Prospective Associations between Weekend Catch-Up Sleep, Physical Activity, and Childhood Obesity

The effects of sleep disruption on metabolism, hunger, and satiety, and the influence of psychosocial stress and exercise: A narrative review

Sleep deficiency is a ubiquitous phenomenon among Americans. In fact, in the United States, ∼78% of teens and 35% of adults currently get less sleep than recommended for their age-group, and the quality of sleep appears to be getting worse for many. The consequences of sleep disruption manifest in a myriad of ways, including insulin resistance and disrupted nutrient metabolism, dysregulation of hunger and satiety, and potentially increased body weight and adiposity. Consequently, inadequate sleep is related to an increased risk of various cardiometabolic diseases, including obesity, diabetes, and heart disease. Exercise has the potential to be an effective therapeutic to counteract the deleterious effects of sleep disruption listed above, whereas chronic psychosocial stress may causally promote sleep disruption and cardiometabolic risk. Here, we provide a narrative review of the current evidence on the consequences of short sleep duration and poor sleep quality on substrate metabolism, circulating appetite hormones, hunger and satiety, and weight gain. Secondly, we provide a brief overview of chronic psychosocial stress and its impact on sleep and metabolic health. Finally, we summarise the current evidence regarding the ability of exercise to counteract the adverse metabolic health effects of sleep disruption. Throughout the review, we highlight areas where additional interrogation and future exploration are necessary.

Association of Sleep Duration and Weekend Catch-Up Sleep with Suicidal Ideation among Adolescents with Atopic Dermatitis

Atopic dermatitis (AD) is a prevalent allergic disease in children that often causes sleep disturbance and which is associated with diminished quality of life and heightened susceptibility to depression and suicidality. In this study, we investigate the relationship between weekend catch-up sleep (WCUS) and mental health in a sample of 71,434 adolescents with AD and 221,057 without AD using multivariate logistic regression analysis. We hypothesized that adolescents with AD experience shorter total and daytime sleep due to pruritus, with compensatory longer WCUS. We found that the lifetime prevalence of AD was 24.4%, and that adolescents with AD slept less overall, with significantly shorter weekday and weekend sleep durations but longer weekend catch-up sleep (WCUS). Sleep dissatisfaction was markedly higher in the AD group. Interestingly, our results suggest that prolonged WCUS is a protective factor against suicidal ideation in adolescents with AD. The study highlights the importance of addressing sleep patterns in adolescents with AD to enhance mental health. Overall, our findings indicate a need for increased awareness and intervention strategies to ensure sufficient sleep and reduce the risk of suicidal ideation in this population.

Effect of catch-up sleep on obesity in Korean adolescents: a nationwide cross-sectional study

Background

Adolescents have weekday/weekend sleep discrepancies and may compensate for weekday sleep debt through sleep extension on weekends.

Objective

We investigated the effects of total sleep duration on weekdays/weekends on obesity and determined if weekend catch-up sleep has an ameliorating effect on obesity in Korean adolescents.

Methods

Using data from the KNHANES VII, 1,306 middle and high school students were assessed for total sleep duration on weekdays, weekends, and the entire week, as well as weekend sleep extension. Participants were classified into four groups according to weekend sleep extension.

Results

Total sleep duration and weekend sleep duration were negatively associated with body mass index z-score. Increased weekend sleep duration and sleep extension on weekends decreased the relative risk of overweight/obesity with each 30 min increment, reducing the risk by a factor of 0.39 and 0.93, respectively. The risk of overweight/obesity in adolescents who slept less than 6 h on weekdays increased by a factor of 1.93 when they slept for less than 3 h on weekends.

Conclusion

Weekend catch-up sleep had a negative dose-dependent association with obesity in Korean adolescents. Sleeping longer on weekends may be associated with a decreased risk of obesity, even if the adolescent obtains less sleep during weekdays. However, further prospective studies are needed to establish the causality between extended weekend sleep and obesity.

