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Abdollahi AM, Li X, Merikanto I, Vepsäläinen H, Lehto R, Rahkola J, Nissinen K, Kanerva N, Roos E, Erkkola M. A tendency toward evening chronotype associates with less healthy diet among preschoolers: cross-sectional findings from the DAGIS study. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae026. [PMID: 38737796 PMCID: PMC11085840 DOI: 10.1093/sleepadvances/zpae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 04/12/2024] [Indexed: 05/14/2024]
Abstract
Study Objectives Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but little is known about these associations in younger children. The objective of the study was to (1) identify and compare individual chronotype tendencies among preschool-aged children and (2) investigate associations of sleep dimensions and chronotype with diet. Methods Participants were 636 3-6 years old (mean ± SD age: 4.74 ± 0.89 years, 49% girls) preschoolers from the cross-sectional Increased Health and Well-Being in Preschoolers (DAGIS) study in Finland. Sleep duration, sleep variability (in duration and midpoint), social jetlag, and midsleep on weekends adjusted for sleep debt (MSWEadj) were measured with 7-day actigraphy. Morning, intermediate, and evening chronotype tendencies were defined based on the lowest and highest 10th percentile cutoffs of MSWEadj. Food, energy, and macronutrient intake were assessed from 3-day records. Associations between sleep dimensions and diet were assessed with regression models. Results MSWEadj was 1:13 ± 14 minutes for morning (n = 64), 2:25 ± 28 minutes for intermediate (n = 560), and 3:38 ± 15 minutes for evening (n = 64) chronotype tendency. Children with an evening chronotype tendency had greater social jetlag and sleep variability. Having an evening chronotype tendency was associated with higher added sugar, higher sugary food consumption, and lower vegetable consumption compared to intermediate tendency types. A later chronotype (MSWEadj) was associated with higher sugary food consumption, as well as lower vegetable and fiber intake. Sleep duration, social jetlag, and sleep variability were not associated with diet. Conclusions Several less healthy sleep and diet behaviors were observed among children with later chronotypes. Future public health interventions aimed towards children would benefit from taking into account chronotype.
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Affiliation(s)
- Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Ilona Merikanto
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Reetta Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Folkhälsan, Helsinki, Finland
| | - Jenna Rahkola
- Folkhälsan Research Center, Folkhälsan, Helsinki, Finland
| | - Kaija Nissinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- School of Food and Agriculture, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Noora Kanerva
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Folkhälsan, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Fernandez-Mendoza J, Calhoun SL, Bixler EO. Edward O. Bixler, PhD: from the Apollo project and chimpanzees to sleep epidemiology. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae020. [PMID: 38562675 PMCID: PMC10983785 DOI: 10.1093/sleepadvances/zpae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/26/2024] [Indexed: 04/04/2024]
Abstract
What an honor to write about Dr. Edward O. Bixler's contributions to the sleep field. In 1967, Dr. Bixler published a case report on a chimpanzee with implanted brain electrodes while working at an Air Force base in New Mexico. A few years later, in 1971, he published on the sleep effects of flurazepam in individuals with insomnia together with Dr. Anthony Kales, data that he had collected when the Sleep Research & Treatment Center (SRTC) was housed at the University of California Los Angeles. Dr. Bixler, a meticulous scientist, learned from Dr. Kales, a devoted clinician, to study "the whole patient, and all aspects of sleep," a legacy that continued when the SRTC moved to Penn State in Hershey. Indeed, Dr. Bixler's tenure at Penn State from 1971 until 2019 kept the science of the SRTC focused on that premise and helped translate scientific evidence into clinical care. He not only contributed early to the pharmacology of sleep and the effects of hypnotics, but he was also a pioneer in "sleep epidemiology." His "Prevalence of sleep disorders in the Los Angeles metropolitan area" study of 1979 was the first rigorous epidemiological study on sleep disturbances. Starting in 1990, he established the Penn State Adult Cohort to estimate the prevalence and natural history of sleep-disordered breathing and other sleep disorders in adults. Inspired by life-course epidemiology, he established in 2001 the Penn State Child Cohort to estimate the same phenomena in children. This Living Legend paper captures and highlights Dr. Bixler's enduring legacy to sleep science.
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Affiliation(s)
- Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Sleep Research & Treatment Center, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research & Treatment Center, Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA
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3
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Malheiros LE, da Costa BG, Lopes MV, Martins da Costa R, Chaput JP, Silva KS. Association of sleep timing and sleep variability with health-related outcomes in a sample of Brazilian adolescents. Behav Sleep Med 2024; 22:129-139. [PMID: 37154038 DOI: 10.1080/15402002.2023.2207699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES This cross-sectional study aimed to examine the relationships of sleep timing and sleep variability with depressive symptoms, health-related quality of life (HRQoL), daytime sleepiness, and body mass index (BMI) in adolescents. METHODS Adolescents from three schools (n = 571, 56% female, 16.3 ± 1.0 years) had their sleep examined by actigraphy, their anthropometrics assessed, and answered a survey. Sleep timing was examined by combining groups of median-dichotomized onset and wakeup times (early onset and early wakeup; early onset and late wakeup; later onset and early wakeup; later onset and later wakeup); sleep variability was based on within-participant standard deviations of onset and wakeup; and sleep duration as the length of time between onset and wakeup. The sleep variables were separated for weekdays and weekend. Mixed linear models were fitted to compare each sleep variable with health-related outcomes. RESULTS Higher values of daytime sleepiness were observed in adolescents from the late-early and late-late timing group during the week. Greater sleep midpoint and wakeup variability on weekdays were related with higher daytime sleepiness. Adolescents in the late-late and early-late groups showed higher daytime sleepiness. Increased of all sleep variability variables was related with greater daytime sleepiness. Higher depressive symptoms scores were found among adolescents in the late-early subgroup and with the increase of sleep variability. Participants with greater sleep onset variability and sleep midpoint variability reported less HRQoL. CONCLUSIONS Not only sleep duration, but sleep timing and variability also relate to health outcomes, and should be addressed by policies and interventions among adolescents.
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Affiliation(s)
- Luís Ea Malheiros
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Bruno Gg da Costa
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
- School of Physical and Health Education, Nipissing University, North Bay, Canada
| | - Marcus Vv Lopes
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Rafael Martins da Costa
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kelly S Silva
- Núcleo de Pesquisa em Atividade Física e Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Gale EL, James Williams A, Cecil JE. The relationship between multiple sleep dimensions and obesity in adolescents: A systematic review. Sleep Med Rev 2024; 73:101875. [PMID: 38029462 DOI: 10.1016/j.smrv.2023.101875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
Sleep is an involuntary behaviour, biologically fundamental to survival and wellbeing. However, sleep is increasingly neglected, with significant health implications. Recent research has identified associations between sleep duration, quality, timing and risk of overweight/obesity in children and adults. The aim of this review was to systematically identify and examine research that investigates the relationships between multiple objective and subjective sleep outcomes and objective adiposity measures in adolescents. A systematic review of literature, published to December 2022, was conducted using ten bibliographic databases. Search terms included objective and subjective sleep/circadian rhythm outcomes, objective adiposity measurements, and adolescents aged 8-18 years. Eighty-nine studies were included in the final review. Sleep outcomes were synthesized into three sleep domains: pre-sleep, during sleep and post-sleep outcomes. In summary, pre-sleep outcomes (including poor sleep hygiene, later chronotype and increased variability and later sleep timings) and increased sleep disturbance are consistently significantly associated with increased obesity and adiposity in adolescents. The relationship between during-sleep outcomes (sleep quality and efficiency) with adiposity and obesity measures was mixed. These findings suggest that adapting an individual's schedule to best suit chronotype preference and improving sleep hygiene, including a consistent bedtime routine, could reduce adiposity and obesity in adolescents.
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Affiliation(s)
- Emma Louise Gale
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews, KY16 9TF, UK.
| | - Andrew James Williams
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews, KY16 9TF, UK
| | - Joanne E Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews, KY16 9TF, UK
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Morales-Ghinaglia N, He F, Calhoun SL, Vgontzas AN, Liao J, Liao D, Bixler EO, Fernandez-Mendoza J. Circadian misalignment impacts the association of visceral adiposity with metabolic syndrome in adolescents. Sleep 2024; 47:zsad262. [PMID: 37792965 PMCID: PMC10782492 DOI: 10.1093/sleep/zsad262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/08/2023] [Indexed: 10/06/2023] Open
Abstract
STUDY OBJECTIVES Although insufficient sleep is a risk factor for metabolic syndrome (MetS), the circadian timing of sleep (CTS) is also involved in cardiac and metabolic regulation. We examined whether delays and deviations in the sleep midpoint (SM), a measure of CTS, modify the association between visceral adipose tissue (VAT) and MetS in adolescents. METHODS We evaluated 277 adolescents (median 16 years) who had at least 5 nights of at-home actigraphy (ACT), in-lab polysomnography (PSG), dual-energy X-ray absorptiometry (DXA) scan, and MetS score data. Sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL) were examined as effect modifiers of the association between VAT and MetS, including waist circumference, blood pressure, insulin resistance, triglycerides, and cholesterol. Linear regression models adjusted for demographics, ACT-sleep duration, ACT-sleep variability, and PSG-apnea-hypopnea index. RESULTS The association between VAT and MetS was significantly stronger (p-values for interactions < 0.001) among adolescents with a schooldays SM later than 4:00 (2.66 [0.30] points increase in MetS score), a SI higher than 1 hour (2.49 [0.30]) or a SJL greater than 1.5 hours (2.15 [0.36]), than in those with an earlier SM (<3:00; 1.76 [0.28]), lower SI (<30 minutes; 0.98 [0.70]), or optimal SJL (<30 minutes; 1.08 [0.45]). CONCLUSIONS A delayed sleep phase, an irregular sleep-wake cycle, and greater social jetlag on schooldays identified adolescents in whom VAT had a stronger association with MetS. Circadian misalignment is a risk factor that enhances the impact of visceral obesity on cardiometabolic morbidity and should be a target of preventative strategies in adolescents.
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Affiliation(s)
- Natasha Morales-Ghinaglia
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Fan He
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| | - Susan L Calhoun
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Jason Liao
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
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He F, Yanosky JD, Bixler EO, Fernandez-Mendoza J, Chinchilli VM, Al-Shaar L, Vgontzas AN, Liao D. Short-term and intermediate-term fine particulate air pollution are synergistically associated with habitual sleep variability in adolescents - A cross-sectional study. ENVIRONMENTAL RESEARCH 2023; 227:115726. [PMID: 36958382 PMCID: PMC10164704 DOI: 10.1016/j.envres.2023.115726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Both air pollution and poor sleep have been associated with increased risk of cardiovascular diseases. However, the association between air pollution and sleep health, especially among adolescents, is rarely investigated. METHODS To investigate the association between fine particulate (PM2.5) air pollution and habitual sleep patterns, we analyzed data obtained from 246 adolescents who participated in the Penn State Child Cohort follow-up examination. We collected their individual-level 24-h (short-term) PM2.5 concentration by using a portable monitor. We estimated their residential-level PM2.5 concentration during the 60-day period prior to the examination (intermediate-term) using a kriging approach. Actigraphy was used to measure participants' sleep durations for seven consecutive nights. Habitual sleep duration (HSD) and sleep variability (HSV) were calculated as the mean and SD of the seven-night sleep duration. Multivariable-adjusted linear regression models were used to assess the association between PM2.5 exposures and HSD/HSV. An interaction between short-term and intermediate-term PM2.5 was created to explore their synergistic associations with HSD/HSV. RESULTS Elevated short-term and intermediate-term PM2.5 exposure were significantly (p < 0.05) associated with higher HSV, but not HSD. Specifically, the mean (95% CI) increase in HSV associated with 1 SD higher 24-h (26.3 μg/m3) and 60-day average (2.2 μg/m3) PM2.5 were 14.6 (9.4, 14.8) and 4.9 (0.5, 9.2) minutes, respectively. In addition, there was a synergistic interaction (p = 0.08) between short-term and intermediate-term PM2.5 exposure on HSV, indicative that the association between intermediate-term PM2.5 and HSV became stronger as short-term PM2.5 increases, and vice versa. CONCLUSION Short-term individual-level and intermediate-term residential-level PM2.5 exposures are adversely and synergistically associated with increased sleep variability, an indicator of instability of sleep quantity, in adolescents. Through such an association with sleep pattern, PM2.5 air pollution may increase long-term cardiometabolic risks.
