characterised by plenty of vegetables, fruit, pulses, wholegrains, nuts, seeds, extra virgin olive oil and fish.

A large 2025 systematic review and meta-analysis brought together 62 studies involving more than 328,000 people. Greater adherence to a Mediterranean-style diet was associated with better sleep duration and sleep quality. That sounds impressive, but there is an important caveat.

Much of this evidence is observational. It shows an association, but it cannot prove that following a Mediterranean diet caused people to sleep better. There was also considerable variation between studies.

Nevertheless, it is interesting that the dietary pattern already associated with wider cardiometabolic health also appears to sit alongside healthier sleep.

What About Tryptophan-Rich Foods?
Tryptophan is one sleep-related nutrient where there is more than just an interesting theory. It is an essential amino acid, meaning that we need to obtain it from food. Sources include eggs, fish, poultry, dairy foods, soy, pulses, nuts, seeds and oats.

Why might it matter? The chemical conversion pathway in the body looks roughly like this:

Tryptophan → 5-HTP → serotonin → melatonin

Tryptophan can be converted into 5-hydroxytryptophan, or 5-HTP, and then into serotonin, a neurotransmitter involved in mood and sleep-wake regulation. Serotonin can subsequently be converted into melatonin, one of the hormones involved in signalling biological night. There is a plausible biological connection between dietary tryptophan and sleep, which has been backed up by evidence.

A systematic review and meta-analysis found that tryptophan supplementation reduced wakefulness after sleep onset, particularly at intakes of 1g or more, although it did not significantly improve every sleep measure studied.

There is less research into tryptophan-rich foods and proteins but it is interesting. Studies of alpha-lactalbumin, a milk protein naturally rich in tryptophan, suggest potential effects on tryptophan availability and aspects of sleep, although trials remain relatively small.

There is one important complication, however. Tryptophan has to cross the blood-brain barrier, and it competes with several other large neutral amino acids for transport. This means that simply eating a huge portion of protein does not necessarily result in large amounts of tryptophan reaching the brain. Researchers therefore sometimes consider the ratio of tryptophan to competing amino acids, rather than tryptophan intake alone.

Where Does Vitamin B6 Fit In?
The pathway also depends on other nutrients. Vitamin B6, in its active form pyridoxal-5'-phosphate, is required for the conversion of 5-HTP into serotonin. The earlier conversion of tryptophan to 5-HTP also depends on other cofactors, including iron and tetrahydrobiopterin. 

This does not mean that everyone with poor sleep needs a vitamin B6 supplement.

Instead, it reinforces a much more useful nutritional message: normal neurotransmitter pathways rely on an adequately nourished body, not on consuming one “magic” sleep nutrient in isolation.

Foods containing vitamin B6 include poultry, fish, potatoes, chickpeas, bananas and fortified cereals, so a varied diet will generally provide multiple nutrients involved in these pathways.

And what about the famous turkey dinner making everyone sleepy?

Turkey contains tryptophan, but so do many other protein foods. The post-Christmas-lunch slump is much more likely to reflect a combination of a large meal, alcohol, time of day and general festive exhaustion than a uniquely sedating effect of turkey.

Does Eating Late Affect Sleep?
Meal timing is another area where social-media certainty has raced ahead of the science.

You may have heard that you should never eat after 6pm or that eating close to bedtime disrupts your body clock.

The emerging field of chrononutrition examines how meal timing interacts with circadian rhythms. It is fascinating but still developing.

There are, however, practical reasons why a very large meal immediately before bed may not suit everyone. Reflux, indigestion and simply feeling overfull can interfere with sleep.

Rather than looking at a specific 6pm cut-off, look at your daily patterns. Aim to finish your evening meal at least 3 hours before going to bed – that way you will have properly digested that meal before lying down for sleep.

Caffeine Probably Matters More Than Most “Sleep Foods”
If we are talking about nutrition and sleep, caffeine deserves considerably more attention than fancy bedtime drinks.

A systematic review and meta-analysis of 24 studies found that caffeine reduced total sleep time by around 45 minutes on average. It also increased the time taken to fall asleep and reduced deep sleep.

Individual sensitivity varies enormously, so there is no perfect caffeine cut-off for everyone. But before spending money on a supplement designed to improve sleep, it is worth asking whether your afternoon coffee, strong tea, energy drink or pre-workout supplement might be quietly working in the opposite direction.

Alcohol: Sleepy Is Not the Same as Sleeping Well
Alcohol is another interesting example because it can make us feel drowsy. That initial sedation can easily be interpreted as better sleep.

