Sweet/dessert foods are more appealing to adolescents after sleep restriction

Dietary patterns and insomnia symptoms: A systematic review and meta-analysis

We aimed to systematically review and synthesize the available evidence regarding the link between dietary patterns and insomnia symptoms among the general population using observational studies. We reviewed 16,455 references, of which 37 studies met inclusion criteria with a total sample size of 591,223. There was a significant association of the Mediterranean diet (OR: 0.86; 95 % CI, 0.79, 0.93; P < 0.001; I2 = 32.68 %), a high-quality diet (OR: 0.66; 95 % CI, 0.48, 0.90; P = 0.010; I2 = 84.62 %), and an empirically-derived healthy dietary pattern (OR: 0.91; 95 % CI, 0.85, 0.98; P = 0.010; I2 = 57.14 %) with a decreased risk of insomnia symptoms. Moreover, the dietary glycemic index (OR: 1.16; 95 % CI, 1.08, 1.25; P < 0.001; I2 = 0.0 %), the dietary glycemic load (OR: 1.10; 95 % CI, 1.01, 1.20; P = 0.032; I2 = 74.36 %), and an empirically-derived unhealthy dietary pattern (OR: 1.20; 95 % CI, 1.01, 1.42; P = 0.040; I2 = 68.38 %) were linked with a higher risk of insomnia symptoms. Most individual studies were of good quality (NOS) but provided very low certainty of evidence (GRADE). Consistent data reveals that following healthy diets is associated with decreased insomnia symptoms prevalence, while adherence to an unhealthy pattern is associated with an increased prevalence of insomnia symptoms.

Altered neuronal response to visual food stimuli in adolescents undergoing chronic sleep restriction

STUDY OBJECTIVES

Poor sleep in adolescents can increase the risk of obesity, possibly due to changes in dietary patterns. Prior neuroimaging evidence, mostly in adults, suggests that lacking sleep results in increased response to food cues in reward-processing brain regions. Needed is a clarification of the mechanisms by which food reward processing is altered by the kind of chronic sleep restriction (SR) typically experienced by adolescents. This study aimed to elucidate the impact of sleep duration on response to visual food stimuli in healthy adolescents using functional neuroimaging, hypothesizing increased reward processing response after SR compared to a well-rested condition.

METHODS

Thirty-nine healthy adolescents, 14-17 years old, completed a 3-week protocol: (1) sleep phase stabilization; (2) SR (~6.5 h nightly); and (3) healthy sleep (HS) duration (~9 h nightly). Participants underwent functional MRI while performing a visual food paradigm. Contrasts of food versus nonfood responses were compared within-subject between conditions of SR and HS.

RESULTS

Under SR, there was a greater response to food stimuli compared to HS in a voxel cluster including the left ventral tegmental area and substantia nigra. No change in food appeal rating due to the sleep manipulation was detected.

CONCLUSIONS

Outcomes of this study suggest that SR, as commonly experienced by healthy adolescents, results in the elevated dopaminergic drive of the reward network that may augment motivation to seek food in the context of individual food appeal and inhibitory profiles. Countermeasures that reduce food salience could include promoting consistent HS habits.

Associations Among Sleep, Emotional Eating, and Body Dissatisfaction in Adolescents

The literature on adolescent sleep has shown a bidirectional relationship between sleep difficulties and altered eating habits, including emotional eating. However, it is unclear if this relationship is related to preexisting body concerns, or if poor sleep is the prime contributor to emotional eating patterns. This study therefore seeks to examine body dissatisfaction as a moderator of the sleep-emotional eating relationship in an at-risk sample. Adolescents (N = 106) presenting for overnight polysomnography self-reported on time-in-bed, insomnia, body dissatisfaction, and emotional eating. Less time-in-bed was correlated with a greater desire for thinness and greater insomnia severity was related to overall emotional eating and eating in response to anxiety, anger, and frustration and in response to depression. Moderation analyses revealed that the relationships between time-in-bed and eating in response to feeling unsettled (b =  -.002, 95% CI[- .003,  - .001], p < .005) and eating in response to anxiety, anger, and frustration (b =  -.01, 95% CI[- .01,  - .001], p < .05) were exacerbated by worse body dissatisfaction. Optimizing sleep may attenuate the risk for disordered eating, particularly for adolescents with high body dissatisfaction.

The efficacy of sleep lifestyle interventions for the management of overweight or obesity in children: a systematic review and meta-analysis

BACKGROUND

Childhood obesity remains a significant public health concern. Sleep duration and quality among children and youth are suboptimal worldwide. Accumulating evidence suggests an association between inadequate sleep and obesity risk, yet it is unclear whether this relationship is causal. This systematic review examines the efficacy of sleep interventions alone or as a part of lifestyle interventions for the management of overweight or obesity among children and adolescents.

METHODS

A keyword/reference search was performed twice, in January 2021 and May 2022 in MEDLINE/PubMed, EMBASE/Ovid, PsycINFO/EBSCO, The Cochrane Library, Web of Science Core Collection/Web of Science, SciELO/Web of Science, and CINAHL/EBSCO. Study eligibility criteria included youth with overweight or obesity between 5 and 17, were RCTs or quasi-randomized, and focused on the treatment of overweight and obesity with a sleep behavior intervention component. Risk of bias was assessed using the Cochrane Risk of Bias assessment tool (RoB2). A Meta-analysis was conducted to estimate the effect of interventions with a sleep component on BMI. The study protocol was registered in PROSPERO (CRD42021233329).

RESULTS

A total of 8 studies (2 quasi-experiments, 6 RCTs) met inclusion criteria and accounted for 2,231 participants across 7 countries. Only one study design isolated the effect of sleep in the intervention and reported statistically significant decreases in weight and waist circumference compared to control, though we rated it at high risk of bias. Our meta-analysis showed no significant overall effect on children's BMI as a result of participation in an intervention with a sleep component (Cohen's d = 0.18, 95% CI= -0.04, 0.40, Z = 1.56, P = .11), though caution is warranted due to substantial heterogeneity observed across studies (Tau2 = 0.08; X2 = 23.05, df = 7; I2 = 83.73%).

CONCLUSIONS

There were mixed results on the effect of sleep interventions across included studies on BMI, other weight-related outcomes, diet, physical activity, and sleep. Except for one study at low risk of bias, three were rated as 'some concerns' and four 'high risk of bias'. Findings from this study highlight the need for additional RCTs isolating sleep as a component, focusing on children and adolescents living with overweight and obesity.

Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices

Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.

The interplay between macronutrients and sleep: focus on circadian and homeostatic processes

Sleep disturbances are an emerging risk factor for metabolic diseases, for which the burden is particularly worrying worldwide. The importance of sleep for metabolic health is being increasingly recognized, and not only the amount of sleep plays an important role, but also its quality. In this review, we studied the evidence in the literature on macronutrients and their influence on sleep, focusing on the mechanisms that may lay behind this interaction. In particular, we focused on the effects of macronutrients on circadian and homeostatic processes of sleep in preclinical models, and reviewed the evidence of clinical studies in humans. Given the importance of sleep for health, and the role of circadian biology in healthy sleep, it is important to understand how macronutrients regulate circadian clocks and sleep homeostasis.