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Affiliation(s)
- Fan He
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Jeff D Yanosky
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Vernon M Chinchilli
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Laila Al-Shaar
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry & Behavioral Health, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Morales-Ghinaglia N, Larsen M, He F, Calhoun SL, Vgontzas AN, Liao J, Liao D, Bixler EO, Fernandez-Mendoza J. Circadian Misalignment Impacts the Association of Visceral Adiposity With Elevated Blood Pressure in Adolescents. Hypertension 2023; 80:861-871. [PMID: 36876501 PMCID: PMC10023353 DOI: 10.1161/hypertensionaha.122.20398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/10/2022] [Indexed: 03/07/2023]
Abstract
BACKGROUND Although insufficient sleep has been shown to contribute to obesity-related elevated blood pressure, the circadian timing of sleep has emerged as a novel risk factor. We hypothesized that deviations in sleep midpoint, a measure of circadian timing of sleep, modify the association between visceral adiposity and elevated blood pressure in adolescents. METHODS We studied 303 subjects from the Penn State Child Cohort (16.2±2.2 years; 47.5% female; 21.5% racial/ethnic minority). Actigraphy-measured sleep duration, midpoint, variability, and regularity were calculated across a 7-night period. Visceral adipose tissue (VAT) was measured with dual-energy X-ray absorptiometry. Systolic blood pressure (SBP) and diastolic blood pressure levels were measured in the seated position. Multivariable linear regression models tested sleep midpoint and its regularity as effect modifiers of VAT on SBP/diastolic blood pressure levels, while adjusting for demographic and sleep covariables. These associations were also examined as a function of being in-school or on-break. RESULTS Significant interactions were found between VAT and sleep irregularity, but not sleep midpoint, on SBP (P interaction=0.007) and diastolic blood pressure (P interaction=0.022). Additionally, significant interactions were found between VAT and schooldays sleep midpoint on SBP (P interaction=0.026) and diastolic blood pressure (P interaction=0.043), whereas significant interactions were found between VAT and on-break weekdays sleep irregularity on SBP (P interaction=0.034). CONCLUSIONS A delayed and an irregular sleep midpoint during school and during free-days, respectively, increase the impact of VAT on elevated blood pressure in adolescents. These data suggest that deviations in the circadian timing of sleep contribute to the increased cardiovascular sequelae associated with obesity and that its distinct metrics require measurement under different entrainment conditions in adolescents.
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Affiliation(s)
- Natasha Morales-Ghinaglia
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Michael Larsen
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Fan He
- Department of Public Health Sciences, Penn State University, College of Medicine, Hershey PA 17033
| | - Susan L. Calhoun
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Alexandros N. Vgontzas
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Jason Liao
- Department of Public Health Sciences, Penn State University, College of Medicine, Hershey PA 17033
| | - Duanping Liao
- Department of Public Health Sciences, Penn State University, College of Medicine, Hershey PA 17033
| | - Edward O. Bixler
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
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Morales-Ghinaglia N, Fernandez-Mendoza J. Sleep variability and regularity as contributors to obesity and cardiometabolic health in adolescence. Obesity (Silver Spring) 2023; 31:597-614. [PMID: 36754840 PMCID: PMC9975080 DOI: 10.1002/oby.23667] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/17/2022] [Accepted: 11/26/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Adolescence is a developmental stage of critical changes in sleep and its circadian timing when the contribution of abnormal sleep variability (amount) and sleep regularity (timing) to obesity and its associated adverse cardiometabolic health outcomes appears to increase. The aim of this study was to summarize findings from studies conducted in adolescents examining both sleep variability and regularity in relation to obesity and cardiometabolic health. Gaps in research and potential causal pathways that future studies should examine are highlighted. RESULTS Nightly deviations in sleep duration and sleep midpoint appear to contribute to the development of obesity and associated adverse cardiometabolic outcomes in youth. Studies show that increased sleep variability and irregularity are associated with obesity, decreased physical activity, dysregulated eating and inadequate diet, metabolic dysfunction, impaired cardiac autonomic balance, and elevated blood pressure in adolescents. CONCLUSIONS A stable circadian timing of sleep is essential to the overall physical well-being of youth. Emerging evidence supports that sleep variability and circadian misalignment, including sleep irregularity, contribute to adverse obesity-related health outcomes early on in adolescence. Future studies should focus on the underlying behavioral and biological mechanisms in the causal pathway between day-to-day deviations in the amount and timing of sleep and obesity.
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Affiliation(s)
- Natasha Morales-Ghinaglia
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
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Bidirectional Daily Associations Between Accelerometer-Measured Sleep and Physical Activity in Brazilian High School Students. Pediatr Exerc Sci 2023; 35:8-14. [PMID: 35613847 DOI: 10.1123/pes.2021-0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE This study analyzed day-to-day estimates of bidirectional associations between sleep parameters and intensity-specific physical activity and assessed whether the timing of physical activity influences these relationships. METHODS The sample was comprised of 651 high school students (51.2% female, 16.33 [1.0] y old) from southern Brazil. Physical activity and sleep were measured using accelerometers. Multilevel models were applied to test associations of nocturnal total sleep time, onset, and efficiency with moderate to vigorous and light (LPA) physical activity. RESULTS Higher engagement in moderate to vigorous physical activity and LPA was associated with increased total sleep time, and this effect was greater when physical activity was performed in the morning. Morning and evening LPA were associated with increased sleep efficiency and reduced total sleep time, respectively. Practice of LPA in the morning leads to early sleep onset, whereas evening LPA was associated with later onset. Higher total sleep time and later sleep onset were associated with lower moderate to vigorous physical activity and LPA on the following day. However, higher sleep efficiency was associated with increased LPA. CONCLUSION The relationship between sleep parameters and physical activity is bidirectional and dependent on physical activity intensity and timing.
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10
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Nicholson L, Bohnert AM, Crowley SJ. A developmental perspective on sleep consistency: Preschool age through emerging adulthood. Behav Sleep Med 2023; 21:97-116. [PMID: 35014925 DOI: 10.1080/15402002.2021.2024192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE/BACKGROUND Beyond sleep duration, the regularity of sleep patterns (e.g., sleep consistency), including variability in sleep timing (e.g., bedtime, wake time) and duration, is a critical marker of sleep health. Sleep consistency is captured using a variety of methods within the literature (e.g., sleep intraindividual variability, social jetlag), but most of the research focuses on adolescents. METHODS Drawing on a developmental perspective, this narrative review highlights how normative changes at the individual (e.g., biological, cognitive, and social) and contextual (e.g., home, school, sociocultural) levels may contribute to inconsistent sleep patterns across development. RESULTS AND CONCLUSIONS This review emphasizes how inconsistent sleep may increase across pivotal transitions throughout development (e.g., elimination of naps, puberty, summertime, entering college). Finally, recommendations for measuring sleep consistency and areas to address in future research are discussed.
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Affiliation(s)
- Laura Nicholson
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Amy M Bohnert
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Stephanie J Crowley
- Biological Rhythms Research Laboratory, Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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Juelich J, Owens R, Denny D, Raatz S, Lindseth G. Effects of Sleep on Adolescents' Appetite, Dietary Intake, and Weight. SAGE Open Nurs 2023; 9:23779608231206753. [PMID: 37881811 PMCID: PMC10594957 DOI: 10.1177/23779608231206753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/20/2023] [Accepted: 09/23/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction Several factors have been associated with excess weight gain in adolescents, including loss of sleep. Objective The purpose of this study is to examine the effects of sleep factors on appetite, dietary intake, and the body weights of adolescent youth. Methods A prospective correlational study design was used. Male and female adolescents (N = 76) ages 12-18 years completed a 5-night study. Sleep was assessed using Fitbits (88.5% accuracy) and the Pittsburgh Sleep Quality Index (PSQI) (test-retest reliability = .81); appetite was assessed by a Visual Analog Scale (α = 0.84); dietary intake was assessed by the Block Kids Food Screener (reliability up to .88); sleep hygiene was assessed using the Adolescent Sleep Hygiene Practice Scale (α = .67). Results Poor sleep quality was reported by 39.5% of participants, and 75% of participants had inadequate sleep time (7.33 h). Participants' age significantly correlated with PSQI scores (r = .28, p < .05) and BMI (r = .37, p < .01). Participants' PSQI scores significantly correlated with sleep hygiene (r = .45, p = .05) and appetite (r = .3 3, p < .01). Sleep latency significantly correlated with sleep hygiene (r = .32, p < .05). Several sleep hygiene factors correlated significantly with the participants' sleep quality, quantity and latency scores and dietary intakes. Conclusion These findings suggest that changes in sleep hygiene practices may improve adolescent sleep quality and quantity as well as appetite and dietary intake.
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Affiliation(s)
- Janell Juelich
- Division of Nursing, Mayville State University, Mayville, ND, USA
| | - Rhoda Owens
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Dawn Denny
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Susan Raatz
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Glenda Lindseth
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
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12
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Zhang C, Qin G. Irregular sleep and cardiometabolic risk: Clinical evidence and mechanisms. Front Cardiovasc Med 2023; 10:1059257. [PMID: 36873401 PMCID: PMC9981680 DOI: 10.3389/fcvm.2023.1059257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Sleep regularity is an essential part of the multidimensional sleep health framework. The phenomenon of irregular sleep patterns is widespread in contemporary lifestyles. This review synthesizes clinical evidence to summarize the measures of sleep regularity and discusses the role of different sleep regularity indicators in developing cardiometabolic diseases (coronary heart disease, hypertension, obesity, and diabetes). Existing literature has proposed several measurements to assess sleep regularity, mainly including the standard deviation (SD) of sleep duration and timing, sleep regularity index (SRI), interdaily stability (IS), and social jetlag (SJL). Evidence on associations between sleep variability and cardiometabolic diseases varies depending on the measure used to characterize variability in sleep. Current studies have identified a robust association between SRI and cardiometabolic diseases. In comparison, the association between other metrics of sleep regularity and cardiometabolic diseases was mixed. Meanwhile, the associations of sleep variability with cardiometabolic diseases differ across the population. SD of sleep characteristics or IS may be more consistently associated with HbA1c in patients with diabetes compared with the general population. The association between SJL and hypertension for patients with diabetes was more accordant than in the general population. Interestingly, the age-stratified association between SJL and metabolic factors was observed in the present studies. Furthermore, the relevant literature was reviewed to generalize the potential mechanisms through which irregular sleep increases cardiometabolic risk, including circadian dysfunction, inflammation, autonomic dysfunction, hypothalamic-pituitary-adrenal (HPA) axis disorder, and gut dysbiosis. Health-related practitioners should give more attention to the role of sleep regularity on human cardiometabolic in the future.
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Affiliation(s)
- Chengjie Zhang
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Gang Qin
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
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13
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Manasse SM, Haedt-Matt AA, Smith KE, Egbert AH, O’Sullivan K, Koren D, Engel S, Goldschmidt AB. The moderating role of sleep duration on momentary relations between negative affect and loss-of-control eating in children and adolescents. EUROPEAN EATING DISORDERS REVIEW 2022; 30:815-822. [PMID: 35474597 PMCID: PMC10860376 DOI: 10.1002/erv.2908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 03/01/2022] [Accepted: 04/08/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Loss-of-control (LOC) eating is associated with eating disorders and obesity, and thus it is imperative to understand its momentary risk factors in order to improve intervention efforts. Negative affect has been proposed as a momentary risk factor for LOC eating, but the evidence for its effects in children and adolescents is mixed. Short sleep duration (which is very common in youth), may be one variable that moderates the relation between negative affect and subsequent LOC eating. As such, we aimed to examine the moderating role of within-person sleep duration on the momentary relations between negative affect and subsequent LOC eating. METHOD We recruited children (N = 30) with overweight/obesity ages 8-14, who completed a 2-week ecological momentary assessment protocol assessing negative affect and LOC eating several times per day, while also wearing a sleep actigraphy device and completing sleep diaries. RESULTS Consistent with hypotheses, within-person sleep duration moderated the next-day momentary relation between within-person negative affect and LOC eating, such that shorter sleep duration strengthened the positive relation between negative affect and loss-of-control eating. CONCLUSIONS Results suggest that, in children and adolescents, fluctuations in sleep duration may influence susceptibility to losing control over eating after experiencing negative affect. Future research should further investigate other metrics of sleep disturbance as they relate to emotion regulation and LOC eating. Such research will set the stage for augmenting paediatric interventions to better target maintenance factors for LOC eating.