Results from the Hong Kong's 2022 report card on physical activity for children and adolescents

Background/objective

This paper aimed to summarize the findings of the third (2022) Active Healthy Kids Hong Kong Report Card on Physical Activity for Children and Adolescents and evaluate the secular trends of physical activity related indicators.

Methods

Five behavioral indicators (Overall Physical Activity, Organized Sport and Physical Activity, Active Play, Active Transportation, and Sedentary Behavior), three outcome indicators (Physical Fitness, Sleep, and Obesity) and four sources of influence indicators (Family and Peers, School, Community and Environment, and Government) were assigned a letter grade (ranging from A+ to F or incomplete) based on the best available evidence following a harmonized approach developed by the Active Healthy Kids Global Alliance. Data sources included published journal articles, government reports, manual searches, and personal contacts; and consisted of both pre-COVID-19 and after-COVID-19 evidence.

Results

Grades for Overall Physical Activity (D−∗∗) and Sedentary Behavior (D) deteriorated compared to the 2018 Report Card. The other three behavioral indicators, Organized Sport and Physical Activity, Active Play, and Active Transportation, were assigned B−, D, and B+, respectively. Physical Fitness (D), Sleep (C−), and Obesity (D−) obtained the same grades as in the 2018 Report Card. School (B) and Government (C+) grades slightly improved, while Community and Environment grade (B) was stable. Family and Peers was not graded due to insufficient evidence.

Conclusions

Despite slight improvements in influence indicators, physical activity and sedentary behavior have changed unfavorably for children and adolescents in Hong Kong. Strategic investments are needed to improve adoption and implementation of effective interventions.

Weekend catch-up sleep is associated with the alleviation of non-alcoholic fatty liver disease

INTRODUCTION AND OBJECTIVES

Recently, interest in the relationship between weekend catch-up sleep (WCUS) and chronic diseases is increasing. We aimed to study the correlation between sleep duration and non-alcoholic fatty liver disease (NAFLD), an emerging metabolic disease.

MATERIALS AND METHODS

Data on sleep duration from the Korea National Health and Nutrition Examination Survey was recorded. The subjects were divided into three groups according to the duration of WCUS: Group 1, those who slept for less than 7 hours in a week; Group 2, those who slept for less than 7 hours on weekdays but more than 7 hours on weekends (those with WCUS pattern); and Group 3, those who slept for more than 7 hours in a week. Multivariate logistic regression analysis was used to analyze the correlation between sleep duration and NAFLD.

RESULTS

A mean sleep time of 7 hours or more showed a significant negative relationship with NAFLD (odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.79-0.89 in all; OR 0.91, 95%CI 0.84-0.99 in males; OR 0.86, 95%CI 0.79-0.94 in females). Groups 2 and 3 showed significant negative relationships with NAFLD when Group 1 was used as a reference (Group 2; OR: 0.80, 95%CI: 0.70-0.92, Group 3; OR: 0.73, 95%CI: 0.66-0.82). WCUS showed similar correlations with NAFLD, regardless of sex.

CONCLUSIONS

WCUS and sleep duration are significantly associated with NAFLD. A prospective cohort study is needed to prove the causal effects.

Effects of ad libitum food intake, insufficient sleep and weekend recovery sleep on energy balance

STUDY OBJECTIVES

Insufficient sleep is believed to promote positive energy balance (EB) and weight-gain. Increasing weekend sleep duration to "recover" from weekday sleep loss is common, yet little is known regarding how weekend recovery sleep influences EB. We conducted a randomized controlled trial to assess how: 1) 2 days and 8 days of insufficient sleep and 2) ad libitum weekend recovery sleep impact EB (energy intake [EI] - energy expenditure [EE]).

METHODS

Following ten baseline days with 9h per night sleep opportunities, participants completed one of three 10-day experimental protocols with ad libitum EI: control (9h sleep opportunities; n=8; 23±5y [mean±SD]); sleep restriction (SR; 5h sleep opportunities; n=14; 25±5y); sleep restriction with weekend recovery sleep (SR+WR; 5 days insufficient sleep, 2 days ad libitum weekend recovery sleep, 3 days recurrent insufficient sleep; n=14; 27±4y).