However, a 2025 systematic review and meta-analysis found that alcohol altered normal sleep architecture, particularly REM sleep. Changes were detectable even at relatively low alcohol intakes and became more pronounced as intake increased. 

So, although alcohol may make falling asleep feel easier for some people, sedation is not the same as restorative sleep. If you regularly wake during the night or feel unrefreshed in the morning, alcohol is worth considering as part of the picture.

What About Tart Cherry Juice?
Tart cherries contain small amounts of melatonin as well as plant compounds including anthocyanins, which has led to interest in their effects on sleep.

A 2025 systematic review found only seven intervention studies. Some reported improvements in measures such as sleep duration, efficiency or time taken to fall asleep, but studies differed considerably in the people involved, the dose and the length of the intervention. 

So, my verdict would be: Interesting? Yes. Proven sleep remedy? No.

Tart cherry juice is also still fruit juice, so depending on the product and quantity it may provide a meaningful amount of free sugars, so ensure to drink it alongside a protein-containing meal.

Should We All Be Eating Two Kiwi Before Bed?

Kiwi fruit is another favourite of the sleep-hack world. A small study involving 24 adults with self-reported sleep difficulties found improvements after participants ate two kiwifruit an hour before bed for four weeks. 

More recently, a 2026 review examining melatonin-containing foods, including cherries and kiwifruit, found potentially promising effects on sleep quality, duration and efficiency.

But the studies varied considerably in their methods, doses and populations. So, if you like kiwi, enjoy it. It is nutritious and contributes fibre, vitamin C and other plant compounds.  But we are not yet at the point where two kiwis before bed should be prescribed as a treatment for insomnia.

What Should You Eat for Better Sleep?
Probably not a special “sleep diet”.  If we step away from individual superfoods, a much more sensible picture emerges.

Eat adequately through the day and include a variety of protein foods, vegetables, fruit, wholegrains or other fibre-rich carbohydrates, healthy fats, pulses, nuts and seeds. Foods naturally containing tryptophan and the nutrients involved in serotonin metabolism can form part of that pattern without needing to become bedtime prescriptions.

Keep caffeine at a time of day that suits your individual sensitivity. Notice how alcohol affects you. Avoid evening meals that are so large or late that they leave you uncomfortable.

If sleep remains persistently poor, food may be one piece of the puzzle, but it is unlikely to be the whole picture. Stress, light exposure, activity, hormones, pain, medication and medical sleep disorders can all matter too.

Sometimes the best nutrition advice is knowing when nutrition is not the only answer.

If conflicting nutrition advice is leaving you unsure what actually matters, my approach is to look at the evidence, your wider health picture and the changes that are realistic for you. Why not book in a free health review?

Why Am I Tired All Day but Wide Awake at Night?

There is a particularly frustrating kind of tiredness that many of us will recognise – dragging ourselves through the afternoon, relying on coffee or sugar to keep us going, only to find that by the time you get into bed to all of a sudden feel completely alert. Sound familiar? Your body feels exhausted, but your brain seems to have other ideas.

We often blame poor sleep on things like stress, hormones, blood sugar or “high cortisol”. These things could be relevant, but sleep is much more complicated than that. Two major biological systems help determine when we feel sleepy and when we feel awake, and our daily routines can either work with them or work against them.

Tired Is Not Always the Same as Sleepy
Sleep is partly controlled by something called sleep pressure. The longer we are awake, the stronger that pressure generally becomes. One of the chemicals involved is called adenosine, and this builds up during waking hours and contributes to our drive to sleep.

At the same time, we have an internal circadian timing system, often described as our body clock. This produces roughly 24-hour rhythms in sleep and wakefulness, alertness, hormone secretion, body temperature and many other aspects of physiology.

This means you can be physically tired but still receive a strong biological “stay awake” signal at the wrong time. That is one reason spending an exhausted afternoon on the sofa does not necessarily guarantee that you will fall asleep easily at 10pm.

Your Body Clock Needs Time Signals
Our circadian clock does not operate in isolation. It takes cues from the outside world, and light is the most important of these.

Light reaching the eyes helps the brain work out what time of day it is. Bright daytime light, particularly earlier in the day, supports the normal timing of our sleep-wake rhythm, while bright light late in the evening can shift circadian timing later in susceptible people. Therefore spending much of the day indoors in relatively dim light, followed by a brightly lit evening, is almost the opposite of the light pattern our biology evolved around.

A simple starting point is to get outside during daylight hours, particularly earlier in the day when possible. A walk, breakfast outside or a few minutes having a cup of tea in the garden can all provide a clear daytime signal.