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Affiliation(s)
- Stephanie M. Manasse
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA
| | | | - Kathryn E. Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA
| | - Amy H. Egbert
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
| | - Katie O’Sullivan
- Department of Medicine, University of Chicago Medicine, Chicago, IL
| | - Dorit Koren
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
| | | | - Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
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14
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Pola DCD, Hirata RP, Schneider LP, Bertoche MP, Furlanetto KC, Mesas AE, Pitta F. Sleep-onset time variability and sleep characteristics on weekday and weekend nights in patients with COPD. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2022; 48:e20210412. [PMID: 36074407 PMCID: PMC9496202 DOI: 10.36416/1806-3756/e20210412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 05/29/2022] [Indexed: 11/18/2022]
Abstract
Objective: To evaluate sleep-onset time variability, as well as sleep characteristics on weekday and weekend nights, in individuals with moderate-to-severe COPD. Methods: Sleep was objectively assessed by an activity/sleep monitor for seven consecutive nights in individuals with COPD. For analysis, individuals were divided into two groups according to sleep-onset time variability results, characterized by intrasubject standard deviation of sleep-onset time (SOTV) ≥ 60 min or < 60 min. Results: The sample comprised 55 individuals (28 males; mean age = 66 ± 8 years; and median FEV1 % of predicted = 55 [38-62]). When compared with the SOTV<60min group (n = 24), the SOTV≥60min group (n = 31) presented shorter total sleep time (5.1 ± 1.3 h vs. 6.0 ± 1.3 h; p = 0.006), lower sleep efficiency (73 ± 12% vs. 65 ± 13%; p = 0.030), longer wake time after sleep onset (155 ± 66 min vs. 115 ± 52 min; p = 0.023), longer duration of wake bouts (19 [16-28] min vs. 16 [13-22] min; p = 0.025), and higher number of steps at night (143 [104-213] vs. 80 [59-135]; p = 0.002). In general, sleep characteristics were poor regardless of the day of the week, the only significant difference being that the participants woke up about 30 min later on weekends than on weekdays (p = 0.013). Conclusions: Sleep-onset time varied over 1 h in a standard week in the majority of individuals with COPD in this sample, and a more irregular sleep onset indicated poor sleep quality both on weekdays and weekends. Sleep hygiene guidance could benefit these individuals if it is integrated with their health care.
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Affiliation(s)
- Daniele Caroline Dala Pola
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Raquel Pastrello Hirata
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Lorena Paltanin Schneider
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Mariana Pereira Bertoche
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
| | - Karina Couto Furlanetto
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil.,. Centro de Pesquisa em Ciências da Saúde, Universidade Pitágoras-Universidade Norte do Paraná - UNOPAR - Londrina (PR) Brasil
| | - Arthur Eumann Mesas
- . Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil.,. Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Fabio Pitta
- . Laboratório de Pesquisa em Fisioterapia Pulmonar - LFIP - Departamento de Fisioterapia, Universidade Estadual de Londrina - UEL - Londrina (PR) Brasil
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15
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He F, Yanosky JD, Fernandez‐Mendoza J, Chinchilli VM, Al‐Shaar L, Vgontzas AN, Bixler EO, Liao D. Acute Impact of Fine Particulate Air Pollution on Cardiac Arrhythmias in a Population‐Based Sample of Adolescents: The Penn State Child Cohort. J Am Heart Assoc 2022; 11:e026370. [DOI: 10.1161/jaha.122.026370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Fine particulate (fine particles with aerodynamic diameters ≤2.5 μm [PM
2.5
]) exposure has been associated with a risk of cardiac arrhythmias in adults. However, the association between PM
2.5
exposure and cardiac arrhythmias in adolescents remains unclear.
Methods and Results
To investigate the association and time course between PM
2.5
exposure with cardiac arrhythmias in adolescents, we analyzed the data collected from 322 adolescents who participated in the PSCC (Penn State Child Cohort) follow‐up examination. We obtained individual‐level 24‐hour PM
2.5
concentrations with a nephelometer. Concurrent with the PM
2.5
measure, we obtained 24‐hour ECG data using a Holter monitor, from which cardiac arrhythmias, including premature atrial contractions and premature ventricular contractions (PVCs), were identified. PM
2.5
concentration and numbers of premature atrial contractions/PVCs were summarized into 30‐minute‐based segments. Polynomial distributed lag models within a framework of a negative binomial model were used to assess the effect of PM
2.5
concentration on numbers of premature atrial contractions and PVCs. PM
2.5
exposure was associated with an acute increase in number of PVCs. Specifically, a 10 μg/m
3
increase in PM
2.5
concentration was associated with a 2% (95% CI, 0.4%–3.3%) increase in PVC counts 0.5 to 1.0, 1.0 to 1.5, and 1.5 to 2.0 hours after the exposure. Cumulatively, a 10 μg/m
3
increment in PM
2.5
was associated with a 5% (95% CI, 1%–10%) increase in PVC counts within 2 hours after exposure. PM
2.5
concentration was not associated with premature atrial contraction.
Conclusions
PM
2.5
exposure was associated with an acute increased number of ventricular arrhythmias in a population‐based sample of adolescents. The time course of the effect of PM
2.5
on ventricular arrhythmia is within 2 hours after exposure.
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Affiliation(s)
- Fan He
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Jeff D. Yanosky
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Julio Fernandez‐Mendoza
- Department of Psychiatry & Behavioral Health, Sleep Research and Treatment Center Pennsylvania State University College of Medicine Hershey PA
| | - Vernon M. Chinchilli
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Laila Al‐Shaar
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Alexandros N. Vgontzas
- Department of Psychiatry & Behavioral Health, Sleep Research and Treatment Center Pennsylvania State University College of Medicine Hershey PA
| | - Edward O. Bixler
- Department of Psychiatry & Behavioral Health, Sleep Research and Treatment Center Pennsylvania State University College of Medicine Hershey PA
| | - Duanping Liao
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
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16
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Doan N, Parker A, Rosati K, van Beers E, Ferro MA. Sleep duration and eating behaviours among adolescents: a scoping review. Health Promot Chronic Dis Prev Can 2022; 42:384-397. [PMID: 36165765 PMCID: PMC9559193 DOI: 10.24095/hpcdp.42.9.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION In the past decade, investigations of the relationship between sleep duration and eating behaviours have been emerging; however, a formal synthesis of the literature focussed on adolescent populations has not yet been conducted. We conducted a scoping review of the literature examining the relationship between sleep duration and eating behaviours in adolescents. Gaps in the research and directions for future research were identified based on the findings. METHODS A systematic search was employed on four research databases: PubMed, PsycInfo, CINAHL and Scopus; relevant grey literature was also reviewed. Studies that reported on the relationship between sleep duration and eating behaviours among high school-aged adolescents were included in the review. Data were extracted, charted and synthesized into a narrative. Consistent with the purpose of a scoping review, the methodological quality of the studies was not appraised. Stakeholders were consulted to validate the findings and provide insight into the interpretation and identification of pressing gaps in the research that remain to be addressed. RESULTS In total, 61 studies published between 2006 and 2021 met the criteria for review. Existing research focussed heavily on examining sleep duration in relation to intake of food from certain food groups, beverages and processed foods, and relied on a population study design, cross-sectional analyses and self-report measures. CONCLUSION Future research is needed to understand the link between sleep duration and eating-related cognition, eating contexts and disordered eating behaviours in order to better understand how ensuring sufficient sleep among adolescents can be leveraged to support healthier eating practices and reduce diet-related risks.
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Affiliation(s)
- Natalie Doan
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Amanda Parker
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Katherine Rosati
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Ella van Beers
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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17
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Rocha S, Almeida DM, Chiang JJ, Cole SW, Irwin MR, Seeman T, Fuligni AJ. The Relationship Between Family Socioeconomic Status and Adolescent Sleep and Diurnal Cortisol. Psychosom Med 2022; 84:848-855. [PMID: 35797448 PMCID: PMC9437129 DOI: 10.1097/psy.0000000000001104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the associations between indices of family socioeconomic status and sleep during adolescence and to examine whether measures of hypothalamic-pituitary-adrenal (HPA) axis functioning mediate the observed associations. METHODS A total of 350 ethnically diverse adolescents (57% female; mean [standard deviation] age wave 1 = 16.4 [0.7] years) completed a three-wave longitudinal study in which sleep and cortisol data were collected at 2-year time intervals. Sleep duration, latency, and variability were assessed via actigraphy during a period of 8 days per study wave. Salivary cortisol was collected across 3 days per study wave to assess cortisol diurnal slope, area under the curve, and the cortisol awakening response. Adolescents' caregivers reported their education levels, family income, and economic hardship. RESULTS A greater family income-to-needs ratio was associated with longer adolescent sleep duration ( b = 2.90, p = .023), whereas greater parental education was associated with shorter sleep duration ( b = -3.70, p = .030), less sleep latency ( b = -0.74, p = .016), and less variability across days ( b = -2.06, p = .010). Diurnal cortisol slope statistically mediated the association of parental education with sleep duration ( b = -0.48, 95% confidence interval = -1.099 to -0.042), but not the association of income-to-needs ratio with sleep duration. CONCLUSIONS Findings suggest that parental education and family resources may have unique impacts upon sleep and HPA axis functioning during the period of adolescence. Future research is needed to examine family and behavioral factors that may underlie socioeconomic status associations with adolescent sleep and HPA axis functioning.
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Affiliation(s)
- Sarah Rocha
- From the Department of Psychology (Rocha, Irwin, Fuligni), University of California, Los Angeles, Los Angeles California; Department of Human Development and Family Studies (Almeida), Pennsylvania State University, University Park, Pennsylvania; Department of Psychology (Chiang), Georgetown University, Washington, DC; and Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences (Cole, Irwin, Fuligni), and Division of Geriatrics, David Geffen School of Medicine (Seeman), University of California, Los Angeles, Los Angeles, California
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18
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Abstract
Sleep habits are directly related to risk of obesity, and this relationship may be partly mediated through food choices and eating behaviour. Short sleep duration, impaired sleep quality and suboptimal sleep timing are all implicated in weight gain and adverse cardiometabolic health, at least partly mediated through their associations with diet quality. Short-term sleep restriction leads to increased energy intake, and habitually short sleepers report dietary intakes that indicate a less healthy diet compared with adequate sleepers. Evidence is emerging that sleep extension interventions in short sleepers may reduce intake of sugars and overall energy intake. Poor sleep quality, night shift work patterns and social jetlag are also associated with lower diet quality and consumption of energy-dense foods. Incorporating sleep advice into weight management interventions may be more effective than energy-restricted diets and exercise advice alone. However, there are a lack of intervention studies that aim to lengthen sleep, improve sleep quality or adjust irregular sleep timing to investigate the impact on dietary intakes and eating behaviour in participants aiming to lose weight or maintain weight loss. Finally, future research should take account of individual characteristics such as age, sex, life stage and changing working practices when designing combined lifestyle interventions including sleep behaviour change for health and well-being.