RESULTS

24h EB increased (P < 0.001; main effect) by an average of 797.7±96.7 (±SEM) kcal during the 10-day experimental protocol versus baseline with no significant differences between groups. Percent change from baseline in 24h-EE was higher (P < 0.05) on day 2 of insufficient sleep (SR and SR+WR groups; 10±1%) versus adequate sleep (control group; 4±3%).

CONCLUSIONS

In this between-group study, the effects of adequate sleep and insufficient sleep, with or without or weekend recovery sleep, on 24h-EB were similar. Examining EB and body weight changes using within-subject cross-over designs and "free-living" conditions outside the laboratory (e.g., sleep extension) are needed to advance our understanding of the links between insufficient sleep, weekend recovery sleep and weight-gain.

Short duration of sleep and incidence of overweight or obesity in Chinese children and adolescents: A systematic review and meta-analysis of prospective studies

BACKGROUND AND AIMS

Overweight and obesity in children have become a global public health problem. Epidemiological studies suggest that sleep duration may contribute to the incidence of overweight and obesity in all stages of life. China has an increasing prevalence of overweight and obesity, and sleep deprivation is common among Chinese children. The aim of this study was to assess the prospective relationship between short sleep duration and overweight or obesity in Chinese children and to gain an estimate of the risk.

METHODS AND RESULTS

A systematic search was performed on 28/04/2020 by using Medline, PubMed and Web of Science. The exposure was the duration of sleep, and the outcome measure the incidence of overweight or obesity. The odds ratios (OR) and hazard ratios (HR) and 95% confidence intervals (C.I.) were extracted to calculate the pooled relative risk (RR) by a random effect model. Heterogeneity and publication bias of the studies were checked by sensitivity analysis. Seven studies fulfilled the criteria for a systematic review, and 5 studies for a meta-analysis. The total of 33,206 participants included boys and girls, aged 6-17 years old. In Chinese children the pooled RR for short sleep duration and overweight or obesity combined was 1.47 (95% C.I. 1.26, 1.71, p < 0.00001, n = 32,607), and for obesity alone 1.40 (95% C.I. 1.01, 1.95, p = 0.04, n = 17,038). There was no significant heterogeneity or publication bias between studies.

CONCLUSION

Short sleep duration is associated with the development of overweight and obesity in Chinese children.

Sleep duration and obesity in children and adolescents: evidence from an updated and dose-response meta-analysis

BACKGROUND AND OBJECTIVES

The association between sleep duration and obesity in children and adolescents has been widely evaluated, whereas the current findings are mixed and prospective studies are limited. To shed more light on this issue and explore the dose-response relationship, we performed the present updated meta-analysis by synthesizing the results of prospective cohorts.

METHODS

Literature retrieval, study selection and data extraction were completed independently and in duplicate. Effect-size estimates are expressed as relative risk (RR) with 95% confidence interval (CI) or standardized regression coefficient (β) with standard error.

RESULTS

Data from 33 articles, involving 57,848 children and adolescents, were meta-analyzed. Overall analyses revealed statistically significant associations of short (adjusted RR = 1.57, 95% CI: 1.36 to 1.81, P < 0.001) and long sleep duration (0.83, 0.75 to 0.93, 0.001) with obesity. Short sleep duration was also associated with significant changes in body mass index z-score (mean difference = -0.06; 95% CI: -0.09 to -0.04; P < 0.001). By contrast, long sleep duration was identified as a protective factor for childhood obesity. In dose-response analyses, short sleep duration was significantly associated with obesity in toddlers (1-2 years) (adjusted RR = 1.20, 95% CI: 1.07 to 1.34, P = 0.001), preschool-aged (3-5 years) children (1.58, 1.36 to 1.83, <0.001), and school-aged (6-13 years) children (1.82, 1.51 to 2.21, <0.001). In subgroup analyses, geographic region, sleep duration assessment, age, and follow-up interval were possible sources of heterogeneity.

