[Relation between sleep and obesity: a literature review]

Shift Work, Shifted Diets: An Observational Follow-Up Study on Diet Quality and Sustainability among Healthcare Workers on Night Shifts

This study aimed to investigate the change in diet quality in addition to dietary adherence to the planetary health diet during night shifts in healthcare workers. This observational follow-up study involved 450 healthcare workers working night shifts (327 females, 123 males). A survey form requesting sociodemographic information (gender, age, marital status), job title, sleeping duration during the night shift, 24 h dietary records for pre-night-shift, during night shift, and post-night-shift, and anthropometric measurements (body weight and height) was applied. The scores of the Planetary Health Diet Index (PHDI) and the Healthy Eating Index 2020 (HEI-2020) were calculated according to the dietary records. The total HEI-2020 and PHDI scores decreased significantly (p < 0.05) during the night shift (44.0 ± 8.8 and 48.3 ± 13.2, respectively) compared to pre-night-shift (46.1 ± 9.2 and 51.9 ± 13.4, respectively) and increased post-night-shift (44.7 ± 9.9 and 50.6 ± 14.9, respectively), with no statistically significant difference between pre- and post-night-shift. There was a significant main effect of night shift working on total PHDI (F(896, 2) = 8.208, p < 0.001, ηp2 = 0.018) and HEI-2020 scores (F(894, 2) = 6.277, p = 0.002, ηp2 = 0.014). Despite healthcare workers' knowledge of health factors, night shifts lead to poor dietary choices. To improve diet quality and sustainability, it is crucial to enhance access to healthy food options in their work environment.

Rotating shift work time is directly associated with excess body adiposity

OBJECTIVE

To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts.

METHODS

The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model.

RESULTS

The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm).

CONCLUSION

The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

Sleep, sedentary behavior, and physical activity in Brazilian adolescents: Achievement recommendations and BMI associations through compositional data analysis

Physical activity, sedentary behavior (SB), and sleep are habitual human behaviors (HHB) which are modifiable throughout the different life phases. Therefore, it is necessary to analyze how the time distribution throughout the day among HHB may be associated with body mass index (BMI). These results could provide inferences which can guide interventions that trigger changes in adolescent behaviors in favor of their health. The objective of this study was to verify the proportion of adolescents who meet the recommendation of sleep, moderate to vigorous physical activity (MVPA), and screen time (ST); to analyze the associations between HHB and BMI, and to determine possible changes in BMI associated with time reallocation between different HHB. Daily HHB recommendations (yes/no) were analyzed by frequency distribution. Compositional data analyses were used to examine the association between HHB and the BMI z-score (zBMI) with covariates (sex, age, and socioeconomic status). Compositional isotemporal substitution models estimated the change in zBMI associated with HHB reallocations from 15 to 120 minutes. A total of 185 adolescents were included (15 to 18 years, 50.8% boys). Thus, total sleep time, SB, light physical activity (LPA) and MVPA were measured by 24-hour accelerometry for seven consecutive days. ST, demographic characteristics, and socioeconomic status were assessed using a questionnaire. Sleep, MVPA, and ST recommendations were achieved by 32.97%, 8.10%, and 1.08% of the sample, respectively. No adolescent was able to achieve all of the daily recommendations. Age was significantly and positively associated with zBMI (p<0.001). Simply replacing 75, 90, and 120 minutes of MVPA by LPA led to an estimated significant increase in zBMI (95CI% z-value, 0.01 to 1.49). The HHB relocation estimates in 24h did not show positive effects on zBMI, nor did it increase the time engaged in MVPA, which may raise the hypothesis that other parameters related to obesity and their related interactions need to be better understood.

[Sleep duration, overweight and consumption of ultra-processed foods among adolescents]

The scope of this article is to analyze the relationship between insufficient sleep duration, overweight/obesity and the consumption of ultra-processed foods among adolescents aged 10 to 14 years. This is a cross-sectional study, with an evaluation of 1,384 adolescents from public schools in João Pessoa-PB, participating in the Longitudinal Study on Sedentary Behavior, Physical Activity, Diet and Adolescent Health (LONCAAFS). Sociodemographic variables, sleep duration, class shift, anthropometric nutritional status, sedentary behavior and food consumption were measured. Linear and logistic regression of the following were performed using Stata 13.0 Software: the prevalence of short sleep duration of 29.5% (<9h/night); a significant association between short sleep duration and excess weight only for adolescents <12 years old. With respect to the relationship between sleep duration and the consumption of ultra-processed foods, the longer the sleep duration, the lower the consumption of snacks by adolescents under 12 years old, with a positive association for ≥12 years old only with adjustment by the physical activity variable. There was no association with the "sugary drinks" and "cookies" groups for any of the age groups analyzed.