The Longitudinal Interplay between Sleep, Anthropometric Indices, Eating Behaviors, and Nutritional Aspects: A Systematic Review and Meta-Analysis

Sleep is fundamental for adolescents' healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social rhythms. Insufficient sleep has been associated with worse physical health status and irregular eating behaviors in adolescents. This review aims to systematically synthesize the longitudinal associations between adolescents' sleep dimensions (i.e., duration, timing, quality, and insomnia symptoms) and physical health indicators (i.e., anthropometric indices, fat percentage, and risk of obesity), eating behaviors, and nutritional aspects (i.e., type of diet related to the intake of specific foods and nutrients, amount and timing of food consumption, energy expenditure). A total of 28 longitudinal studies were included. The meta-analytic results showed that longer sleep duration, better sleep quality, and lower insomnia symptoms were associated with lower BMI and fat percentage and that shorter sleep duration (<7 h) and lower sleep quality were associated with a higher risk of obesity. Conversely, anthropometric indices were not related to sleep over time. Limited literature examined the bidirectional association between adolescents' sleep and their eating behaviors and nutritional aspects. Such knowledge sheds new light on the role of sleep for adolescents' health, highlighting the need to examine further the interplay between these variables.

Pediatric sleep: current knowledge, gaps, and opportunities for the future

This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field.

Impact of delaying high school start times on weight and related behaviors - the START study

In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016-2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50-65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors - for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.

The impact of delayed school start time on adolescent beverage consumption, findings from the START study

OBJECTIVES

We sought to examine the effects of high school start time delay, a proven sleep-promoting intervention, on sugary beverage (SB) consumption among U.S. adolescents.

METHODS

In the Spring of 2016 (baseline), the START study recruited 2134 ninth grade students who were enrolled high schools in the Twin Cities, MN metropolitan area. These participants were surveyed again in their 10th and 11th grade years, in Spring 2017 and 2018 (follow-ups 1 and 2). All five high schools started early (7:30 or 7:45 a.m.) at baseline. By follow-up 1, two "policy change" schools shifted their start times later (8:20 or 8:50 a.m.) and maintained these later start times through follow-up 2 while three "comparison schools" retained an early start time at all time points. Generalized estimating equations using a negative binomial distribution were used to obtain estimates of the number of sugary beverages consumed per day at each wave as well as the difference in difference (DiD) estimates between baseline and each follow-up period comparing policy change to comparison schools.

RESULTS

Mean baseline sugary beverage consumption was 0.9 (1.5) beverages per day in policy change schools and 1.2 (1.7) beverages per day in the comparison schools. While there was no evidence of impact of start time change on total SB consumption, DiD estimates revealed a small decrease in the number of caffeinated sugary beverages consumed between baseline and the second follow-up period in students attending the policy change schools relative to comparison schools in both crude (0.11/day reduction, p-value = 0.048) and adjusted analyses (0.11/day reduction, p-value = 0.028).

CONCLUSION

Although the differences in this study were quite modest, a population-wide reduction in sugary beverage consumption could have public health benefit.

Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases

Sleep is extremely important for the homeostasis of the organism. In recent years, various studies have been carried out to address factors related to sleep patterns and their influence on food choices, as well as on the onset of chronic noncommunicable diseases. The aim of this article is to provide a scientific literature review on the possible role of sleep patterns on eating behavior and the risk of noncommunicable diseases. A search was performed on Medline (PubMed interface) using several keywords (e.g., "Factors Influencing Sleep" OR "Sleep and Chronic Diseases"). Articles published between 2000 and the present date that relate sleep to cyclic metabolic processes and changes in eating behavior were selected. Changes in sleep patterns are increasingly detected today, and these modifications are mainly caused by work and lifestyle conditions as well as a growing dependence on electronic devices. Sleep deprivation and the resultant short sleep duration lead to an increased appetite via an increase in the hunger hormone (ghrelin) and a decrease in the satiety hormone (leptin). Nowadays, sleep is undervalued, and thus often impaired, with consequences for the performance of various body systems. Sleep deprivation alters physiological homeostasis and influences eating behavior as well as the onset of chronic diseases.

Dimensions of sleep quality are related to objectively measured eating behaviors among children at high familial risk for obesity

OBJECTIVE

The aim of this study was to evaluate whether dimensions of sleep quality were associated with homeostatic and hedonic eating behaviors among children with healthy weight (BMI-for-age < 90%) but varying maternal weight status.

METHODS

A total of 77 children (mean [SD], age: 7.4 [0.6] years; BMI z score: -0.10 [0.7]) with healthy weight and high (n = 32) or low (n = 45) familial obesity risk based on maternal weight status were served an ad libitum meal (homeostatic eating) followed by palatable snacks to assess eating in the absence of hunger (EAH; hedonic eating). Habitual sleep quality was quantified from seven nights of wrist actigraphy. Partial correlations, adjusted for child energy needs, pre-meal hunger, food liking, and socioeconomic status, evaluated associations of sleep with meal intake and EAH. Additionally, sleep-by-obesity risk interactions were assessed.

RESULTS

Greater sleep fragmentation was associated with higher homeostatic meal energy intake, but only among children at high familial obesity risk (p value for interaction = 0.001; β high risk = 48.6, p = 0.001). Sleep fragmentation was not associated with total EAH but was related to higher and lower intake of carbohydrates (r = 0.33, p = 0.003) and fat (r = -0.33, p = 0.003), respectively.

CONCLUSIONS

Adverse associations of poor sleep with energy intake may be amplified among children already predisposed to obesity. Furthermore, that fragmented sleep relates to preferential intake of carbohydrates over fat during EAH may suggest alterations in taste preferences with poor sleep.

The Effects of Acute Sleep Curtailment on Salt Taste Measures and Relationships with Energy-Corrected Sodium Intake: A Randomized Cross-Over Trial with Methodology Validation

(1) Background: Sleep may be a factor that influences the taste-dietary intake relationship. The effect of sleep on salt taste measures has not been adequately studied, and no standardized methodology has been developed for measuring salt taste preference. (2) Methods: A sweet taste forced-choice paired-comparison test was adapted and validated to determine salt taste preference. In a randomized cross-over trial, participants slept a curtailed night (33% reduction in sleep duration) and a habitual night, confirmed by a single-channel electroencephalograph. Salt taste tests were conducted the day after each sleep condition using five aqueous NaCl solutions. One 24-h dietary recall was obtained after each taste test. (3) Results: The adapted forced-choice paired-comparison tracking test reliably determined salt taste preference. No changes in salt taste function (intensity slopes: p = 0.844) or hedonic measures (liking slopes: p = 0.074; preferred NaCl concentrations: p = 0.092) were observed after the curtailed sleep condition compared to habitual sleep. However, sleep curtailment disrupted the association between liking slope and energy-corrected Na intake (p < 0.001). (4) Conclusions: The present study serves as the first step toward more standardized taste assessments to facilitate comparison between studies and suggests accounting for sleep when exploring taste-diet relationships.

The effect of modest changes in sleep on dietary intake and eating behavior in children: secondary outcomes of a randomized crossover trial

BACKGROUND

Insufficient sleep duration increases obesity risk in children, but the mechanisms remain unclear.

OBJECTIVES

This study seeks to determine how changes in sleep influence energy intake and eating behavior.

METHODS

Sleep was experimentally manipulated in a randomized, crossover study in 105 children (8-12 y) who met current sleep guidelines (8-11 h/night). Participants went to bed 1 h earlier (sleep extension condition) and 1 h later (sleep restriction condition) than their usual bedtime for 7 consecutive nights, separated by a 1-wk washout. Sleep was measured via waist-worn actigraphy. Dietary intake (2 24-h recalls/wk), eating behaviors (Child Eating Behavior Questionnaire), and the desire to eat different foods (questionnaire) were measured during or at the end of both sleep conditions. The type of food was classified by the level of processing (NOVA) and as core or noncore (typically energy-dense foods) foods. Data were analyzed according to 'intention to treat' and 'per protocol,' an a priori difference in sleep duration between intervention conditions of ≥30 min.