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19
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Tomaso CC, Yaroch AL, Hill JL, Jackson T, Nelson JM, James T, Mason WA, Espy KA, Nelson TD. The roles of sleep and executive function in adolescent nighttime eating. Eat Behav 2022; 46:101657. [PMID: 36029566 PMCID: PMC11260188 DOI: 10.1016/j.eatbeh.2022.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022]
Abstract
Nighttime eating has been associated with obesity, inflammation, and poor nutritional intake, yet correlates of this behavior are understudied in pediatric populations and among adolescents in particular. The current study examines modifiable factors related to nighttime eating, including sleep parameters and regulatory abilities-as well as the interplay between these constructs-in adolescents. A total of 223 adolescents (Mage = 15.32 years, 52.9 % female, 15.7 % classified as overweight, 21.1 % had obesity) wore ActiGraph devices to measure sleep and were instructed to complete three 24-h dietary recall measures over a two-week period. Participants also completed self-report measures of executive function. Greater variability in sleep duration was consistently associated with higher average calorie, sugar, and fat consumption after 8, 9, and 10 PM. The main effect of global executive function on all nighttime eating measures was nonsignificant, and executive function did not moderate relationships between sleep parameters and nighttime eating measures. Since adolescents' eating habits may set the stage for lifelong dietary practices, efforts to ensure consistent sleep duration may reduce risk for nighttime eating in this nutritionally vulnerable population.
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Affiliation(s)
- Cara C Tomaso
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE, USA.
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, 14301 FNB Parkway, Suite 100, Omaha, NE, USA
| | - Jennie L Hill
- Department of Epidemiology, University of Nebraska Medical Center College of Medicine, 984395 Nebraska Medical Center, Omaha, NE, USA
| | - Tammy Jackson
- Office of Research and Economic Development, University of Nebraska-Lincoln, 301 Canfield Hall, Lincoln, NE, USA
| | - Jennifer M Nelson
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE, USA; Office of Research and Economic Development, University of Nebraska-Lincoln, 301 Canfield Hall, Lincoln, NE, USA
| | - Tiffany James
- Office of Research and Economic Development, University of Nebraska-Lincoln, 301 Canfield Hall, Lincoln, NE, USA
| | - W Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, 875 Monroe Avenue, Memphis, TN, USA
| | - Kimberly A Espy
- Department of Psychology, University of Texas at San Antonio, 10 Cocke Drive, San Antonio, TX, USA; Department of Psychiatry and Behavioral Science, University of Texas Health Science Center at San Antonio, Long School of Medicine, 7703 Floyd Curl Drive, San Antonio, TX, USA
| | - Timothy D Nelson
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE, USA
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20
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Goetz AR, Jindal I, Moreno JP, Puyau MR, Adolph AL, Musaad S, Butte NF, Bacha F. The Role of Sleep and Eating Patterns in Adiposity Gain among Preschool-Aged Children. Am J Clin Nutr 2022; 116:1334-1342. [PMID: 35833269 PMCID: PMC9630867 DOI: 10.1093/ajcn/nqac197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/05/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Short sleep duration is related to risk for obesity in preschool children. However, the underlying mechanism(s) are not clear. OBJECTIVE We evaluated the relationship between sleep characteristics with body composition, energetics and weight-regulating behaviors in preschool-aged children; and the longitudinal associations between children's sleep and eating patterns with body composition at 1-year follow-up. METHODS Data were drawn from a longitudinal study of 118 children aged 3-5 years. Sleep (duration, midpoint, regularity) and physical activity (PA) were measured by accelerometry over 6 consecutive days; total energy expenditure (TEE) using the doubly-labeled water method; body composition (fat mass, fat-free mass, and %body fat) by dual energy x-ray absorptiometry; and dietary intake (energy intake, timing) using two 24-h recalls. Multivariable regression was used to estimate interindividual associations of sleep parameters with body composition, PA, TEE and dietary outcomes; and to examine the relationship between sleep and dietary behaviors with body composition one year later. RESULTS Cross-sectionally, later sleep midpoint was associated with greater fat mass (0.33; 95% CI: 0.05, 0.60) and %body fat (0.92; 95% CI: 0.15, 1.70). Later sleep midpoint was associated with delayed morning (0.51; 95% CI: 0.28, 0.74) and evening meal times (0.41; 95% CI: 0.29, 0.53), higher nighttime (45.6; 95% CI: 19.7, 71.4), and lower morning (-44.8; 95% CI: -72.0, -17.6) energy intake. Longitudinally, shorter sleep duration (-0.02; 95% CI: -0.03, -0.00) and later meal timing (0.83; 95% CI: 0.24, 1.42) were associated with higher %body fat 1 year later. CONCLUSIONS Shorter sleep duration and later meal timing are associated with adiposity gain in preschoolers.
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Affiliation(s)
- Amy R Goetz
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ishita Jindal
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA,Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Jennette P Moreno
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Maurice R Puyau
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Anne L Adolph
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Salma Musaad
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Nancy F Butte
- Department of Pediatrics, USDA and Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Fida Bacha
- Address correspondence to Fida Bacha (e-mail: )
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21
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Parker MN, LeMay-Russell S, Schvey NA, Crosby RD, Ramirez E, Kelly NR, Shank LM, Byrne ME, Engel SG, Swanson TN, Djan KG, Kwarteng EA, Faulkner LM, Zenno A, Brady SM, Yanovski SZ, Tanofsky-Kraff M, Yanovski JA. Associations of sleep with food cravings and loss-of-control eating in youth: An ecological momentary assessment study. Pediatr Obes 2022; 17:e12851. [PMID: 34498417 PMCID: PMC8766870 DOI: 10.1111/ijpo.12851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/14/2021] [Accepted: 08/16/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Inconsistent sleep patterns may promote excess weight gain by increasing food cravings and loss-of-control (LOC)-eating; however, these relationships have not been elucidated in youth. OBJECTIVE We tested whether sleep duration and timing were associated with food cravings and LOC-eating. METHOD For 14 days, youths wore actigraphy monitors to assess sleep and reported severity of food cravings and LOC-eating using ecological momentary assessment. Generalized linear mixed models tested the associations between weekly and nightly shifts in facets of sleep (i.e., duration, onset, midpoint, and waketime) and next-day food cravings and LOC-eating. Models were re-run adjusting for relevant covariates (e.g., age, sex, adiposity). RESULTS Among 48 youths (12.88 ± 2.69 years, 68.8% female, 33.3% with overweight/obesity), neither weekly nor nightly facets of sleep were significantly associated with food cravings (ps = 0.08-0.93). Youths with shorter weekly sleep duration (est. ß = -0.31, p = 0.004), earlier weekly midpoints (est. ß = -0.47, p = 0.010) and later weekly waketimes (est. ß = 0.49, p = 0.010) reported greater LOC-eating severity; findings persisted in adjusted models. CONCLUSIONS In youth, weekly, but not nightly, shifts in multiple facets of sleep were associated with LOC-eating severity; associations were not significant for food cravings. Sleep should be assessed as a potentially modifiable target in paediatric LOC-eating and obesity prevention programs.
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Affiliation(s)
- Megan N. Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Ross D. Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Eliana Ramirez
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, College of Education, Prevention Science Institute, University of Oregon, Eugene, Oregon, USA
| | - Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD, USA
- Metis Foundation, San Antonio, TX, USA
| | - Meghan E. Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Scott G. Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Taylor N. Swanson
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
- Metis Foundation, San Antonio, TX, USA
| | - Kweku G. Djan
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Esther A. Kwarteng
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Loie M. Faulkner
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Anna Zenno
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Susan Z. Yanovski
- Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, MD, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, MD, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, MD, USA
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22
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Jeon E, Kim N. Correspondence between Parents' and Adolescents' Sleep Duration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031034. [PMID: 35162058 PMCID: PMC8833878 DOI: 10.3390/ijerph19031034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 02/01/2023]
Abstract
This study explored the correspondence between adolescents’ sleep duration and that of their parents and identified the factors affecting the appropriate sleep duration for adolescents. The data of 795 adolescents from the Korea National Health and Nutrition Examination Survey (2015–2018) were analyzed. We used Cohen’s kappa coefficient to measure the correspondence between adolescents’ sleep duration and that of their parents. A multiple logistic regression analysis was used to identify the factors affecting adequate sleep duration among adolescents. Our study found that factors such as adolescents’ gender, father’s education level, and drinking among adolescents and parents influenced the adolescents’ sleep duration. Second, a higher correspondence between the sleep duration of adolescents and that of mothers (Kappa = 0.213, p < 0.001) was found compared to that of fathers (Kappa = 0.064, p = 0.031). Finally, an adequate sleep duration among adolescents’ mothers was a major factor that influenced the adequate sleep duration of adolescents (OR = 2.494, 95% CI = 1.850–3.362, p < 0.001). Therefore, when organizing adolescent sleep education and management programs in various community sleep management institutions, the main caregiver’s sleep duration management and family drinking management should be combined. Additionally, gender equality awareness should be improved for parenting, including monitoring adolescents’ sleep accordingly.
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Affiliation(s)
- Eunyoung Jeon
- Department of Nursing, Daegu University, Daegu 42400, Korea;
| | - Nayoung Kim
- Department of Nursing, Daegu Haany University, Gyeongsan-si 38610, Korea
- Correspondence: ; Tel.: +82-53-819-1887
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23
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Chehal PK, Shafer L, Cunningham SA. Examination of Sleep and Obesity in Children and Adolescents in the United States. Am J Health Promot 2022; 36:46-54. [PMID: 34247520 PMCID: PMC10870837 DOI: 10.1177/08901171211029189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study contributes to the growing literature on the association between sleep and obesity by examining the associations between hours of sleep, consistency of bedtime, and obesity among children in the US. DESIGN Analysis of a nationally representative sample of non-institutionalized children from the 2016-17 National Survey of Children's Health. SETTING US, national. SUBJECTS Children ages 10-17 years (n = 34,640). MEASURES Parent reported weeknight average hours of sleep and consistency of bedtime. Body mass index classified as underweight, normal, overweight or obesity using parent-reported child height and weight information, classified using CDC BMI-for-Age Growth Charts. ANALYSIS Multivariate logistic regression models were used to estimate associations between measures of sleep and body mass index weight category adjusting for individual, household and neighborhood characteristics. RESULTS An additional hour of sleep was associated with 10.8% lower odds of obesity, net of consistency in bedtime. After controlling for sleep duration, children who usually went to bed at the same time on weeknights had lower odds of obesity (24.8%) relative to children who always went to bed at the same time. CONCLUSION Sleep duration is predictive of lower odds of obesity in US children and adolescents. Some variability in weeknight bedtime is associated with lower odds of obesity, though there were no additional benefits to extensive variability in bedtime.
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Affiliation(s)
- Puneet Kaur Chehal
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Livvy Shafer
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Community Interventions for Infection Control Unit, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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24
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LeMay-Russell S, Schvey NA, Kelly NR, Parker MN, Ramirez E, Shank LM, Byrne ME, Swanson TN, Kwarteng EA, Faulkner LM, Djan KG, Zenno A, Brady SM, Yang SB, Yanovski SZ, Tanofsky-Kraff M, Yanovski JA. Longitudinal associations between facets of sleep and adiposity in youth. Obesity (Silver Spring) 2021; 29:1760-1769. [PMID: 34734495 PMCID: PMC8575078 DOI: 10.1002/oby.23281] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/06/2021] [Accepted: 07/30/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Beyond sleep duration, other facets of sleep such as variability and timing may be associated with obesity risk in youth. However, data are limited. Using a longitudinal design, this study tested whether multiple facets of sleep were associated with fat mass gain over 1 year. METHODS A convenience sample of non-treatment-seeking youth (age 8-17 years) wore actigraphy monitors for 14 days. Average weekly sleep duration, within-person sleep duration variability, weekend catch-up sleep, bedtime and wake time shift, social jet lag, bedtime, wake time, and sleep midpoint were calculated. The association of each facet of baseline sleep with 1-year fat mass, adjusting for baseline fat mass and height, was examined. RESULTS A total of 137 youths (54.0% female; mean [SD], age 12.5 [2.6] years; 28.4% non-Hispanic Black or African American; baseline fat mass = 15.3 [8.9] kg; 1-year fat mass = 17.0 [10.0] kg; 28.5% with baseline overweight or obesity) were studied. Wake time (p = 0.03) and sleep midpoint (p = 0.02) were inversely associated with 1-year fat mass, such that earlier wake time and midpoint were associated with higher 1-year fat mass. No other facet of sleep was significantly associated with 1-year fat mass (p > 0.09). CONCLUSIONS Using objective measures, youth with earlier wake times and sleep midpoints had greater gains in fat mass. Additional research is needed to determine whether sleep timing may be a modifiable target to prevent pediatric obesity.