Could Caffeine Be Lasting Longer Than You Think?
Coffee can easily become part of a vicious circle. You sleep badly, so you need more caffeine the following day. That caffeine may then make the next night slightly worse, encouraging another coffee-fuelled day.

Caffeine works partly by blocking adenosine receptors, reducing that feeling of sleep pressure. The effect can last much longer than many people realise.

A 2023 systematic review and meta-analysis of 24 studies found that caffeine reduced total sleep time by around 45 minutes on average. It also reduced sleep efficiency, increased the time taken to fall asleep and reduced deep sleep. Based on the studies included, the researchers estimated that a coffee containing around 107mg caffeine would need to be consumed about 8.8 hours before bedtime to avoid reducing total sleep time. 

People metabolise caffeine differently, and the caffeine content of coffee can vary considerably. However, if you regularly struggle to fall asleep, wake often in the night, or don’t feel refreshed in the morning, experimenting with an earlier caffeine cut-off is a sensible place to start.

And remember, caffeine is not only found in coffee. Tea, cola, energy drinks, chocolate and some sports or pre-workout products can all contribute.

Why Alcohol Can Make You Sleepy but Still Disrupt Sleep
A glass of wine may feel relaxing, and alcohol can make people feel drowsy. This sometimes leads to the conclusion that alcohol helps sleep.  Sedation, however, is not the same thing as good-quality sleep!

A systematic review and meta-analysis published in 2025 examined 27 studies and found that alcohol altered normal sleep architecture. In particular, it delayed the onset of REM sleep and reduced the amount of REM sleep. These effects were seen even at relatively low alcohol intakes and became more pronounced as intake increased. 

This may be particularly relevant in midlife, when sleep can already be affected by hot flushes, night sweats, stress or changes in sleep patterns. If your sleep is noticeably worse after drinking, it is worth observing the pattern rather than automatically assuming the problem is simply “hormonal”.

What About Eating Late?
Meal timing and sleep is an interesting area of research, but it is also one where social-media certainty has raced ahead of the evidence.

There are good practical reasons why a very large meal immediately before bed may not suit everyone. Reflux, indigestion, feeling overly full or simply being uncomfortable can interfere with sleep. However, there is not good evidence that everybody needs to stop eating at a particular clock time.

Ideally, we should be looking to finish eating our meal at least 3 hours before we go to sleep. So if bedtime is at 10.30pm, you want to make sure you’ve finished your evening meal by 7.30pm, if you can.

Sometimes Poor Sleep Isn't a Lifestyle Problem
It is easy to turn sleep into another wellness project and assume that if you just find the right routine, supplement or evening drink, you should be able to fix it yourself.

But persistent sleep problems can have many causes.

Menopause and perimenopause are important examples. A 2024 meta-analysis involving 37 studies and more than 29,000 women estimated that around half of women studied during menopause had poor sleep quality, although prevalence varied considerably between studies.

Pain, anxiety and depression, some medications, restless legs syndrome, thyroid problems and obstructive sleep apnoea can also contribute to poor or disrupted sleep.

Sleep apnoea is particularly important not to miss. NHS symptoms include loud snoring, breathing that stops and starts during sleep, gasping or choking noises, frequent waking and marked daytime tiredness. If that sounds familiar, it is worth speaking to your GP. 

Likewise, if you have had insomnia for months, changes to your sleeping habits have not helped, or poor sleep is making daily life difficult, the NHS recommends seeking medical advice. 

For long-term insomnia, cognitive behavioural therapy for insomnia, known as CBT-I, is considered a first-line treatment, rather than simply adding more and more sleep-hygiene rules.

What Can You Do Tonight?
If you are tired all day but wide awake at night, resist the temptation to change everything at once. Start by looking for the patterns that may be sending mixed signals to your sleep-wake system.

Try keeping your wake time reasonably consistent, even after a poor night. Get outside during the day, particularly earlier on if you can. Experiment with moving caffeine earlier and notice whether alcohol affects the quality of your sleep.

Make sure you are eating adequately through the day rather than arriving at the evening ravenous, and give yourself some transition time between a busy day and bed.

Most importantly, do not judge your sleep solely by whether you have performed the perfect bedtime routine.

If poor sleep persists, or you are regularly exhausted despite spending enough time in bed, it is worth looking beyond the obvious. Sometimes the most useful next step is not another supplement or sleep hack, but working out what is actually getting in the way.

Need Some Support?
Sleep, energy, stress, eating patterns and health rarely exist in isolation. If several of these areas are starting to overlap, personalised nutrition and lifestyle support can help you look at the bigger picture and identify realistic changes that work for you. Why not book in a free call?