RESULTS

The intention to treat analysis (n = 100) showed a mean difference (95% CI) in daily energy intake of 233 kJ (-42, 509), with significantly more energy from noncore foods (416 kJ; 6.5, 826) during sleep restriction. Differences were magnified in the per-protocol analysis, with differences in daily energy of 361 kJ (20, 702), noncore foods of 504 kJ (25, 984), and ultraprocessed foods of 523 kJ (93, 952). Differences in eating behaviors were also observed, with greater emotional overeating (0.12; 0.01, 0.24) and undereating (0.15; 0.03, 0.27), but not satiety responsiveness (-0.06; -0.17, 0.04) with sleep restriction.

CONCLUSIONS

Mild sleep deprivation may play a role in pediatric obesity by increasing caloric intake, particularly from noncore and ultraprocessed foods. Eating in response to emotions rather than perceived hunger may partly explain why children engage in unhealthy dietary behaviors when tired. This trial was registered at Australian New Zealand Clinical Trials Registry; ANZCTR as CTRN12618001671257.

Timing of Meals and Sleep in the Mediterranean Population: The Effect of Taste, Genetics, Environmental Determinants, and Interactions on Obesity Phenotypes

Circadian rhythms regulate the sleep-wake and feeding-fasting cycles. Sleep and feeding constitute a complex cycle that is determined by several factors. Despite the importance of sleep duration and mealtimes for many obesity phenotypes, most studies on dietary patterns have not investigated the contribution of these variables to the phenotypes analyzed. Likewise, they have not investigated the factors related to sleep or mealtimes. Thus, our aims were to investigate the link between taste perception and eating/sleep patterns and to analyze the effect of the interactions between sleep/meal patterns and genetic factors on obesity phenotypes. We conducted a cross-sectional analysis on 412 adults from the Mediterranean population. We measured taste perception (bitter, sweet, salty, sour, and umami) and assessed sleep duration and waketime. The midpoint of sleep and social jetlag was computed. From the self-reported timing of meals, we estimated the eating window, eating midpoint, and eating jetlag. Adherence to the Mediterranean diet was measured with a validated score. Selected polymorphisms in the TAS2R38, CLOCK, and FTO genes were determined, and their associations and interactions with relevant phenotypes were analyzed. We found various associations between temporal eating, sleep patterns, and taste perception. A higher bitter taste perception was associated with an earlier eating midpoint (p = 0.001), breakfast time (p = 0.043), dinner time (p = 0.009), waketime (p < 0.001), and midpoint of sleep (p = 0.009). Similar results were observed for the bitter taste polymorphism TAS2R38-rs713598, a genetic instrumental variable for bitter perception, increasing the causality of the associations. Moreover, significant gene-sleep interactions were detected between the midpoint of sleep and the TAS2R38-rs713598 (p = 0.032), FTO-rs9939609 (p = 0.037), and CLOCK-rs4580704 (p = 0.004) polymorphisms which played a role in determining obesity phenotypes. In conclusion, our study provided more information on the sleep and mealtime patterns of the general Spanish Mediterranean population than on their main relationships. Moreover, we were able to show significant associations between taste perception, specifically bitter taste; sleep time; and mealtimes as well as an interaction between sleep time and several genetic variants linked to obesity phenotypes. However, additional research is needed to better characterize the causality and mechanisms behind these associations.

Chronic Unpredictable Mild Stress Model of Depression: Possible Sources of Poor Reproducibility and Latent Variables

Major depressive disorder (MDD) is one of the most common mood disorders worldwide. A lack of understanding of the exact neurobiological mechanisms of depression complicates the search for new effective drugs. Animal models are an important tool in the search for new approaches to the treatment of this disorder. All animal models of depression have certain advantages and disadvantages. We often hear that the main drawback of the chronic unpredictable mild stress (CUMS) model of depression is its poor reproducibility, but rarely does anyone try to find the real causes and sources of such poor reproducibility. Analyzing the articles available in the PubMed database, we tried to identify the factors that may be the sources of the poor reproducibility of CUMS. Among such factors, there may be chronic sleep deprivation, painful stressors, social stress, the difference in sex and age of animals, different stress susceptibility of different animal strains, handling quality, habituation to stressful factors, various combinations of physical and psychological stressors in the CUMS protocol, the influence of olfactory and auditory stimuli on animals, as well as the possible influence of various other factors that are rarely taken into account by researchers. We assume that careful inspection of these factors will increase the reproducibility of the CUMS model between laboratories and allow to make the interpretation of the obtained results and their comparison between laboratories to be more adequate.

Sleep dimensions are associated with obesity, poor diet quality and eating behaviors in school-aged children

Objectives

The aim of this cross-sectional study was to investigate the association between sleep dimensions (duration, patterns, and disturbances) with body mass index (BMI), diet quality, and eating behaviors in school-aged children. Additionally, we aimed to investigate whether obesogenic eating behaviors (higher food responsiveness, lower satiety responsiveness, and less slowness in eating) and poor diet quality could mediate the potential association between sleep and obesity in school-aged children.

Materials and methods

For all participants (n = 588 children, age 5–12 years; 51% girls) we evaluated: sleep dimensions, BMI, diet quality, eating behaviors (food responsiveness, satiety responsiveness and slowness in eating). Linear regression models were used to test associations between exposure and outcome variables. Additionally, path analysis was conducted to test whether eating behaviors mediated the relationship between sleep and obesity.

Results

Shorter sleep duration (β = −0.722, p = 0.009) and greater sleep disturbances (β = 0.031, p = 0.012) were significantly associated with BMI. Additionally, we observed that diet quality was significantly associated with sleep duration (β = 0.430, p = 0.004), the midpoint of sleep (β = −0.927, p < 0.001), and sleep disturbances (β = −0.029, p < 0.001). Among other findings, greater sleep disturbances were associated with food responsiveness (β = 0.017, p < 0.001), satiety responsiveness (β = 0.015, p < 0.001), and slowness in eating (β = 0.012, p < 0.001). Importantly, food responsiveness was found as significant mediator of the relationship between sleep and BMI (R = 0.427, R² = 0.182, p < 0.001).

Conclusions

Late sleep patterns, short sleep duration, and greater sleep disturbances are significantly related with what and how school-aged children eat. Importantly, poor diet quality was significantly related to all three sleep dimensions, while eating behaviors had a significant relationship with greater sleep disturbances. These findings may be relevant to the development of behavioral targets to prevent childhood obesity, including sleep hygiene guidelines as a strategy to improve children's eating habits, as well as their BMI.

Associations between Major Health Behaviors and Sleep Problems: Results from the 2015, 2016, 2017 Canadian Community Health Survey

BACKGROUND AND OBJECTIVES

Key health behaviors including cigarette smoking, alcohol consumption, fruit and vegetable (FV) consumption, and physical activity have been associated with sleep-related problems. This cross-sectional study describes sleep quality and duration by gender in a large adult population and examines whether health behavioral factors are associated with short/long sleep duration and sleep problems (difficulty initiating/maintaining sleep [DIMS], daytime sleepiness, and finding sleep refreshing).

METHODS

Using Canadian Community Health Survey data from cycles 2015, 2016, and 2017, binary and multinomial logistic regression models were computed.

RESULTS

Of the 44,911 respondents included, only half of respondents met the recommended sleep duration. Fifty-five percent of females and forty-one percent of males reported DIMS. Binge drinking was associated with increased DIMS, with the strongest relationship being among females reporting weekly binge drinking (odds ratio (OR) 2.03 [1.59,2.60]). Binge drinking was also associated with decreased odds of finding sleep refreshing among females only (OR 0.73 [0.56,0.96] in weekly binge drinkers). Compared to respondents who had never smoked, daily smokers had higher odds of short sleep (OR 1.50 [1.30,1.74] and OR 1.39 [1.21,1.60]; females and males, respectively). Similarly, former smokers had higher odds of DIMS (OR 1.18 [1.06,1.31]) and not finding sleep refreshing (OR 0.85 [0.77,0.95]), among females; similar OR among males. Increased FV consumption was associated with increased odds of finding sleep refreshing (OR 1.05 [1.03,1.07] and OR 1.06 [1.04,1.08] in females and males, respectively).

