Tools for Practice Outils pour la pratique


#355 – Gobbling up the evidence for turkey dinner


CLINICAL QUESTION
QUESTION CLINIQUE
What is the evidence surrounding turkey in a holiday meal?


BOTTOM LINE
RÉSULTAT FINAL
Please note that this TFP article is in the spirit of the holidays and is intended for fun only. It has not been peer reviewed or certified.

We could find no reliable evidence around sedation from a holiday meal of turkey.  It is unclear if tryptophan changes sleep at all, but according to flawed research, it would take ~1 pound of turkey to reduce time awake after falling asleep by 1 minute.  Really, at this point, evidence is inadequate to say whether there is enough tryptophan in a turkey to make a turkey tired.



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EVIDENCE
DONNÉES PROBANTES
  • Why are some people tired after a holiday turkey meal?
    • No Randomized Controlled Trials (RCTs): Many potential variables including overeating, alcohol consumption, kids waking early, and the rewards/challenges of family gatherings (you know what we mean…).
  • Does eating turkey cause sedation/sleepiness?
    • No RCTs comparing turkey to ham or other protein: research money has been spent on worse questions (see example below).
  • Does tryptophan cause sedation/sleepiness?
    • Systematic review, 18 RCTs in adults.1 Tryptophan doses 0.25-15g 20-30 minutes before bedtime. After 5.5 days:
      • No effect on total sleep time, time to fall asleep, or time asleep while in bed
        • Not dose dependent.
      • Tryptophan decreased time awake after falling asleep by 1.08 minutes.
      • Unreliable: Meta-analyses and interpretation of statistics issues.
        • Example decreased time awake after falling asleep also reported correlation statistic as 81 minutes/gram of tryptophan: that means 20+ hours less time awake/night for 15g dose.
      • Tryptophan content in turkey: 287mg per 100g.2
        • If above authors primary findings/interpretation were real,1 a one pound serving of turkey might improve sleep by 0-1minute.
  • What is the best method to close a stuffed turkey?
    • Veterinarians, with spare-time, made large incisions (neck-to-tail) in 15 turkeys for deboning/stuffing, then randomized to repair with sutures or staples.3 Three “cooking experts” rated the appearance score, post-cooking and suture/staple removal (range 1-5, higher=better): staples: 4.6, sutures 1.3-2.3.
      • Unclear if authors aware of existing body cavity for stuffing a store-bought turkey: perhaps why they needed “cooking experts” to evaluate outcomes.

CONTEXT
CONTEXTE
  • Spending time with in-laws over the holidays, as compared to your own family, alters gut microbiota: specifically a reduction in Ruminococcaceae bacterium, associated with stress and depression.4
  • During holidays, mean weight gain ~1-2pounds.5
    • Potential weight gain does not appear to deter future holiday celebrations.6
  • Time needed to cook turkey dinner: 3+ hours. Time to order pizza: ~30 minutes.


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Author(s)
Auteur(s)
  • Adrienne J Lindblad BSP ACPR PharmD
  • Danielle Perry RN MSc
  • Jennifer Potter MD CCFP
  • Jamie Falk BSc(Pharm) PharmD

1. Sutano CN, Loh WW,Kim JE. Nutr Rev. 2022; 80(2):306-16.

2. US Department of Agriculture. Available at: https://fdc.nal.usda.gov/fdc-app.html#/food-details/171496/nutrients. Accessed on: Dec 11, 2023.

3. Verwilghen D, Busoni V, van Galen G, Wilke M. Vet Record. 2011; 169:685-6.

4. Clercq NC, Frissen MN, Levin E, et al. Human Microbiome J. 2019; 13:100058.

5. Abdulan IM, Popescu G, Mastaleru A, et al. Nutrients. 2023; 15:4201.

6. Yanovski JA, Yanovski SZ, Sovik KN, et al. New Engl J Med. 2000; 342:861-7.

No turkeys responded to request for comment, except the turkeys who wrote this TFP.