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Affiliation(s)
- Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, College of Education, University of Oregon
| | - Megan N. Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences
- Metis Foundation
| | - Meghan E. Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Taylor N. Swanson
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences
- Metis Foundation
| | - Esther A. Kwarteng
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Loie M. Faulkner
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Kweku G. Djan
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Anna Zenno
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
| | - Shanna B. Yang
- Nutrition Department, National Institutes of Health (NIH)
| | - Susan Z. Yanovski
- Office of Obesity Research, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
- Department of Counseling Psychology and Human Services, Prevention Science Institute, College of Education, University of Oregon
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS)
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25
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What Is the Impact of Energy Expenditure on Energy Intake? Nutrients 2021; 13:nu13103508. [PMID: 34684509 PMCID: PMC8539813 DOI: 10.3390/nu13103508] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 02/07/2023] Open
Abstract
Coupling energy intake (EI) to increases in energy expenditure (EE) may be adaptively, compensatorily, or maladaptively leading to weight gain. This narrative review examines if functioning of the homeostatic responses depends on the type of physiological perturbations in EE (e.g., due to exercise, sleep, temperature, or growth), or if it is influenced by protein intake, or the extent, duration, timing, and frequency of EE. As different measures to increase EE could convey discrepant neuronal or humoral signals that help to control food intake, the coupling of EI to EE could be tight or loose, which implies that some ways to increase EE may have advantages for body weight regulation. Exercise, physical activity, heat exposure, and a high protein intake favor weight loss, whereas an increase in EE due to cold exposure or sleep loss likely contributes to an overcompensation of EI, especially in vulnerable thrifty phenotypes, as well as under obesogenic environmental conditions, such as energy dense high fat—high carbohydrate diets. Irrespective of the type of EE, transient elevations in the metabolic rate seem to be general risk factors for weight gain, because a subsequent decrease in energy requirement is not compensated by an adequate adaptation of appetite and EI.
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26
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Fernandez-Mendoza J, He F, Calhoun SL, Vgontzas AN, Liao D, Bixler EO. Association of Pediatric Obstructive Sleep Apnea With Elevated Blood Pressure and Orthostatic Hypertension in Adolescence. JAMA Cardiol 2021; 6:1144-1151. [PMID: 34160576 PMCID: PMC8223141 DOI: 10.1001/jamacardio.2021.2003] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/29/2021] [Indexed: 12/17/2022]
Abstract
Importance Although pediatric guidelines have delineated updated thresholds for elevated blood pressure (eBP) in youth and adult guidelines have recognized obstructive sleep apnea (OSA) as an established risk factor for eBP, the relative association of pediatric OSA with adolescent eBP remains unexplored. Objective To assess the association of pediatric OSA with eBP and its orthostatic reactivity in adolescence. Design, Setting, and Participants At baseline of this population-based cohort study (Penn State Child Cohort) in 2000-2005, a random sample of 700 children aged 5 to 12 years from the general population was studied. A total of 421 participants (60.1%) were followed up in 2010-2013 after 7.4 years as adolescents (ages, 12-23 years). Data analyses were conducted from July 6 to October 29, 2020. Main Outcomes and Measures Outcomes were the apnea-hypopnea index (AHI) score, ascertained via polysomnography conducted in a laboratory; eBP measured in the seated position identified using guideline-recommended pediatric criteria; orthostatic hyperreactivity identified with BP assessed in the supine and standing positions; and visceral adipose tissue assessed via dual-energy x-ray absorptiometry. Results Among the 421 participants (mean [SD] age at follow-up, 16.5 [2.3] years), 227 (53.9%) were male and 92 (21.9%) were racial/ethnic minorities. A persistent AHI of 2 or more since childhood was longitudinally associated with adolescent eBP (odds ratio [OR], 2.9; 95% CI 1.1-7.5), while a remitted AHI of 2 or more was not (OR, 0.9; 95% CI 0.3-2.6). Adolescent OSA was associated with eBP in a dose-response manner; however, the association of an AHI of 2 to less than 5 among adolescents was nonsignificant (OR, 1.5; 95% CI, 0.9-2.6) and that of an AHI of 5 or more was approximately 2-fold (OR, 2.3; 95% CI, 1.1-4.9) after adjusting for visceral adipose tissue. An AHI of 5 or more (OR, 3.1; 95% CI, 1.2-8.5), but not between 2 and less than 5 (OR, 1.3; 95% CI, 0.6-3.0), was associated with orthostatic hyperreactivity among adolescents even after adjusting for visceral adipose tissue. Childhood OSA was not associated with adolescent eBP in female participants, while the risk of OSA and eBP was greater in male participants. Conclusions and Relevance The results of this cohort study suggest that childhood OSA is associated with adolescent hypertension only if it persists during this developmental period. Visceral adiposity explains a large extent of, but not all, the risk of hypertension associated with adolescent OSA, which is greater in male individuals.
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Affiliation(s)
- Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, College of Medicine, Penn State University, Hershey, Pennsylvania
| | - Fan He
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, Pennsylvania
| | - Susan L. Calhoun
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, College of Medicine, Penn State University, Hershey, Pennsylvania
| | - Alexandros N. Vgontzas
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, College of Medicine, Penn State University, Hershey, Pennsylvania
| | - Duanping Liao
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, Pennsylvania
| | - Edward O. Bixler
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, College of Medicine, Penn State University, Hershey, Pennsylvania
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27
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Fresan A, Genis-Mendoza AD, López-Narváez ML, Gómez-Peralta TG, Aguilar-Velázquez DG, Juárez-Rojop IE, González-Castro TB, Tovilla-Zárate CA, Castillo-Avila RG, Nicolini H. Association between Short Hours of Sleep and Overweight/Obesity in Mexican Adolescent Population: A School-Based Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9080939. [PMID: 34442076 PMCID: PMC8393640 DOI: 10.3390/healthcare9080939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/03/2022] Open
Abstract
Background/Aim: Obesity in adolescents is increasing; as such, the aim of this study was to determine the prevalence of obesity in Mexican adolescents and examine its possible association with hours of sleep. Methods: A school-based cross-sectional study was carried out. This study included 863 adolescents aged between 11 and 16 years. The prevalence of obesity was estimated using the body mass index (BMI). The duration of sleep (and other information) was assessed by a self-reported questionnaire. The Cochran–Mantel–Hansel test for categorical variables and a general linear model for continuous variables were used to evaluate the interaction effect of BMI and sex with respect to sleeping and assessed activity conditions. Results: It was found that 47.6% of the adolescents were overweight/obese. Men were more frequently overweight/obese than women (52.6% vs. 41.8%, p = 0.002). Moreover, overweight/obese adolescents were younger and spent fewer daily hours watching television (p < 0.05). Men practiced sports more hours per week than women (p = 0.04). However, women spent more daily time on the internet (p = 0.05), and overweight/obese adolescent women slept fewer hours than overweight/obese men and adolescents with normal weight (p = 0.008). Conclusions: The development of strategies for the prevention of overweight/obesity and the improvement of sleep duration should include a gender perspective to improve health habits in Mexican adolescents.
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Affiliation(s)
- Ana Fresan
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 14370, Mexico;
| | | | - María Lilia López-Narváez
- Hospital Chiapas Nos Une Dr. Gilberto Gómez Maza, Secretaría de Salud de Chiapas, Tuxtla Gutiérrez 29045, Mexico
- Correspondence: (M.L.L.-N.); (H.N.)
| | - Tania Guadalupe Gómez-Peralta
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Mexico; (T.G.G.-P.); (D.G.A.-V.); (C.A.T.-Z.)
| | - Daniela Georgina Aguilar-Velázquez
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Mexico; (T.G.G.-P.); (D.G.A.-V.); (C.A.T.-Z.)
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico; (I.E.J.-R.); (R.G.C.-A.)
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Mexico;
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Mexico; (T.G.G.-P.); (D.G.A.-V.); (C.A.T.-Z.)
| | - Rosa Giannina Castillo-Avila
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico; (I.E.J.-R.); (R.G.C.-A.)
| | - Humberto Nicolini
- Instituto Nacional de Medicina Genómica, Secretaría de Salud, Ciudad de México 14610, Mexico;
- Correspondence: (M.L.L.-N.); (H.N.)
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28
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Nicholson LM, Egbert AH, Moreno JP, Bohnert AM. Variability of Sleep and Relations to Body Weight Among First-Year College Students. Int J Behav Med 2021; 28:227-237. [PMID: 32385844 DOI: 10.1007/s12529-020-09888-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Existing research suggests that greater sleep variability may increase risk for weight gain. College often marks a transition to a less consistent daily schedule, which may adversely impact sleep routines and further increase risk for weight gain. The current study is among the first to explore relations between nighttime sleep variability and daytime sleep (napping) and body weight among first-year college students. METHODS Using daily diary methods, first-year college students (N = 307; 84.7% female) self-reported their sleep for seven days. Several indices were created to capture sleep variability for reported bedtime, wake time, and sleep duration, including weekday versus weekend differences (WvW), day to day differences (D2D), and overall standard deviation (SD). Napping was also assessed. Based on body mass index (BMI), individuals were categorized as underweight, healthy weight, overweight, and obese. RESULTS Across indices, students' sleep varied over an hour on average across the week. Hierarchical regressions revealed that greater differences in wake time D2D, wake time SD, and sleep duration WvW were all associated with higher BMI, after accounting for gender, depressive symptoms, and sleep duration. Longer napping was also associated with higher BMI, using the same covariates. Finally, greater sleep variability was reported by overweight and obese than healthy weight individuals. CONCLUSION These findings suggest that sleep variability, particularly wake times and napping may be important modifiable sleep behaviors to investigate in future studies. More longitudinal research is needed to explore relations between multiple facets of sleep variability and weight gain, including possible mechanisms.
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Affiliation(s)
| | | | - Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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29
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Okoli A, Hanlon EC, Brady MJ. The Relationship between Sleep, Obesity, and Metabolic Health in Adolescents - a Review. ACTA ACUST UNITED AC 2020; 17:15-19. [PMID: 33283071 DOI: 10.1016/j.coemr.2020.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this literature review, we discuss the importance of adequate sleep and the various effects of suboptimal sleep on weight maintenance and metabolic health specifically for adolescents. Two major contributors to adolescents experiencing decreased sleep duration and quality, and thus increasing the risk for developing metabolic syndrome in adolescence as well as later in adulthood, are increased electronic screen time particularly at night and early school start times. The less time adolescents spend sleeping, the less quality sleep they obtain, and the greater the disruption of endocrine hormone function. As another consequence, adolescents are more prone to making poor food choices, from choosing relatively nutrient-poor foods to consuming excess calories without necessarily increasing their energy expenditure. These choices put adolescents at greater risk for becoming obese throughout their lifespan.