CONCLUSION

There is a high prevalence of sleep problems among Canadians. Potential gender differences in the relationships between health behaviors and sleep problems warrant further research.

The association between sleeping behavior, obesity, psychological depression, and eating habits among adolescents in the emirate of Abu Dhabi–United Arab Emirates

Objective

The study aimed to investigate the association between sleeping behavior (specifically sleep duration), body mass index (BMI), eating habits, and psychological mood depression among adolescents in the Emirate of Abu Dhabi- UAE.

Methods and materials

A subsample of three hundred and ninety-five participants (209 females and 186 males) from middle and high schools (aged 12–18 years) in the emirate of Abu Dhabi completed the surveys in the presence of their parents and two research assistants. Measures of daytime sleepiness and other sleep parameters (sleep duration on weekdays and weekends), eating habits, and mood depression questionnaires were reported.

Results

Differences in BMI between males and females were statistically significant (26.12 ± 4.5 vs. 24.4 ± 4.3; p < 0.01). There was a negative linear association (p < 0.01) between the students’ BMI and the weekday/ weekend sleep duration. The average weekday and weekend sleep duration ranged from 5.7 hours (weekdays) to 9.3 hours(weekend). The study showed that an increase in BMI was correlated to mood depression (r = 0.396, p<0.01). In terms of eating habits, there was a significant association between eating unhealthy food and sleep duration; 72.6% of students who slept less than 6 hours reported unhealthy eating habits (p <0.05).

Conclusion

The study showed a clear association between short sleep duration and obesity among adolescents in the UAE. This relationship between sleep duration and obesity is less studied and less understandable. Future research about exploring how sleeping behaviors can affect obesity during adolescence can support understanding this association and create an effective intervention.

Characteristic Sleep Patterns and Associated Obesity in Adolescents

Poor sleep adversely affects health and may cause obesity. Poor sleep includes short sleep duration, low quality of sleep, and sleep discrepancy. Although most studies have focused on the association between sleep duration and obesity, poor sleep is a significant risk factor for obesity. Adolescents have characteristic sleep patterns which correspond to poor sleep. Adolescents sleep late due to various biological and psychosocial factors; also, they wake up early to be on time for school. This causes them to sleep less. To make up for this sleep debt, adolescents sleep more on non-school days, which causes sleep discrepancies. Therefore, since adolescents have characteristic sleep patterns, an in-depth investigation is needed to identify whether poor sleep is a risk for obesity. This article presents an overview of the characteristic sleep patterns of adolescents, and reviews studies on the association of each sleep pattern with obesity.

The roles of sleep and executive function in adolescent nighttime eating

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.

Effect of changes in children's bedtime and sleep period on targeted eating behaviors and timing of caloric intake

Short sleep is associated with obesity risk. Experimental studies with adults and observational studies with children demonstrate that changes in eating, including increased caloric intake from energy-dense foods and sugar-sweetened beverages as well as increased caloric intake in the evening, may partially account for this increased risk. We therefore examined whether experimental changes in children's sleep period lead to changes in reported caloric intake from energy-dense snack foods and sugar-sweetened beverages, and in the evening. Thirty-seven children, 8-11 years old, completed a three-week study that used a within-subject randomized cross-over design. Children slept their typical amount for one week and were subsequently randomized to either increase or decrease their typical amount by 1.5 h/night for one week; the alternate schedule was completed during the third week of the study, creating a 3-h time in bed difference between the increase and decrease conditions. Sleep was monitored with actigraphy, and dietary intake was assessed with 24-hour dietary recalls. Participants reported consuming 35 kcal per day more from sugar-sweetened beverages during the decrease sleep than the increase sleep condition, p = .033. There were no reported differences between conditions from energy-dense snack foods. Although no differences in reported intake were observed earlier in the day, from 2000 h (8:00 PM) and later, children reported consuming 132 kcal more during the decrease sleep condition than the increase condition, p < 0.001. Shortened sleep achieved by delaying bedtimes led to increased caloric intake in the evening and from sugar-sweetened beverages. Clinical Trials Registration: clinicaltrials.gov Identifier: NCT01030107.

Losing sleep by staying up late leads adolescents to consume more carbohydrates and a higher glycemic load

This study examined how short sleep impacts dietary consumption in adolescents by testing whether experimentally shortening sleep influences the amount, macronutrient content, food types, and timing of food consumed. Ninety-three adolescents completed a within-subjects crossover paradigm comparing five nights of short sleep (6.5-hour sleep opportunity) to five nights of Healthy Sleep (9.5-hour sleep opportunity). Within each condition, adolescents completed three multiple-pass dietary recalls that recorded the types, amount, and timing of food intake. The following outcomes were averaged across days of dietary recall within condition: kilocalories, grams of carbohydrates, fat, protein, and added sugars, glycemic load of foods, and servings of specific types of foods (low-calorie drinks, sweetened drinks, fruits/vegetables, meats/proteins, processed snacks, "fast food" entrees, grains, and sweets/desserts). Timing of consumption of kilocalorie and macronutrient outcomes were also examined across four noncumulative time bins: 06:00-10:59, 11:00-15:59, 16:00-20:59, and 21:00-01:00. Adolescents slept 2 h and 20 min longer in Healthy Sleep than in Short Sleep (p < .0001). While in Short Sleep, adolescents ate more grams of carbohydrates (p = .031) and added sugars (p = .047), foods higher in glycemic load (p = .013), and servings of sweet drinks (p = .023) and ate fewer servings of fruits/vegetables (p = .006) compared to Healthy Sleep. Differences in consumption of kilocalories, fat, and carbohydrates emerged after 9:00 pm (ps = .012, .043, .006, respectively). These experimental findings suggest that adolescents who have insufficient sleep exhibit dietary patterns that may increase the risk for negative weight and cardiometabolic outcomes. Future health promotion efforts should include promoting optimal sleep to increase healthy dietary habits.

Associations of sleep with food cravings and loss-of-control eating in youth: An ecological momentary assessment study

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.

Examination of Sleep and Obesity in Children and Adolescents in the United States

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.

Measuring short-term eating behaviour and desire to eat: Validation of the child eating behaviour questionnaire and a computerized 'desire to eat' computerized questionnaire

The Child Eating Behaviour Questionnaire (CEBQ) is designed to measure 'usual' eating behaviour, with no time period attached, thus may not be suitable for assessing the effectiveness of short-term experimental studies. The aim of this study was to validate i) the CEBQ adapted to measure 'past week' rather than 'usual' eating behaviour, and ii) a computerized questionnaire assessing desire to eat core and non-core foods, against an objective measure of eating behaviour and food intake (eating in the absence of hunger (EAH) experiment). Children (n = 103) aged 8-12 years completed the desire to eat questionnaire followed by the EAH experiment while primary caregivers completed the adapted CEBQ. Results from the CEBQ showed that children with greater 'satiety responsiveness' (1-point higher) consumed less energy (-342 kJ; 95% CI -574, -110) whereas those with greater 'enjoyment of food' scale consumed more energy (380 kJ; 95% CI 124, 636) during the ad-libitum phase of the EAH experiment. Higher scores for slowness in eating (-705 kJ; 95% CI -1157, -254), emotional undereating (-590 kJ; 95% CI -1074, -106) and food fussiness (-629 kJ; 95% CI -1103, -155) were associated with lower total energy intake. Children who expressed greater desire to eat non-core foods consumed more energy in total (275 kJ; 95% CI 87, 463). Overall, this adapted CEBQ appears valid for measuring several short-term eating behaviours in children. The desire to eat questionnaire may be useful for identifying short-term susceptibility to overeating, however further investigation into how ratings of desire relate to the intake of highly palatable, energy dense foods is warranted.