Is self-reported short sleep duration associated with obesity? A systematic review and meta-analysis of cohort studies

CONTEXT

A possible association between self-reported short sleep duration and risk of obesity has been studied.

OBJECTIVE

To analyze the association between sleep duration and obesity.

METHODS

The LILACS, Medline, Central, Embase, and OpenGrey databases were searched from inception until July 2020. Two authors screened the studies independently according to the PECO strategy, as follows: participants: > 18 years old; exposure: short sleep duration; control: regular sleep; outcome: obesity). Only cohort studies were included. A total of 3286 studies were retrieved with the search strategy, but only 36 were included. Disagreements were resolved by a third author. The quality of studies was assessed with Newcastle-Ottawa Quality Assessment Form for Cohort Studies. The certainty of the evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation.

RESULTS

Thirty-six studies were included, and 22 contributed quantitative data. Most of the studies (n = 27) assessed sleep by self-report. The meta-analysis showed a significant association between self-reported short sleep and development of obesity, and the chances of developing obesity increased when self-reported sleep duration decreased.

CONCLUSIONS

Self-reported short sleep was significantly associated with a higher incidence of obesity, with moderate quality of evidence.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42019130143.

Night shift work, short sleep and obesity

BACKGROUND

Obesity is associated with increased general mortality and comorbidities, it is multifactorial and some evidence has shown that sleep duration and shift work may be implicated in its pathogenesis.

OBJECTIVES

The aim of this study was to evaluate the association between shift work, quality of life and obesity among healthcare workers of a Brazilian University Hospital.

METHODS

A cross-sectional study was performed from April 2013 to December 2014 with 200 workers of a University Hospital. Sociodemographic data were evaluated and BREF WHOQOL was used for quality of life. The physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ), Chronotypes and daily sleep preference were investigated using Munich Chronotype Questionnaire (MCTQ). Venous blood was collected after 12-h of fasting for laboratory tests.

RESULTS

In this sample, the night shift workers had higher income and were older compared to day shift workers. Night shift workers sleep less hours, had higher weight, body mass index and abdominal circumference when compared to the day shift workers. Night shift workers had almost 3 times higher association with abdominal obesity independent of age and gender, than day shift workers. MCTQ parameters showed that night shift workers had lower sleep duration during working days and also during free days, associated with a higher level of social jetlag. Social jetlag had an association with obesity. We found no difference for quality of life between shifts.

CONCLUSIONS

Night work was a risk factor for abdominal obesity, social jetlag was higher in night shift workers and it was associated with presence of obesity.

Sleep pattern, obesity and healthcare expenditures in Brazilian adults

The aim of this study was to analyze the relationship between sleep pattern and healthcare expenditures in adults, as well as to identify whether physical activity, biochemical markers and obesity affect this relationship. The sample was composed of 168 adults aged ≥ 50 years attended by two Basic Healthcare Units in Presidente Prudente, SP, Brazil. Health expenditure, sleep pattern, anthropometry, adiposity index, physical activity, metabolic and cardiovascular variables were assessed. Statistical analyses were performed using Kruskal-Wallis, Mann-Whitney and Spearman tests. Sleep disorders were positively correlated to higher costs with medicines and negatively correlated to costs with laboratory tests, even after adjusts by confounders. In addition, healthcare costs were also correlated to physical activity score, blood pressure, obesity and metabolic variables. Severe sleep disorders and high percentage of body fat were associated with increased use of medications. Sleep pattern is correlated to primary care healthcare costs, obesity and physical activity level.