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Affiliation(s)
- Amarachi Okoli
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, 60607
| | - Erin C Hanlon
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago IL, 60637
| | - Matthew J Brady
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago IL, 60637
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30
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He F, Dong H, Fernandez-Mendoza J, Bixler EO, Liao J, Liao D. Racial/ethnic disparity in habitual sleep is modified by caloric intake in adolescents. Sleep Med 2020; 76:65-71. [PMID: 33120130 DOI: 10.1016/j.sleep.2020.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
STUDY OBJECTIVES We investigated the moderation of caloric intake on the association between race/ethnicity and habitual sleep in adolescents. METHODS We analyzed the data obtained from 324 adolescents who completed the follow-up examination of the Penn State Child Cohort study. We collected actigraphy-measured sleep duration on 7 consecutive nights and computed their mean and standard deviation as habitual sleep duration (HSD) and habitual sleep variability (HSV), respectively. We also measured participants' daily intakes of total calorie, total fat, carbohydrates, and protein, through the Youth/Adolescent Food Frequency Questionnaire. Adjusted mean HSD and HSV among non-Hispanic whites and racial/ethnic minorities were compared by using analysis of covariance (ANCOVA), while controlling for age, sex, BMI percentile, total caloric intake, and socioeconomic status. The significance of the interaction between race/ethnicity and caloric intake was further tested in ANCOVA models. RESULTS The study sample consisted of 79.3% non-Hispanic whites, 13.0% African American, 4.6% Hispanics, 2.2% Asian, and 0.9% American Indian. Adolescents who are racial/ethnic minorities showed shorter HSD (mean (SE): 6.80 (0.10) vs. 7.07 (0.05) hours/night, p = 0.02) and higher HSV (mean (SE): 1.31 (0.07) vs. 1.15 (0.04) hours/night, p = 0.04) than non-Hispanic whites. Racial/ethnic differences in HSV were significantly more pronounced among adolescents with high caloric intake (p interaction = 0.01), especially from carbohydrates (p interaction = 0.03) and fat (p interaction = 0.05). CONCLUSION Adolescents who are racial/ethnic minorities slept objectively shorter and with greater night-to-night variability than non-Hispanic whites. The racial/ethnic disparity in habitual sleep variability was more pronounced among adolescents with high caloric intake, particularly from carbohydrates and fat.
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Affiliation(s)
- Fan He
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, 90 Hope Dr. Suite 2200, A210, Hershey, PA 17033, USA.
| | - Huamei Dong
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, 90 Hope Dr. Suite 2200, A210, Hershey, PA 17033, USA.
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry, The Pennsylvania State University College of Medicine, 500 University Dr., Hershey, PA 17033, USA.
| | - Edward O Bixler
- Sleep Research and Treatment Center, Department of Psychiatry, The Pennsylvania State University College of Medicine, 500 University Dr., Hershey, PA 17033, USA.
| | - Jiangang Liao
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, 90 Hope Dr. Suite 2200, A210, Hershey, PA 17033, USA.
| | - Duanping Liao
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, 90 Hope Dr. Suite 2200, A210, Hershey, PA 17033, USA.
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Sleep, social behaviour and food consumption of schoolchildren of a large Brazilian city. Public Health Nutr 2020; 24:1531-1541. [PMID: 33023716 DOI: 10.1017/s1368980020003924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the impact of inadequate sleep and associated factors on the social behaviour and food consumption of children and adolescents. DESIGN Cross-sectional study. SETTING Sleep information, social behaviour (Strengths and Difficulties Questionnaire), food consumption, demography, nutritional status, lifestyle, and biochemical tests were investigated. PARTICIPANTS School children in the 4th grade of the municipal school system of a large Brazilian city. RESULTS Of a total of 797 schoolchildren, 50·9 % were female, with a median age of 9·7 (9·5-10·0) years old and an energy consumption of 7613·6 (5982·7-9766·2) kJ. It was determined that 31·6 % were overweight, and 76·8 % reported insufficient weekly practice of physical activity. A median of 9·6 (8·9-10·5) h of sleep (lower values on weekdays: 9·3 v. 10·5 h, P < 0·001) was recorded. In addition, 27 % of the individuals who experienced inadequate sleep (<9 h) engaged in longer screen time daily (≥2 h/d) (P = 0·05), had an inadequate bedtime (> 22 h) or adequate wake-up time (5-7 h), studied in the morning (P < 0·001) and never took a shower before school (P < 0·001). Of the entire sample, 9·9 % had poor or very poor sleep quality and a greater probability of sleep talking regularly, had difficulty falling asleep, and engaged in inadequate social behaviour while experiencing these conditions compared with those with positive sleep quality. There was no association between sleep and the other variables investigated. CONCLUSIONS Sleep impairment contributed to changes in sleep and social behaviour in schoolchildren. The findings of this study may reinforce the importance of developing actions to promote adequate sleep and a healthy lifestyle at school age.
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Adolescent sleep characteristics and body-mass index in the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Sci Rep 2020; 10:13277. [PMID: 32764616 PMCID: PMC7411010 DOI: 10.1038/s41598-020-70193-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 07/22/2020] [Indexed: 01/08/2023] Open
Abstract
Sleep may play a role in overweight and obesity in adolescents. The objective of this study is to investigate the relationships between sleep duration and timing and overweight and obesity status in adolescents, with a special emphasis on weekday-weekend difference in sleep characteristics as well as sex-specific relationships. We examined 1,254 U.S. adolescents (12-17 years) self-reported sleep duration, timing, weekday-weekend differences in duration and timing in relation to overweight and obesity. We found an inverse association between sleep duration and overweight and obesity. Compared to 8-9 h of sleep, short sleep (< 7 h) on weekdays was associated with higher odds of overweight and obesity [Odds ratio (95% confidence interval), 1.73 (1.00, 2.97)] in the overall population, while long sleep (10+ h) on weekends was associated with lower odds, but only in males [0.56 (0.34, 0.92)]. We also found that a larger weekday-weekend difference in sleep duration was associated with overweight and obesity in females, but not in males. Specifically, the odds of overweight and obesity were significantly higher among females reporting longer sleep on weekends than weekdays by ≥ 2 h [2.31 (1.15, 4.63)] when compared to those reporting little weekday-weekend differences. Sleep timing, or weekday-weekend differences in sleep timing, were not associated with overweight and obesity in the overall population, although we found suggestive evidence linking later weekend sleep with overweight and obesity in females. Our findings support a role of sleep in adolescent obesity and suggest sex-differences in this relationship that warrant future studies.
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Zuraikat FM, Makarem N, Redline S, Aggarwal B, Jelic S, St-Onge MP. Sleep Regularity and Cardiometabolic Heath: Is Variability in Sleep Patterns a Risk Factor for Excess Adiposity and Glycemic Dysregulation? Curr Diab Rep 2020; 20:38. [PMID: 32700156 PMCID: PMC7584347 DOI: 10.1007/s11892-020-01324-w] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW Night-to-night variability in sleep patterns leads to circadian disruption and, consequently, could increase cardiometabolic risk. The purpose of this review is to summarize findings from studies published between 2015 and 2020 examining various measures of night-to-night variability in sleep in relation to metabolic syndrome (MetS), type 2 diabetes (T2D), and their risk factors. We illustrate a potential causal pathway between irregular sleep patterns and T2D, highlighting knowledge gaps along the way. RECENT FINDINGS Across different measures of sleep variability, irregular sleep patterns were associated with poorer cardiometabolic outcomes. Higher standard deviations (SD) across nights of sleep duration and onset or midpoint of sleep were associated with increased odds of having MetS and clusters of metabolic abnormalities as well as greater adiposity and poorer glycemic control. Conversely, greater regularity of rest-activity patterns related to lower risk for T2D. Social jetlag was associated with glycemic dysregulation, adiposity, T2D, and MetS. These associations are often observed in both metabolically healthy and unhealthy individuals; both higher SD of sleep duration and social jetlag relate to poorer glucose regulation in individuals with diabetes. There is consistent evidence of associations of sleep variability with increased risk for adiposity, glucose dysregulation, T2D, and MetS. Although experimental evidence is needed to determine causation, there is support to recommend stabilizing sleep patterns for cardiometabolic risk prevention.
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Affiliation(s)
- Faris M Zuraikat
- Department of Medicine, Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Nour Makarem
- Department of Medicine, Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Medicine, Columbia University Irving Medical Center, 51 Audubon Avenue, 5th floor, New York, NY, USA
| | - Susan Redline
- Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Brooke Aggarwal
- Department of Medicine, Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Medicine, Columbia University Irving Medical Center, 51 Audubon Avenue, 5th floor, New York, NY, USA
| | - Sanja Jelic
- Department of Medicine, Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Medicine, Columbia University Irving Medical Center, 630 West 168th Street, P&S8-512, New York, NY, USA
| | - Marie-Pierre St-Onge
- Department of Medicine, Sleep Center of Excellence, Columbia University Irving Medical Center, New York, NY, 10032, USA.
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Yano Y, Gao Y, Johnson DA, Carnethon M, Correa A, Mittleman MA, Sims M, Mostofsky E, Wilson JG, Redline S. Sleep Characteristics and Measures of Glucose Metabolism in Blacks: The Jackson Heart Study. J Am Heart Assoc 2020; 9:e013209. [PMID: 32342760 PMCID: PMC7428566 DOI: 10.1161/jaha.119.013209] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 01/07/2020] [Indexed: 01/21/2023]
Abstract
Background Characterizing associations of sleep characteristics with blood-glucose-level factors among blacks may clarify the underlying mechanisms of impaired glucose metabolism and help identify treatment targets to prevent diabetes mellitus in blacks. Methods and Results Cross-sectional analyses were conducted in 789 blacks who completed home sleep apnea testing and 7-day wrist actigraphy in 2012-2016. Sleep-disordered breathing measurements included respiratory event index associated with 4% oxygen desaturation and minimum oxygen saturation. Sleep patterns on actigraphy included fragmented sleep indices. Associations between sleep characteristics (8 exposures) and measures of glucose metabolism (3 outcomes) were determined using multivariable linear regression. Mean (SD) age of the participants was 63 (11) years; 581 (74%) were women; 198 (25%) were diabetes mellitus, and 158 (20%) were taking antihyperglycemic medication. After multivariable adjustment, including antihyperglycemic medication use, the betas (95% CI) for fasting glucose and hemoglobin A1c, respectively, for each SD higher level were 0.13 (0.02, 0.24) mmol/L and 1.11 (0.42, 1.79) mmol/mol for respiratory event index associated with 4% oxygen desaturation and 0.16 (0.05, 0.27) mmol/L and 0.77 (0.10, 1.43) mmol/mol for fragmented sleep indices. Among 589 participants without diabetes mellitus, the betas (95% CI) for homeostatic model assessment of insulin resistance for each SD higher level were 1.09 (1.03, 1.16) for respiratory event index associated with 4% oxygen desaturation, 0.90 (0.85, 0.96) for minimum oxygen saturation, and 1.07 (1.01, 1.13) for fragmented sleep indices. Conclusions Sleep-disordered breathing, overnight hypoxemia, and sleep fragmentation were associated with higher blood glucose levels among blacks.