Chronobiology and Metabolism: Is Ketogenic Diet Able to Influence Circadian Rhythm?

Circadian rhythms underpin most physiological processes, including energy metabolism. The core circadian clock consists of a transcription-translation negative feedback loop, and is synchronized to light-dark cycles by virtue of light input from the retina, to the central clock in the suprachiasmatic nucleus in the hypothalamus. All cells in the body have circadian oscillators which are entrained to the central clock by neural and humoral signals. In addition to light entrainment of the central clock in the brain, it now emerges that other stimuli can drive circadian clock function in peripheral tissues, the major one being food. This can then drive the liver clock to be misaligned with the central brain clock, a situation of internal misalignment with metabolic disease consequences. Such misalignment is prevalent, with shift workers making up 20% of the working population. The effects of diet composition on the clock are not completely clarified yet. High-fat diet and fasting influence circadian expression of clock genes, inducing phase-advance and phase-delay in animal models. Ketogenic diet (KD) is able to induce a metabolic switch from carbohydrate to fatty acid oxidation, miming a fasting state. In recent years, some animal studies have been conducted to investigate the ability of the KD to modify circadian gene expression, and demonstrated that the KD alters circadian rhythm and induces a rearrangement of metabolic gene expression. These findings may lead to new approaches to obesity and metabolic pathologies treatment.

Longitudinal associations between facets of sleep and adiposity in youth

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.

Effect of sleep duration on dietary intake, desire to eat, measures of food intake and metabolic hormones: A systematic review of clinical trials

BACKGROUND AND AIMS

Sleep, as well as diet and physical activity, plays a significant role in growth, maturation, health, and regulation of energy homeostasis. Recently, there is increasing evidence indicating a possible causal association between sleep duration and energy balance. We aimed to examine the relationship between sleep duration and food consumption, energy intake, anthropometric characteristics, and appetite-regulating hormones by randomized controlled trials (RCTs).

METHODS

Electronic literature searches were conducted on Medline, Web of Science, and Google Scholar until July 2020. The search was conducted with the following words: "Sleep Duration", "Circadian Rhythm", "Sleep Disorders" in combination with "Obesity", "Overweight", "Abdominal Obesity", "Physical Activity", "Energy Intake", "Body Mass Index", "Lipid Metabolism", "Caloric Restriction", Leptin, "Weight Gain", and "Appetite Regulation" using human studies.methods RESULTS: After screening 708 abstracts, 50 RCTs (7 on children or adolescents and 43 on adults) were identified and met the inclusion criteria. In general, the findings suggested that sleep restriction may leads to a significant increment in energy intake, fat intake, body weight, appetite, hunger, eating occasions, and portion size, while protein and carbohydrate consumption, total energy expenditure, and respiratory quotient remained unaffected as a result of sleep restriction. Serum leptin, ghrelin, and cortisol concentrations were not influenced by sleep duration as well.

CONCLUSION

Insufficient sleep can be considered as a contributing factor for energy imbalance, weight gain, and metabolic disorders and it is suggested that to tackle disordered eating it may be necessary to pay more attention to sleep duration.

Eating in the absence of hunger in children with mild sleep loss: a randomized crossover trial with learning effects

BACKGROUND

While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater "eating in the absence of hunger" (EAH) or energy intake beyond the point of satiety, when tired.

OBJECTIVE

The aim was to determine whether mild sleep loss increases EAH in children.

METHODS

A crossover study was undertaken in 105 healthy children (8-12 y) with normal sleep (∼8-11 h/night). After randomization, children went to bed 1 h earlier (sleep extension) or 1 h later (sleep restriction) than their usual bedtime, over 2 intervention weeks separated by a 1-wk washout. At the end of each intervention week, children underwent an EAH feeding experiment involving a preloading meal until satiation, followed by an ad libitum buffet (of highly palatable snacks) to measure EAH, with each food item weighed before and after consumption.

RESULTS

Ninety-three children completed the EAH experiment. There was no evidence of a difference in energy intake from EAH between sleep restriction and extension conditions when analyzed as a crossover design. However, a learning effect was found, with children eating significantly less (-239 kJ; 95% CI: -437, -41 kJ; P = 0.018) during the preload phase and significantly more (181 kJ; 95% CI: 38, 322 kJ; P = 0.013) in the ad libitum phase in the second week. No significant differences were seen using an underpowered parallel analysis for energy intake during the ad libitum phase when sleep deprived (106 kJ; 95% CI: -217, 431 kJ; P = 0.514).

CONCLUSIONS

Our findings suggest that measuring a difference in eating behavior in relation to sleep proved unsuitable using the EAH experiment in a crossover design in children, due to a learning effect. This trial was registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true) as ACTRN12618001671257 .

Weekend night vs. school night sleep patterns, weight status, and weight-related behaviors among adolescents

OBJECTIVE

In this study, we examine associations between objectively measured weekend night vs. school night sleep patterns, weight status, and weight-related behaviors among adolescents.

DESIGN

Cross-sectional study.

SETTING

Five Minnesota high schools that started early (7:30 or 7:45 AM) in Spring 2016.

PARTICIPANTS

Ninth grade students, ages 14.5-16 years (n = 284).

MEASUREMENTS

Students completed surveys, had body measurements taken, and wore sleep (wrist) actigraphs for 1 week (n = 284). We examined weekend night-school night differences in sleep duration and sleep timing. We then assessed whether these factors were related to weight status and weight-related behaviors (eating behaviors, food consumption, physical activity, beverage consumption) using generalized linear mixed models.

RESULTS

On average, students slept 1.5 hours (95% confidence interval 1.3-1.7) more and had a sleep midpoint 1.9 hours (1.8-2.1) later on weekend nights compared to school nights. Female students had larger increases in sleep duration on weekend nights than males but similar timing differences. Sleep duration differences were uncorrelated with sleep timing differences (r = 0.01). Neither duration nor timing differences were associated with overweight, obesity, or any of the eating behaviors we examined. However, sleeping longer on weekend nights than on school nights was associated with lower probability of being active 6-7 days per week (p = .02).

CONCLUSIONS

Adolescents have substantial sleep duration and sleep timing differences on weekend nights vs. school nights. While these differences may not be associated with weight status or weight-related behaviors, they reflect the reality that most adolescents have schedules that restrict their sleep.

Assessing Changes in Adolescents' Sleep Characteristics and Dietary Quality in the START Study, a Natural Experiment on Delayed School Start Time Policies

BACKGROUND

Sleep duration, quality, and timing may influence dietary quality. In adults, poor dietary quality is a risk factor for numerous chronic diseases. It is unclear how these various sleep domains influence adolescents' diets because prior population-based studies have not effectively manipulated sleep, did not include objective sleep measures, and had short follow-up times.

OBJECTIVES

The objectives of this study were to examine 1) how adolescent sleep characteristics relate to dietary quality; and 2) how delay in high school start times (which lengthened sleep duration) affects dietary quality over 2 y.