Eating approach of bereaved individuals: A protocol proposal

ABSTRACT Objective The objective of this manuscript was to discuss the care inherent to the methodological procedures for food research in bereavement situations, proposing the use of a conduct protocol. Methods The protocol for food research in bereavement is presented, based on the critical review of literature and the experience with food surveys applied to bereaved people. Results The conduct protocol is divided into three moments corresponding to the meetings and the steps of approach are discussed in these care services. This research seeks to problematize this investigation, outlining the phases of coping with bereavement that involve greater adherence, from these individuals, to food surveys. Conclusion The conduct protocol guiding the investigation of eating habits of bereaved individuals provides information that allows the professional to evaluate the influence of bereavement on food in addition to allowing a greater adherence of these individuals to the survey.

Excess weight in regular aviation pilots associated with work and sleep characteristics

OBJECTIVE

To identify the prevalence and associated factors of overweight and obesity in Brazilian commercial airline pilots. Methods An observational, cross-sectional study involving 1198 Brazilian commercial airline pilots with a sampling power >80% (ß=20%) and confidence level of 95% (α=5%) was carried out. The pilots completed an on-line questionnaire collecting data on sociodemographics, work, health, lifestyle and sleep. Poisson regression, with robust variance (stepwise forward technique), was employed to analyze the factors associated with excess weight (overweight and obesity). The models were adjusted for the variables age, marital status and education. The data were analyzed using the STATA 12.0 program.

RESULTS

The prevalence of overweight among the pilots was 53.7% and of obesity was 14.6%. The probability of being overweight was highest among pilots working night shifts for 6-10 years and that had difficulty relaxing after work, where perceived morningness was a protective factor. Risk factors for obesity included working night-shifts for 6-10 years, having difficulty relaxing after work, sleeping <6 h on days off, having other diagnosed diseases, and practicing <150 min/week of physical exercise.

CONCLUSION

It was concluded that the prevalence of overweight and obesity among the commercial airline pilots was high and represents a public health problem in this population. Excess weight was associated with time working night-shifts, difficulty relaxing after work, inadequate sleep on days off, having other chronic diseases, and physical inactivity. In this context, nutritional status can be regarded as the result of dynamic and complex interactions promoted by occupational, sleep and health factors.

Quality of life, sleepiness and depressive symptoms in adolescents with insomnia: A cross-sectional study

Objectives

To determine the prevalence of insomnia in a sample of Portuguese adolescents and assess its repercussions on HRQoL, daytime sleepiness and depressive symptomatology.

Design

We carried out a cross-sectional school-based study evaluating students from Viseu.

Location

Students from twenty-six public secondary schools in the county of Viseu, Portugal.

Participants

Of 9237 questionnaires distributed, 7581 were collected (82.1%). We excluded from analysis all questionnaires from adolescents younger than 12 or older than 18 years of age (211) and unfilled forms (451). The sample comprised 6919 adolescents, the 7th to 12th grade, from 26 public secondary schools.

Interventions

None.

Measurements

Data gathering was done using a self-applied questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders – IV criteria. HRQoL was evaluated with the Quality of Life Health Survey SF-36, depressive symptomatology with BDI-II and daytime sleepiness with the Epworth Sleepiness Scale.

Results

Prevalence of insomnia was 8.3% and the prevalence of adolescents with symptoms of insomnia without daytime impairment (disturbed sleepers) was 13.1%. HRQoL was significantly reduced among adolescents with insomnia compared to normal sleepers (p < 0.001) and even when compared to disturbed sleepers (p < 0.001). There was an increase in daytime sleepiness from normal sleepers to disturbed sleepers and to adolescents with insomnia (p < 0.001). There was also an increase in the prevalence and severity of depressive symptoms (p < 0.001).

Conclusions

Our results show that insomnia is associated with a significantly lower health related quality of life among adolescents.

[Nutritional damages and disturbances in the sleep pattern of nursing workers]

This article presents an integrative review of national and international scientific publications that investigate the sleep habits, the feed intake and nutritional status of nursing professionals. It was analyzed articles published in national and international journals in the period 2002 to 2014 and made available in the database PubMed / MEDLINE (USA National Library of Medicine), Lilacs / SciELO (Scientific Eletronic Library Online) and Google Scholar. Thirty one articles met the criteria. In the analysis of these studies it has been found a high prevalence of overweight and obesity, a negative change in the eating habits, as well as losses in the sleep patterns of nursing professionals.