CONCLUSIONS

Our findings indicate that short sleep duration can increase the risk of obesity in children and adolescents, especially within 3-13 years of age, and long sleep duration seemed beneficial in preventing obesity.

A Systematic Review of Children's Physical Activity Patterns: Concept, Operational Definitions, Instruments, Statistical Analyses, and Health Implications

Despite the widespread use of the expression “physical activity pattern” (PAP), there apparently is no general consensus regarding its definition. This systematic review aimed to examine available research focussing on (1) definitions of PAP, (2) instruments/techniques used to describe PAP, (3) statistical approaches used to analyse PAP, and (4) implications of PAP on children’s health. A systematic review of the available literature was done to identify studies published up to October 2019, and 76 studies were eligible. None of the studies presented a formal definition of PAP; a wide range of instruments were used to investigate children’s PAP, and most of the revised studies did not explicitly present a formal statistical model to define PAP. Twenty-four papers purported to examine associations between PAP and health indicators. The review highlights no consensus on a clear PAP definition whatever the instrument used to capture it, and we did not find any agreement regarding how best to analyse PAP. We suggest that PAP should be used when targeting the investigation of similarities/dissimilarities, as well as stabilities and/or changes in children’s PA at an intra-personal level. In sum, PAP should be used to best describe individual streams of behaviours, and not exclusively PA levels/intensities.

Compliance With 24-Hour Movement Guidelines in Hong Kong Adolescents: Associations With Weight Status

BACKGROUND

This study examined the compliance with the 24-Hour Movement Guidelines among Hong Kong adolescents and its associations with body mass index (BMI).

METHODS

A total of 1039 adolescents (11-18 y) wore the activPAL™ for 24 hours for 7 consecutive days to assess physical activity (PA) and sleep duration. Screen time was measured using the Children's Leisure Activities Study Survey (Chinese version). Linear mixed models were performed for analysis.

RESULTS

The analytic sample consisted of 692 adolescents (53% girls). Only 1.0% of the adolescents met all of the recommendations. The proportions of adolescents who met the recommendation for PA, screen time, and sleep were 9.1%, 31.2%, and 38.6%, respectively. Adolescent boys who did not meet the PA recommendation (β = 3.36; 95% CI, 1.04 to 5.68; P = .001) and those who did not meet the combination of PA and sleep recommendations (β = 2.10, 95% CI, 0.64 to 3.56; P = .01) had a higher body mass index than those who met the respective recommendations.

CONCLUSIONS

Compliance with the 24-Hour Movement Guidelines was alarmingly low among Hong Kong adolescents. Meeting the PA recommendation or the combination of PA and sleep recommendations was associated with a healthier body weight in boys.

Does Weekend Catch-up Sleep Affect High-Sensitivity C-Reactive Protein Levels Among Korean Workers?: A Cross-Sectional Study Using KNHANES

OBJECTIVE

We sought to determine whether weekend catch-up sleep (CUS) influenced serum high-sensitivity C-reactive protein (hs-CRP) levels in workers.

METHODS

We analyzed the Korean National Health and Nutrition Examination Survey (2016) data from 3304 workers. Univariate and multivariate logistic regression analyses were used to calculate odds ratios and 95% confidence intervals based on serum hs-CRP cut-off values of 1.0 and 3.0 mg/L, respectively.

RESULTS

We found that at least 1-hour and less than 2 hours of weekend CUS reduced the risk of elevated hs-CRP levels (odds ratio 0.80, 95% confidence interval 0.64 to 0.99) in multivariate logistic regression analysis.

CONCLUSION

CUS may reduce serum hs-CRP levels in workers, thereby reducing the risk of cardiovascular disease.

Sleep: Never Wasted but Often Too Short

Sleep duration and food intake are interconnected and important for health. New research shows that reducing sleep across five nights leads to more snacking after dinner and metabolic disturbances, which ad libitum weekend sleep could only partially compensate for.