METHODS

In the START study, adolescents (grades 9-11, n = 423) attending 5 high schools in the Minneapolis, Minnesota metropolitan area were annually assessed in 3 waves (2016-2018). At Baseline, all schools started "early" (07:30 or 07:45). From Follow-up 1 through Follow-up 2, 2 "policy change schools" shifted to later start times (to 08:20 and 08:50). Three "comparison schools" maintained their early start throughout. Sleep characteristics were measured with actigraphy. Mixed-effect regression models were used to examine cross-sectional and longitudinal associations of sleep characteristics with dietary quality, and school start time policy change with dietary quality change.

RESULTS

Cross-sectionally, later sleep midpoint and onset were associated with dietary quality scores 1.6-1.7 lower (both P < 0.05). However, no prospective associations were observed between sleep characteristics and dietary quality in longitudinal models. Shifting to later school start time tended to be associated with a 2.4-point increase in dietary quality score (P = 0.09) at Follow-up 1, but was not associated with change in dietary quality scores at Follow-up 2 (P = 0.35).

CONCLUSIONS

High school students attending delayed-start schools maintained better dietary quality than students in comparison schools; however, differences were not statistically significant. Overall study findings highlight the complexity of the relation between sleep behavior and diet in adolescence.

Effects of sleep deprivation on sarcopenia and obesity: A narrative review of randomized controlled and crossover trials

Shortened and fragmented sleeping patterns occupying modern industrialized societies may promote metabolic disturbances accompanied by increased risk of weight gain and skeletal muscle degradation. Short-term sleep restriction may alter energy homeostasis by modifying dopamine brain receptor signaling, leading to hyperpalatable food consumption and risk of increased adiposity. Concomitantly, the metabolic damage caused by lower testosterone and higher cortisol levels may stimulate systemic inflammation, insulin resistance, and suppress pathways involved in muscle protein synthesis. These changes may lead to dysregulated energy balance and skeletal muscle metabolism, increasing the risk of sarcopenic obesity, an additional public health burden. Future trials controlling for food intake and exploring further the influence of sleep deprivation on anabolic and catabolic signaling, and gut peptide interaction with energy balance are warranted.

Insufficient Sleep and Poor Sleep Quality Completely Mediate the Relationship between Financial Stress and Dietary Risk among Higher Education Students

The coronavirus disease 2019 (COVID-19) pandemic worsened financial stress for higher education students in the U.S. Financial stress is associated with poor dietary behaviors; however, factors that might influence this relationship are not well characterized. The present cross-sectional study investigated the associations between financial stress and dietary intake and dietary risk scores among higher education students (undergraduate and graduate students) in the U.S. and examined whether poor sleep quality and short sleep duration mediated the relationship between financial stress and dietary risk score. Validated tools were used to assess financial stress, sleep quality, sleep duration, dietary intake, and dietary risk. A total of 1280 students from three large U.S. universities completed the study. Results indicated that higher financial stress was associated with lower vegetable, fruit, fiber, and calcium intake, higher added sugar intake from sugar sweetened beverages, and higher dietary risk score. Further, the positive relationship between financial stress and dietary risk score was completely mediated by poor sleep quality among students who reported poor sleep quality and by short sleep duration among students who slept less than 7 h per night. These findings suggest that students might benefit from both financial management training and sleep education services to reduce undesirable dietary behaviors.

Severe sleep restriction suppresses appetite independent of effects on appetite regulating hormones in healthy young men without obesity

OBJECTIVE

Several nights of moderate (4-5 hr/night) sleep restriction increases appetite and energy intake, and may alter circulating concentrations of appetite regulating hormones. Whether more severe sleep restriction has similar effects is unclear. This study aimed to determine the effects of severe, short-term sleep restriction on appetite, ad libitum energy intake during a single meal, appetite regulating hormones, and food preferences.

METHODS

Randomized, crossover study in which 18 healthy men (mean ± SD: BMI 24.4 ± 2.3 kg/m², 20 ± 2 yr) were assigned to three consecutive nights of sleep restriction (SR; 2 hr sleep opportunity/night) or adequate sleep (AS; 7-9 hr sleep opportunity/night) with controlled feeding and activity designed to maintain energy balance throughout the 3-day period. On day 4, participants consumed a standardized breakfast. Appetite, assessed by visual analogue scales, and circulating ghrelin, peptide-YY (PYY), glucagon-like peptide (GLP-1), insulin, and glucose concentrations were measured before and every 20-60 min for 4hr after the meal. Ad libitum energy and macronutrient intakes were then measured at a provided buffet lunch. Food preferences were measured by Leeds Food Preference Questionnaire (LFPQ) administered before and after the lunch.

RESULTS

Area under the curve (AUC) of postprandial hunger (-23%), desire to eat (-23%), and prospective consumption (-18%) ratings were all lower, and postprandial fullness AUC (25%) was higher after SR relative to after AS (p ≤ 0.02). Ad libitum energy intake at the lunch meal was 332 kcal [95% CI: -479, -185] (p<0.001) lower after SR relative to after AS, but relative macronutrient intakes and LFPQ scores did not differ. Postprandial glucose, insulin, PYY, GLP-1, and ghrelin AUCs did not differ between phases. However, mean concentrations of PYY (-11%) and GLP-1 (-4%) over the 4-hr testing period were lower, and glucose concentrations were 6% higher, after SR relative to after AS (p ≤ 0.01).

CONCLUSION

In contrast with reported effects of moderate sleep restriction, severe sleep restriction reduced appetite and energy intake, had no impact food preferences, and had little impact on appetite regulating hormones. Findings suggest that severe sleep restriction may suppress appetite and food intake, at least at a single meal, by a mechanism independent of changes in food preference or appetite regulating hormones.

A Model of Adolescent Sleep Health and Risk for Type 2 Diabetes

PURPOSE OF REVIEW

This paper presents a review of the current literature in support of a model explaining the relationships between sleep health and risk for type 2 diabetes in adolescents.

RECENT FINDINGS

Short sleep duration is associated with risk of developing obesity in youth. Sleep restriction increases energy expenditure, but also increases hunger, appetite, and food intake, causing positive energy balance, impacting appetite-regulating hormones, and leading to increased eating late at night. Insufficient sleep may lead to reduced physical activity and greater sedentary behaviors. In addition, short sleep duration is associated with reduced insulin sensitivity. The cumulative negative consequences of insufficient sleep increase risk for type 2 diabetes. Applications to clinical care, public policy, and future research are discussed. Insufficient sleep in adolescence increases risk for type 2 diabetes directly through impact on insulin sensitivity and indirectly through increased dietary intake, sedentary activity, and weight gain.

Taste sensitivity throughout age and the relationship with the sleep quality

Objective

The aim of the present study was to evaluate taste sensitivity and sleep pattern throughout age.

Methods

Thirty-five male adults aged (25.05±0.71 years), and twenty- four older adults (68.92 ± 6.43 years) were selected and submitted to sleep evaluation (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale), as well as taste sensitivity. Taste sensitivity was evaluated using three dilutions and the different concentrations were presented for the four basic flavors (salty, sweet, bitter and sour). These samples were encoded with three digits and randomly presented to the participants in 50 mL plastic cups.

Results

In both groups, sleep quality was poor (PSQI >5). Older adults presented a negative effect to identify sweet and salty taste and, in this population, sleep time was associated with sweet taste perception.

Discussion

We may suggest that aging may cause changes in taste sensitivity, as well as total sleep time was observed to be a significant predictor of sweet taste. Sleep may play an important role in taste sensitivity, although the mechanisms are still unknown. Thus, the results of this research may contribute to the emergence of new studies that seek to better understand this relationship of sleep quality as taste sensitivity.

Effects of Sleep Restriction on Food-Related Inhibitory Control and Reward in Adolescents

OBJECTIVE

This experimental study evaluated associations between sleep duration, food-related inhibitory control, and food reward in adolescents aged 12-18 with normal weight and overweight/obesity. The potential moderating effect of weight status on the associations between sleep, inhibitory control, and food reward was also examined.