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Affiliation(s)
- Yuichiro Yano
- Department of Family Medicine and Community HealthDuke UniversityDurhamNC
| | - Yan Gao
- Department of Physiology and BiophysicsUniversity of Mississippi Medical CenterJacksonMS
| | - Dayna A. Johnson
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Division of Sleep MedicineHarvard Medical SchoolBostonMA
| | - Mercedes Carnethon
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Adolfo Correa
- Departments of Pediatrics and MedicineUniversity of Mississippi Medical CenterJacksonMS
| | - Murray A. Mittleman
- Department of EpidemiologyHarvard T.H. Chan School 12 of Public HealthBostonMA
- Cardiovascular Epidemiology Research UnitBeth Israel Deaconess Medical CenterBostonMA
| | - Mario Sims
- Departments of Pediatrics and MedicineUniversity of Mississippi Medical CenterJacksonMS
| | - Elizabeth Mostofsky
- Department of EpidemiologyHarvard T.H. Chan School 12 of Public HealthBostonMA
- Cardiovascular Epidemiology Research UnitBeth Israel Deaconess Medical CenterBostonMA
| | - James G. Wilson
- Department of Physiology and BiophysicsUniversity of Mississippi Medical CenterJacksonMS
| | - Susan Redline
- Division of Sleep and Circadian DisordersBrigham and Women’s HospitalBostonMA
- Division of Sleep MedicineHarvard Medical SchoolBostonMA
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Taylor RW, Williams SM, Galland BC, Farmer VL, Meredith-Jones KA, Schofield G, Mann JI. Quantity versus quality of objectively measured sleep in relation to body mass index in children: cross-sectional and longitudinal analyses. Int J Obes (Lond) 2020; 44:803-811. [PMID: 32099105 DOI: 10.1038/s41366-020-0552-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 02/06/2020] [Accepted: 02/12/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Although sleep duration is well established as a risk factor for child obesity, how measures of sleep quality relate to body size is less certain. The aim of this study was to determine how objectively measured sleep duration, sleep timing, and sleep quality were related to body mass index (BMI) cross-sectionally and longitudinally in school-aged children. SUBJECTS/METHODS All measures were obtained at baseline, 12 and 24 months in 823 children (51% female, 53% European, 18% Māori, 12% Pacific, 9% Asian) aged 6-10 years at baseline. Sleep duration, timing, and quality were measured using actigraphy over 7 days, height and weight were measured using standard techniques, and parents completed questionnaires on demographics (baseline only), dietary intake, and television usage. Data were analysed using imputation; mixed models, with random effects for person and age, estimated both a cross-sectional effect and a longitudinal effect on BMI z-score, adjusted for multiple confounders. RESULTS The estimate of the effect on BMI z-score for each additional hour of sleep was -0.22 (95% CI: -0.33, -0.11) in cross-sectional analyses and -0.05 (-0.10, -0.004) in longitudinal analyses. A greater effect was observed for weekday sleep duration than weekend sleep duration but variability in duration was not related to BMI z-score. While sleep timing (onset or midpoint of sleep) was not related to BMI, children who were awake in the night more frequently (0.19; 0.06, 0.32) or for longer periods (0.18; 0.06, 0.36) had significantly higher BMI z-scores cross-sectionally, but only the estimates for total time awake (minutes) were significant longitudinally (increase in BMI z-score of 0.04 for each additional hour awake). CONCLUSION The beneficial effect of a longer sleep duration on BMI was consistent in children, whereas evidence for markers of sleep quality and timing were more variable.
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Affiliation(s)
- Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Sheila M Williams
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | | | | | - Grant Schofield
- Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
| | - Jim I Mann
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Galland B, de Wilde T, Taylor R, Smith C. Sleep and pre-bedtime activities in New Zealand adolescents: differences by ethnicity. Sleep Health 2020; 6:23-31. [DOI: 10.1016/j.sleh.2019.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/27/2019] [Accepted: 09/05/2019] [Indexed: 11/16/2022]
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Hooker SA, Oswald LB, Reid KJ, Baron KG. Do Physical Activity, Caloric Intake, and Sleep Vary Together Day to Day? Exploration of Intraindividual Variability in 3 Key Health Behaviors. J Phys Act Health 2020; 17:45-51. [PMID: 31756722 PMCID: PMC7211555 DOI: 10.1123/jpah.2019-0207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/20/2019] [Accepted: 09/25/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known about how daily fluctuations in health behaviors relate to chronic disease risk. The goal of this study was to examine whether variability in physical activity, caloric intake, and sleep is related to body composition (body mass index and body fat percentage). METHODS Healthy adults (N = 103; 64% female) were monitored for 7 days to assess physical activity (SenseWear Armband), caloric intake (daily food diaries), and sleep duration and timing (Actiwatch Spectrum). Data were analyzed using correlations (between- and within-subjects correlations) and regression. RESULTS The results demonstrated that variabilities in physical activity, caloric intake, and sleep were unrelated. Caloric intake and sleep variability were unrelated to body composition. At greater levels of physical activity variability, any level of physical activity was protective for body composition. CONCLUSIONS These results suggest that among healthy adults, variabilities in health behaviors may be independent of each other, and physical activity variability may be more strongly related to body composition among those who are less active.
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Zhang Z, Pereira JR, Sousa-Sá E, Okely AD, Feng X, Santos R. The cross-sectional and prospective associations between sleep characteristics and adiposity in toddlers: Results from the GET UP! Study. Pediatr Obes 2019; 14:e12557. [PMID: 31270962 DOI: 10.1111/ijpo.12557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/13/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The associations between sleep characteristics and adiposity in children under three years are not fully understood yet. OBJECTIVE The objective of the study is to examine the cross-sectional and prospective associations between sleep characteristics and adiposity in toddlers over a 12-month period. METHODS Participants were 202 toddlers from the GET-UP! STUDY Sleep duration, sleep timing, and sleep variability were assessed using 24-hour accelerometry for seven consecutive days. Height and weight were measured, and BMI z scores were calculated. Linear mixed models were performed to examine the cross-sectional and prospective associations between sleep characteristics and adiposity, with adjustments for clustering effects and demographic factors. RESULTS Total sleep duration was negatively associated with higher adiposity cross-sectionally (B = -0.12; 95% CI: -0.23, -0.01; .033) but not prospectively (B = 0.01; 95% CI: -0.13, 0.10; .843). Nap duration was prospectively associated with higher levels of adiposity (B = 0.41; 95% CI: 0.14, 0.68; .003). Sleep variability and sleep timing were not associated with concurrent or subsequent adiposity. CONCLUSION Although sleep duration is an important factor associated with obesity in toddlerhood, the potential effects of different types of sleep duration may vary. While longer total sleep duration may protect children from increasing adiposity, longer nap duration seems to be risk factor. As evidence in this age group is scarce, more research is needed to confirm this finding.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,CIDAF (UID/DTP/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Keiraville, Australia
| | - Xiaoqi Feng
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Keiraville, Australia.,Population Wellbeing and Environment Research Lab, Faculty of Social Science, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona de Humanidades e Tecnologia, Lisbon, Portugal
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Duraccio KM, Krietsch KN, Chardon ML, Van Dyk TR, Beebe DW. Poor sleep and adolescent obesity risk: a narrative review of potential mechanisms. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2019; 10:117-130. [PMID: 31572040 PMCID: PMC6749827 DOI: 10.2147/ahmt.s219594] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/17/2019] [Indexed: 12/12/2022]
Abstract
Poor sleep is related to increased obesity risk in adolescents, though the mechanisms of this relationship are unclear. This paper presents a conceptual framework of the various pathways that have been proposed to drive this relationship. In this framework, increased food reward, emotional reactivity, decreased inhibitory control, metabolic disturbances, poorer dietary quality, and disrupted meal timings may increase the likelihood of increasing overall energy intake. This paper further notes how poor sleep increases sedentary behavior and screen time, which likely limits overall energy expenditure. The model posits that these mechanisms result in an imbalance of energy intake and expenditure following poor sleep, intensifying the overall risk for obesity. Increases in food reward processes, decreases in insulin sensitivity, disrupted meal timing, and increases in sedentary behavior seem to be the most compelling mechanisms linking poor sleep with increased obesity risk in adolescents. Future directions and clinical implications of this framework are discussed.
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Affiliation(s)
- Kara M Duraccio
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Kendra N Krietsch
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Marie L Chardon
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA
| | - Tori R Van Dyk
- Loma Linda University, Department of Psychology, Loma Linda, CA, USA
| | - Dean W Beebe
- Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA
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40
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Sleep and weight-related factors in youth: A systematic review of recent studies. Sleep Med Rev 2019; 46:87-96. [DOI: 10.1016/j.smrv.2019.04.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/11/2019] [Accepted: 04/18/2019] [Indexed: 12/28/2022]
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Van Dyk TR, Zhang N, Combs A, Howarth T, Whitacre C, McAlister S, Beebe DW. Feasibility and impact on daytime sleepiness of an experimental protocol inducing variable sleep duration in adolescents. PLoS One 2019; 14:e0218894. [PMID: 31226161 PMCID: PMC6588251 DOI: 10.1371/journal.pone.0218894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/11/2019] [Indexed: 11/19/2022] Open
Abstract
Although most research on sleep and adolescent health has focused on how long each youth sleeps on average, variability in sleep duration may be just as problematic. Existing findings have been inconsistent and unable to address cause-effect relationships. This study piloted an experimental protocol to induce sleep variability and explore its impact on daytime sleepiness in adolescents. Healthy adolescents aged 14–17 participated in a 3-week, at-home protocol. Sleep was monitored by sleep diaries and actigraphy. Following a run-in period to stabilize wake times (set at 6:30am throughout the protocol), participants were randomly counterbalanced across two 5-night experimental conditions. Bedtimes were consistent at 11:00pm during the stable sleep condition (7.5-hour sleep period each night) but changed on alternating nights during the variable sleep condition (ranging from 9:30pm to 12:30am) so that sleep duration averaged 7.5 hours across the condition with a standard deviation of 1.37 hours. Difficulty waking was assessed each morning and daytime sleepiness was assessed by end-of-condition parent- and adolescent-reports. Of the 20 participants who completed the study, 16 met the predetermined adherence definition. For those who were adherent, there were no differences in overall sleep duration between the stable and variable sleep conditions (p>.05) but adolescents had 58.6 minutes greater night-to-night variation in sleep duration in the variable condition (p < .001). Across all nights, youth reported greater difficulty waking following nights of shorter assigned sleep (p = .004) and greater overall sleepiness during the variable condition (p = .03). It is feasible to experimentally vary how long adolescents sleep on a nightly basis while holding average sleep duration constant. Such a protocol will promote tests of the acute effects of day-to-day changes in sleep duration on health.
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Affiliation(s)
- Tori R. Van Dyk
- Department of Psychology, Loma Linda University, Loma Linda, California, United States of America
- * E-mail:
| | - Nanhua Zhang
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Angela Combs
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Taylor Howarth
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Catharine Whitacre
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Shealan McAlister
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Dean W. Beebe
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
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Benestad B, Júlíusson PB, Siegfried W, Lekhal S, Småstuen MC, Hertel JK, Agosti F, Marazzi N, Hjelmesæth J, Sartorio A. Cardiometabolic risk factors differ among adolescents with obesity in three European countries - a cross-sectional study. Acta Paediatr 2019; 108:493-501. [PMID: 30118191 PMCID: PMC6585823 DOI: 10.1111/apa.14542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 12/20/2022]
Abstract
Aim We aimed to compare modifiable cardiometabolic risk factors among treatment‐seeking adolescents with obesity in Italy, Germany and Norway. Methods This retrospective, registry‐based, cross‐sectional cohort study included 2,327 (59% girls) 12–18 year‐old adolescents with obesity from three tertiary care outpatient clinics in Europe, between 1999 and 2015. The prevalence of cardiometabolic risk factors was compared between clinics, and multivariate logistic regression models including gender, age, waist circumference and body mass index were used to assess the associations between population and cardiometabolic risk. Results In total, 1,396 adolescents (60% girls) from Italy, 654 (58% girls) from Germany and 277 (51% girls) from Norway were included. The mean ± SD age was 15.2 ± 1.6 years, body mass index 38.8 ± 6.5 kg/m2 and body mass index standard deviation score 3.21 ± 0.43. The prevalence of elevated nonhigh‐density lipoprotein‐cholesterol in Norway, Germany and Italy was 60%, 54% and 45%, while the prevalence of high systolic or diastolic blood pressure (≥130 or ≥85 mmHg) were 15%, 46% and 66%, respectively. Conclusion Cardiometabolic risk factors among treatment‐seeking adolescents with obesity from Italy, Germany and Norway differed across the populations in this study, which might imply that preventive clinical work should reflect such differences.