[Correlation between anthropometric indicators and sleep quality among Brazilian university students]

The current study investigated the correlation between anthropometric indicators and sleep quality among Brazilian university students using the Pittsburgh Sleep Quality Index. A cross-sectional assessment with 702 university students was conducted between March 2010 and June 2011. Results showed that cases of obesity were more frequent among students who were good sleepers. On the other hand, overweight and high cervical and abdominal circumference was most prominent among poor sleepers. Thus, apart from the damage caused by sleep disorders alone, additional risks due to the association between poor sleep quality and being overweight, central obesity, and increased cervical perimeter are highlighted.

Quality of life and sleep in obese adolescents

Obesity and sleep disorders in adolescence are strongly associated, and they impact both on the health and on quality of life (QL) in this age group.

OBJECTIVE

To comparatively assess QL and sleep in obese and eutrophic adolescents, who are older than ten years of age.

METHODS

Cross-sectional study including obese adolescents. This analysis was carried out between August 2009 and August 2010. The Control (eutrophic) Group comprised schoolchildren recruited from State schools in the city of Americana, in São Paulo State, Brazil. Instruments applied included a standardized questionnaire, the Sleep Behavior Questionnaire (SBQ), and the Pediatric QL Inventory (PedsQL TM 4.0).

RESULTS

The obese adolescents had poorer QL on physical (p<0.001), emotional (p=0.03), and social (p=0.002) functioning domains. A difference in mean psychosocial functioning was found between the groups (p=0.009) with obese subjects having a mean score of 69.5 (±16.0) and in eutrophic individuals of 76.2 (±16.7). A greater number of sleep problems was evident in the Obese Group (p=0.03).

CONCLUSIONS

The obese adolescents had an impaired QL and a higher frequency of sleep problems compared to the eutrophic subjects.

Hipertensão arterial em profissionais que atuam em serviços de atendimento pré-hospitalar

Avaliou-se a prevalência de hipertensão e variáveis relacionadas em 154 profissionais de serviço pré-hospitalar pela medida casual da pressão e monitorização ambulatorial da pressão. A prevalência de hipertensão na medida casual foi 33,1% e 26,6% na monitorização ambulatorial da pressão arterial. A presença de hipertensão se associou (odds ratio=OR): a) medida casual da pressão, com o HDL-c >40 mg/dL (OR=0,25); b) monitorização ambulatorial (24 h) com glicemia > 110 mg/dL (OR:9,98), sexo masculino (OR=2,71), trabalhar cansado raramente/nunca (OR=0,19) e às vezes (OR=0,17); c) monitorização ambulatorial (vigília) com glicemia > 110 mg/dL (OR=11,18), sexo masculino (OR=3,24), trabalhar cansado raramente/nunca (OR=0,14) e às vezes (OR=0,16), índice de massa corporal (OR=1,10), trabalhar cansado raramente/nunca (OR=0,14) e às vezes (OR=0,16); e d) monitorização ambulatorial (sono) com sono diurno (OR=0,14) e índice de massa corporal (OR=1,11). Foi elevada a prevalência de hipertensão e fatores de risco associados.

Transtornos alimentares e padrão circadiano alimentar: uma revisão

Este artigo tem como objetivo revisar aspectos relacionados a transtornos alimentares e suas relações com as alterações no ritmo circadiano. Realizou-se uma busca sistematizada das informações nas bases de dados PubMed usando os seguintes descritores: eating disorders, circadian rhythm, night eating syndrome, binge eating disorder e sleep patterns. Os transtornos alimentares, como a síndrome do comer noturno e o transtorno da compulsão alimentar periódica, têm sido considerados e relacionados a um atraso no ritmo circadiano da ingestão alimentar e saciedade prejudicada. Os ritmos circadianos são aqueles que apresentam um período de 24 h, como, por exemplo, o ciclo sono-vigília, temperatura corporal, atividade e comportamento alimentar. Distúrbios provocados pelas alterações nos horários de sono/vigília influenciam o apetite, a saciedade e, consequentemente, a ingestão alimentar, o que parece favorecer o aumento desses transtornos. Percebe-se que o comportamento alimentar pode ser influenciado por ritmos circadianos. Porém, mais estudos e o maior conhecimento sobre a ritmicidade alimentar podem contribuir com o melhor entendimento do comportamento alimentar atual, atuando na prevenção e/ou tratamento de transtornos alimentares.