METHODS

Thirty-two adolescents with normal weight and 32 adolescents with overweight/obesity (ages 12-18) participated in this study. Participants spent 5 hr in bed per night (restricted sleep) or 9 hr in bed per night (habitual sleep) for five nights with experimental periods separated by 3 weeks. Participants completed a food-related inhibitory control task and a questionnaire assessing food reward on the sixth day of each study phase.

RESULTS

Repeated measures analyses of variance revealed that adolescents performed more poorly on a food-related inhibitory control task and had heightened food reward following sleep restriction. Adolescents with overweight/obesity demonstrated heightened food reward compared with adolescents with normal weight; there was no main effect of weight on food-related inhibitory control. There was a significant interaction between sleep condition and weight status on food reward, with adolescents with normal weight demonstrating heightened food reward following sleep restriction. Adolescents with overweight/obesity showed consistently high food reward with no effect of sleep duration.

CONCLUSIONS

When sleep restricted, adolescents demonstrated heightened food reward and were less able to inhibit prepotent responses to food images. Adolescents with normal weight who experience acute sleep restriction may perceive foods to be more rewarding relative to normal sleep.

The impact of short sleep on food reward processes in adolescents

Short sleep has been linked to adolescent risk of obesity, but questions remain regarding the dietary mechanisms by which this occurs. We tested whether mildly shortening sleep influences how rewarding and appealing healthy adolescents find several kinds of foods. Eighty-eight healthy adolescents completed a within-subjects crossover sleep experiment comparing 5 days of Short Sleep (6.5 hr sleep opportunity) with 5 days of Healthy Sleep (9.5 hr sleep opportunity). Following each condition, adolescents completed measures of food appeal and reinforcing value of food across five food types: sweets/desserts, fruits/vegetables, lean meats/eggs, fast food and processed snacks. Adolescents averaged 2.2 hr/night longer sleep periods in Healthy Sleep versus Short Sleep. We observed a significant interaction of experimental order with sleep condition on three of four primary outcomes related to the appeal and reinforcing value of foods (p's < .005). When Short Sleep preceded Healthy Sleep, adolescents endorsed significantly greater appeal (p < .04) and rewarding value of food (p's ranging from <.01 to .048) during Short Sleep (compared to Healthy Sleep). However, when Healthy Sleep preceded Short Sleep, we did not observe a main effect of sleep condition on the same outcomes (p's > .05). This study provides evidence that restricting adolescents' sleep opportunity to 6.5 hr (compared to sleeping a healthy amount) increases the appeal and reinforcing value of a variety of foods, but this may occur only under protracted short sleep. Increased food reward may be one mechanism linking chronically shortened sleep with risk of obesity in adolescence.

Sleep duration differentially affects brain activation in response to food images in adolescents with overweight/obesity compared to adolescents with normal weight

STUDY OBJECTIVES

Sleep is an important behavior that affects appetite and eating in adolescents. Our study examined food-related neural activation in brain regions associated with food reward and inhibition in adolescents under sleep-restricted and well-rested conditions.

METHODS

In this within-subjects study, 52 adolescents (ages 12-18; 46% female; M age = 15.96 years, SD = 1.56) with normal weight (NW; N = 29, M body mass index % [BMI%] = 54.55, SD = 24.54) or overweight/obesity (OV/OB; N = 23, M BMI% = 93.78, SD = 4.60) spent 5 hours in bed at home each night for five consecutive nights and 9 hours in bed at home each night for 5 consecutive nights, with the first day of each condition occurring 4 weeks apart. The morning following each sleep modification period, functional magnetic resonance imaging (fMRI) data were collected while participants performed an inhibitory (go/no-go) task with food stimuli.

RESULTS

We found significantly greater activation in brain regions associated with inhibition in adolescents with NW in response to food cues when sleep restricted. No increase in inhibition-related neural activation was observed in adolescents with OV/OB when sleep restricted. We also found neural activation consistent with greater reward processing associated with food cues following sleep restriction regardless of weight status.

CONCLUSIONS

These findings suggest that chronic sleep restriction may increase the likelihood of suboptimal dietary behavior for adolescents with OV/OB because they do not experience increased inhibition-related neural responding to counter possible increased reward-related neural responding following sleep restriction.

Association of sleep duration and snack consumption in children and adolescents: The CASPIAN-V study

OBJECTIVES

The relationship between sleep deprivation and the risk of overweight and obesity is somewhat known in children and adolescents. This study aimed to investigate the relationship between sleep duration and eating snacks in a national sample of children and adolescents aged 6-18 years old.

METHODS

This cross-sectional study was carried out on the data of the fifth survey of the national school-based surveillance system entitled the "Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable Disease" (CASPIAN-V) study. Short sleeping duration was defined 10 hr per day for children under 10 years and 9 hr per day for children ≥ 10 years. To assess food habits, the consumption frequency of some food groups including sweets, salty snacks, carbonated beverages, diet soft drinks, soft beer, fresh fruits, dried fruits, fresh juices, vegetables, packed juices, dairy products (milk, yogurt, and cheese), fast foods, tea, sugar along with tea, and coffee was asked using Likert scale ( never, rarely, weekly, and daily).

RESULTS

In multivariate model, short sleep versus long sleep in students was associated with increased chance of eating salty snacks (OR = 1.49 [95% CI: 1.38-1.61]; p = .001), soft drinks (OR = 1.12 [95% CI: 1.04-1.20]; p = .002), fast foods (OR = 1.66 [95% CI: 1.54-1.79]; p < .001), tea (OR = 1.49 [95% CI: 1.39-1.61]; p < .001), and tea with sugar (OR = 1.13 [95% CI: 1.05-1.22]; p < .001). In addition, short sleep in students was associated with a decreased odds of daily intake of soft drinks without sugars (OR = 0.64 [95% CI: 0.58-0.70]; p < .001), soft beer (OR = 0.92 [95% CI: 0.85-0.99]; p < .001), fresh fruit (OR = 0.83 [95% CI: 0.76-0.90]; p < .001), dried fruit (OR = 0.43 [95% CI: 0.39-0.46]; p < .001), fresh fruit juice (OR = 0.66 [95% CI: 0.62-0.72]; p < .001), packed juice (OR = 0.91 [95% CI: 0.84-0.98]; p < .009), milk (OR = 0.51 [95% CI: 0.47-0.55]; p < .001), yogurt (OR = 0.86 [95% CI: 0.79-0.93]; p ≤ .001), and coffee (OR = 0.82 [95% CI: 0.76-0.89]; p ≤ .001).

CONCLUSIONS

The findings of this study indicate a significant relationship between sleep duration and unhealthy food habits. Therefore, increasing awareness of families in this area may reduce obesity and its complications.

Sleep-related disorders in patients with type 1 diabetes mellitus: current insights

Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results from destruction of beta cells in the pancreas. Several reviews have concluded that sleep contributes to poor glycemic control, diabetes management, and diabetes-related complications in individuals with T1DM and represents an untapped opportunity for intervention. However, at the current juncture, the American Diabetes Association's Standards of Medical Care are devoid of recommendations about how to address sleep in the management of T1DM. This article summarizes reviews of sleep in youth and adults with T1DM and empirical studies that have examined various sleep parameters ranging from sleep disturbances (general, perceived sleep quality, sleepiness, awakenings, and sleep efficiency), sleep duration, sleep consistency, sleep-disordered breathing (SDB), and sleep architecture. The data show that many individuals with T1DM sleep less than recommendations; individuals with the poorest sleep have difficulties with diabetes management; and sleep deficiency including SDB often corresponds to several disease morbidities (neuropathy, nephropathy, etc). Mixed findings exist regarding direct associations of various sleep parameters and glycemic control. SDB appears to be just as prevalent, if not more, than other conditions that have been recommended for universal screening in individuals with T1DM. The article concludes with recommendations for collaborative research efforts to further elucidate the role of sleep in diabetes-related outcomes; investigations to test behavioral strategies to increase sleep quantity and consistency; and considerations for clinical care to address sleep.