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Affiliation(s)
- Beate Benestad
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
- Faculty of Medicine University of Oslo Oslo Norway
| | - Pétur B. Júlíusson
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
- Department of Clinical Science University of Bergen Bergen Norway
| | | | - Samira Lekhal
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
| | | | - Jens Kristoffer Hertel
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
| | - Fiorenza Agosti
- Istituto Auxologico Italiano, IRCCS Division of Metabolic Diseases and Auxology Experimental Laboratory for Auxo‐endocrinological Research, Research Center for Growth Disorders Verbania and Milan Italy
| | - Nicoletta Marazzi
- Istituto Auxologico Italiano, IRCCS Division of Metabolic Diseases and Auxology Experimental Laboratory for Auxo‐endocrinological Research, Research Center for Growth Disorders Verbania and Milan Italy
| | - Jøran Hjelmesæth
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS Division of Metabolic Diseases and Auxology Experimental Laboratory for Auxo‐endocrinological Research, Research Center for Growth Disorders Verbania and Milan Italy
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Miller AL, Miller SE, LeBourgeois MK, Sturza J, Rosenblum KL, Lumeng JC. Sleep duration and quality are associated with eating behavior in low-income toddlers. Appetite 2019; 135:100-107. [PMID: 30634008 DOI: 10.1016/j.appet.2019.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The present study examined whether different sleep health parameters (duration, timing, and quality) are associated with obesity-related eating behaviors including emotional overeating, food responsiveness, enjoyment of food, satiety responsiveness, and eating in the absence of hunger (EAH), during toddlerhood. DESIGN Among 134 low-income 33-month-old children, parents reported on child sleep parameters, including sleep quality (Children's Sleep Wake Scale; CSWS) and usual bedtimes and wake times on weekdays and weekends (weeknight sleep duration, weekday-to-weekend bedtime delay). Child eating behaviors were assessed using both observed and parent-report measures. Child Emotional Overeating, Food Responsiveness, Enjoyment of Food, and Satiety Responsiveness were measured by parent report using the Child Eating Behavior Questionnaire-Toddler. Observed child EAH was evaluated by measuring kilocalories of palatable foods consumed following a meal. Multivariable linear regression was used to examine the associations between sleep parameters and eating behaviors. RESULTS Poorer child sleep quality was associated with greater Emotional Overeating (standardized β = -0.20 (SE 0.09), p < .05) and greater Food Responsiveness (β = -0.18 (SE 0.09), p < .05). Shorter child nighttime sleep duration was associated with greater EAH kcal consumed (standardized β = -0.22 (SE 0.09), p < .05). Child bedtime delay was not associated with any of the eating behaviors, and no child sleep variables were associated with either Enjoyment of Food or Satiety Responsiveness. CONCLUSIONS Shorter nocturnal sleep duration and poorer sleep quality during toddlerhood were associated with some, but not all, of the obesity-related eating behaviors. Poor sleep health may promote childhood obesity risk through different eating behavior pathways. As children growing up in poverty may experience greater sleep decrements, sleep duration and sleep quality may be important targets for intervention among low-income families with young children.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States; Center for Human Growth and Development, University of Michigan, United States.
| | - Sara E Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States
| | | | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, United States
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, United States; Department of Psychiatry, University of Michigan Medical School, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, United States; Department of Pediatrics, University of Michigan Medical School, United States; Department of Nutritional Sciences, University of Michigan School of Public Health, United States
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Córdova FV, Barja S, Brockmann PE. Consequences of short sleep duration on the dietary intake in children: A systematic review and metanalysis. Sleep Med Rev 2018; 42:68-84. [DOI: 10.1016/j.smrv.2018.05.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/28/2018] [Accepted: 05/31/2018] [Indexed: 11/27/2022]
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Family contexts and sleep during adolescence. SSM Popul Health 2018; 7:004-4. [PMID: 30581955 PMCID: PMC6293031 DOI: 10.1016/j.ssmph.2018.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 01/13/2023] Open
Abstract
Sleep deprivation among adolescents has received much attention from health researchers and policymakers. Recent research indicates that variation in sleep duration from night to night is associated with multiple health outcomes. While there is evidence that sleep deprivation is socially patterned, we know little about how social contexts are associated with nightly sleep variation during adolescence (a life course stage when nightly sleep variation is particularly high). Given the importance of family environments for influencing adolescents’ sleep patterns, we hypothesized that disadvantaged family contexts would be associated with higher intra-individual variation (IIV) in nightly sleep duration, in addition to lower average nightly sleep duration. We tested these hypotheses in a diverse, population-based sample of 11–17 year-olds (N = 1095) from the Adolescent Health and Development in Context Study. Using survey and ecological momentary assessment data and a novel form of multi-level regression modeling (location-scale mixed modeling), we found that adolescents living in unmarried-parent, low SES, economically insecure, and high caregiver stress families had higher IIV in sleep than adolescents in families with more resources and less caregiver stress. There were fewer family effects on average sleep duration. This suggests family social and economic contexts are associated with an under-researched aspect of adolescent sleep, nightly variation, and may contribute to adolescent sleep problems with implications for their health and health disparities. Consistency in nightly sleep duration is important for adolescent health. SES and family stress associated with variability in sleep duration in adolescents. Caregiver distress also associated with lower mean sleep duration among adolescents.
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Chan WS. Daily associations between objective sleep and consumption of highly palatable food in free-living conditions. Obes Sci Pract 2018; 4:379-386. [PMID: 30151232 PMCID: PMC6105709 DOI: 10.1002/osp4.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Prior studies have shown that individuals with shorter sleep duration and later sleep timing consume more highly palatable food (HPF). It is unclear if this relationship exists at the within-individual level, e.g. if sleeping less or later on one night is associated with greater HPF consumption in the following day in naturalistic environments. This study examined the daily associations between naturalistic sleep and HPF consumption. METHODS Data were obtained from 78 healthy young adults (age = 20.38 [SD = 2.40] years). Participants carried a wrist actigraph and completed daily diaries tracking food consumption and covariates for seven consecutive days. Data were analysed using mixed models. RESULTS Individuals with later bedtime were less likely to consume HPF at breakfast in the following day (odds ratio, OR [between] = 0.55 [0.44, 0.70], p < 0.001). This association was also significant at the within-individual level (OR (within) = 0.85 [0.74, 0.97], p = 0.016) - sleeping later on one night was associated with 15% decrease in the odds of consuming HPF at breakfast in the following day. Individual with later wake time had greater likelihood of consuming HPF at dinner (OR = 1.34 [1.03, 1.75], p = 0.027). CONCLUSIONS Sleep schedules characterized by later bedtimes and later wake times were associated with lower HPF consumption earlier in the following day but greater HPF consumption later in the day. This pattern of energy intake might mediate the association between sleep and the risk of obesity.
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Affiliation(s)
- W. S. Chan
- Department of Psychiatry, Geisel School of Medicine at DartmouthDartmouth‐Hitchcock Medical CenterLebanonNHUSA
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Ingram DG, Irish LA, Tomayko EJ, Prince RJ, Cronin KA, Parker T, Kim K, Carmichael L, Grant VM, Sheche JN, Adams AK. Overnight sleep duration and obesity in 2-5 year-old American Indian children. Pediatr Obes 2018; 13:406-412. [PMID: 29700995 PMCID: PMC6383521 DOI: 10.1111/ijpo.12281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sleep has emerged as a potentially modifiable risk factor for obesity in children. OBJECTIVES The purpose of this investigation was to evaluate the association between overnight sleep duration and obesity among American Indian (AI) children ages 2-5 years. METHODS Data were examined from the baseline assessment of children enrolling in the Healthy Children, Strong Families study, which is a randomized lifestyle intervention trial in five diverse rural and urban AI communities nationally among children ages 2-5 years. Multivariable models were built to assess the relationship between sleep duration and BMI z-score while controlling for potential sociodemographic and behavioural covariates. RESULTS Three hundred and ninety-eight children had sufficient data to be included in analysis. In multivariable models controlling for potential covariates, overnight sleep duration was significantly and inversely associated with BMI z-score (B = -0.158, t = -1.774, P = 0.006). Similarly, when controlling for covariates, children who slept 12 or more hours had significantly lower BMI z-scores compared with those who slept 8 to 10 h (P = 0.018) or less than 8 h (P = 0.035); the difference between 12+ hours and 10 to 12-h groups did not reach statistical significance (P = 0.073) but supported a linear relationship between overnight sleep duration and BMI. Weekday-to-weekend variability in overnight sleep duration was not associated with BMI z-score (B = 0.010, t = 0.206, P = 0.837). CONCLUSIONS Overnight sleep duration is independently and inversely related to BMI z-score among AI children ages 2-5 years, even when controlling for important sociodemographic and obesogenic lifestyle factors. This represents the first report, to our knowledge, of sleep duration as a risk factor for obesity among AI children.
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Affiliation(s)
- David G Ingram
- Division of Pulmonary and Sleep Medicine, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Leah A Irish
- Department of Psychology, North Dakota State University, Fargo, ND, 58102, USA
| | - Emily J Tomayko
- Department of Nutrition, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Ronald J Prince
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53715, USA
| | - Kate A Cronin
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53715, USA
| | - Tassy Parker
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - KyungMann Kim
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53729, USA
| | - Lakeesha Carmichael
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53729, USA
| | - Vernon M Grant
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53715, USA
| | - Judith N Sheche
- First Nations Community Healthsource, Albuquerque, NM, 87108, USA
| | - Alexandra K Adams
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, 53715, USA
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Borisenkov MF, Polugrudov AS, Paderin NM, Bakutova LA. Young inhabitants of the North with late chronotype and social jetlag consume more high-calorie foods and alcohol. BIOL RHYTHM RES 2018. [DOI: 10.1080/09291016.2018.1455867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- M. F. Borisenkov
- Institute of Physiology, Komi Science Centre, the Urals Branch of the Russian Academy of Science, Syktyvkar, Russia
| | - A. S. Polugrudov
- Institute of Physiology, Komi Science Centre, the Urals Branch of the Russian Academy of Science, Syktyvkar, Russia
| | - N. M. Paderin
- Institute of Physiology, Komi Science Centre, the Urals Branch of the Russian Academy of Science, Syktyvkar, Russia
| | - L. A. Bakutova
- Institute of Physiology, Komi Science Centre, the Urals Branch of the Russian Academy of Science, Syktyvkar, Russia
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Watson EJ, Coates AM, Banks S, Kohler M. Total dietary sugar consumption does not influence sleep or behaviour in Australian children. Int J Food Sci Nutr 2017; 69:503-512. [DOI: 10.1080/09637486.2017.1386628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Emily J. Watson
- Centre for Sleep Research, School of Psychology, University of South Australia, Adelaide, Australia
| | - Alison M. Coates
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Siobhan Banks
- Centre for Sleep Research, School of Psychology, University of South Australia, Adelaide, Australia
| | - Mark Kohler
- Centre for Sleep Research, School of Psychology, University of South Australia, Adelaide, Australia
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Felső R, Lohner S, Hollódy K, Erhardt É, Molnár D. Relationship between sleep duration and childhood obesity: Systematic review including the potential underlying mechanisms. Nutr Metab Cardiovasc Dis 2017; 27:751-761. [PMID: 28818457 DOI: 10.1016/j.numecd.2017.07.008] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 12/11/2022]
Abstract
AIM The prevalence of obesity is continually increasing worldwide. Determining risk factors for obesity may facilitate effective preventive programs. The present review focuses on sleep duration as a potential risk factor for childhood obesity. The aim is to summarize the evidence on the association of sleep duration and obesity and to discuss the underlying potential physiological and/or pathophysiological mechanisms. DATA SYNTHESIS The Ovid MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for papers using text words with appropriate truncation and relevant indexing terms. All studies objectively measuring sleep duration and investigating the association between sleep duration and obesity or factors (lifestyle and hormonal) possibly associated with obesity were included, without making restrictions based on study design or language. Data from eligible studies were extracted in tabular form and summarized narratively. After removing duplicates, 3540 articles were obtained. Finally, 33 studies (including 3 randomized controlled trials and 30 observational studies) were included in the review. CONCLUSION Sleep duration seems to influence weight gain in children, however, the underlying explanatory mechanisms are still uncertain. In our review only the link between short sleep duration and the development of insulin resistance, sedentarism and unhealthy dietary patterns could be verified, while the role of other mediators, such as physical activity, screen time, change in ghrelin and leptin levels, remained uncertain. There are numerous evidence gaps. To answer the remaining questions, there is a need for studies meeting high methodological standards and including a large number of children.
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Affiliation(s)
- R Felső
- University of Pécs, Department of Paediatrics, Pécs, Hungary
| | - S Lohner
- University of Pécs, Cochrane, Hungary
| | - K Hollódy
- University of Pécs, Department of Paediatrics, Pécs, Hungary
| | - É Erhardt
- University of Pécs, Department of Paediatrics, Pécs, Hungary
| | - D Molnár
- University of Pécs, Department of Paediatrics, Pécs, Hungary.
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