Sleep duration and bedtime in preschool-age children with obesity: Relation to BMI and diet following a weight management intervention

BACKGROUND

Sleep duration is associated with obesity in preschoolers. Weight-management interventions may be an opportunity to incorporate sleep health recommendations.

OBJECTIVES

To examine changes in sleep in preschool-age children with obesity following a family-based weight-management intervention (Learning about Activity and Understanding Nutrition for Child Health [LAUNCH]) compared with motivational interviewing and standard care conditions. Additionally, we examined associations between sleep with body mass index (BMI) z score (BMIz) and diet.

METHODS

One hundred fifty-one children (4.6 ± 0.93 y) completed baseline (pretreatment) and posttreatment (week 24) assessments, including anthropometrics, 24-hour dietary recalls, and a 7-day sleep diary. Analysis of variance (ANOVA) and chi-squared tests compared sleep variables between groups; linear regression models examined effects of sleep on BMIz and dietary intake at posttreatment, controlling for baseline values.

RESULTS

Bedtime and sleep duration were not significantly different between treatment groups from baseline to posttreatment. After adjusting for baseline sleep, earlier bedtime was associated with lower BMIz (95% CI, 0.00-0.04; .03), intake of added sugars (95% CI, 0.70-4.32; .007), and sweet/dessert food servings (95% CI, 0.00-0.19; .04) at posttreatment. Longer night-time sleep duration was associated with fewer added sugars at posttreatment, adjusting for baseline sleep (95% CI, -3.79 to -0.35; .02).

CONCLUSIONS

More comprehensive sleep intervention incorporated into weight-management intervention may be necessary to promote positive changes for preschoolers with obesity. A focus on earlier bedtime and longer sleep duration appears to be important given associations between sleep duration and bedtime with BMIz and dietary intake.

The effect of mild sleep deprivation on diet and eating behaviour in children: protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial

BACKGROUND

Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger.

METHODS

The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night.

DISCUSSION

Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018.

The Effect of Sleep Curtailment on Hedonic Responses to Liquid and Solid Food

It is currently unclear whether changes in sweet taste perception of model systems after sleep curtailment extend to complex food matrices. Therefore, the primary objective of this study was to use a novel solid oat-based food (crisps) and oat-based beverage stimulus sweetened with sucralose to assess changes in taste perception after sleep curtailment. Forty-one participants recorded a habitual and curtailed night of sleep using a single-channel electroencephalograph. The next morning, overall sweetness, flavor, and texture liking responses to energy- and nutrient-matched oat products across five concentrations of sweetness were measured. Overall (p = 0.047) and flavor (p = 0.017) liking slopes across measured concentrations were steeper after curtailment, suggesting that sweeter versions of the oat products were liked more after sleep curtailment. Additionally, a hierarchical cluster analysis was used to classify sweet likers and non-likers. While the effect of sleep curtailment on sweet liking did not differ between sweet liking classification categories, sleep curtailment resulted in decreased texture liking in the solid oat crisps for sweet non-likers (p < 0.001), but not in the oat beverage. These findings illustrate the varied effects of sleep on hedonic response in complex food matrices and possible mechanisms by which insufficient sleep can lead to sensory-moderated increases in energy intake.

Olfactory connectivity mediates sleep-dependent food choices in humans

Sleep deprivation has marked effects on food intake, shifting food choices toward energy-dense options. Here we test the hypothesis that neural processing in central olfactory circuits, in tandem with the endocannabinoid system (ECS), plays a key role in mediating this relationship. We combined a partial sleep-deprivation protocol, pattern-based olfactory neuroimaging, and ad libitum food intake to test how central olfactory mechanisms alter food intake after sleep deprivation. We found that sleep restriction increased levels of the ECS compound 2-oleoylglycerol (2-OG), enhanced encoding of food odors in piriform cortex, and shifted food choices toward energy-dense food items. Importantly, the relationship between changes in 2-OG and food choices was formally mediated by odor-evoked connectivity between the piriform cortex and insula, a region involved in integrating feeding-related signals. These findings describe a potential neurobiological pathway by which state-dependent changes in the ECS may modulate chemosensory processing to regulate food choices.

People who do not get enough sleep often start to favor sweet and fatty foods, which contributes to weight gain. While the exact mechanisms are still unknown, lack of sleep seems to change food preferences by influencing the levels of molecules that regulate food intake. In particular, it could have an effect on the endocannabinoid system, a complex network of molecules in the nervous system that controls biological processes such as appetite.

The sense of smell is also tightly linked to how and what organisms choose to eat. Recent experiments indicate that in rodents, endocannabinoids enhance food intake by influencing the activity of the brain areas that process odors. However, it is still unclear whether the brain regions that process odors play a similar role in humans.

To investigate, Bhutani et al. examined the impact of a four-hour night’s sleep on 25 healthy human volunteers. Blood analyses showed that after a short night, individuals had increased amounts of 2-oleoylglycerol, a molecule that is part of the endocannabinoid system. When sleep-deprived people were given the choice to eat whatever they wanted, those with greater levels of 2-oleoylglycerol preferred food higher in energy. Bhutani et al. also imaged the volunteers’ brains to examine whether these changes were connected to modifications in the way the brain processed smells. This revealed that, in people who did not sleep enough, an odor-processing region called the piriform cortex was encoding smells more strongly.

The piriform cortex is connected to another region, the insula, which integrates information about the state of the body to control food intake. Lack of sleep altered this connection, and this was associated with a preference for high-energy food. In addition, further analysis showed that changes in the amounts of 2-oleoylglycerol were linked to modifications in the connection between the two brain areas. Taken together, these results suggest that sleep deprivation influences the endocannabinoid system, which in turn alters the connection between piriform and insular cortex, leading to a shift toward foods which are high in calories.

In the United States alone, one in three people sleep less than six hours a night. Learning more about how sleep deprivation affects brain pathways and food choice may help scientists to develop new drugs or behavioral therapies for conditions like obesity.

Sleep Duration and Weight-Related Behaviors among Adolescents

Background: Insufficient sleep is widespread among adolescents and has consequences that extend far beyond hampering day-to-day functioning. It may influence eating and physical activity patterns and be an important determinant of adolescent overweight/obesity status. Methods: We assessed how self-reported sleep duration on school nights was associated with weight-related behaviors (eating, diet, and physical activity) and overweight/obesity at the baseline wave (ninth grade year) of the START study (n = 2134). Results: Fifteen percent of our sample reported optimal sleep duration (8.5-10.0 hours); nonwhites, participants of lower socioeconomic status, and girls were at greater risk for insufficient sleep. Suboptimal sleep was associated with various poor weight-related behaviors such as increased sugar-sweetened beverage consumption, decreased vegetable consumption, and decreased breakfast eating (p < 0.001). Fewer hours of sleep were also associated with less physical activity and an increased likelihood of obesity (p = 0.02 for both associations). Conclusions: The influence of adolescent sleep insufficiency on diet and activity could impact childhood obesity and following chronic disease risk especially if lack of sleep sets the stage for enduring, lifelong, poor, weight-related behavior patterns.

Poor sleep and adolescent obesity risk: a narrative review of potential mechanisms

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.