0271 Effects of Experimentally Shortened Sleep on Dietary Outcomes in Adolescents

Introduction

Adolescents who sleep less may consume more calories during the day; however, shortened sleep may have greater impact on the dietary quality of foods, particularly foods high in sugar content. This study examined the impact of shortened sleep on total caloric intake, macronutrients of food (fats, proteins, carbohydrates), added sugars consumed, and glycemic load/index of foods consumed.

Methods

110 adolescents (ages 14–17, M = 15.73(1.80); 63.6% female) underwent a within-subject counterbalanced experimental sleep manipulation, spending either 6.5 or 9.5 hours/night in bed for five nights. During each sleep period, adolescents completed three dietary recalls (reporting amounts and types of foods consumed over a 24-hour period) administered by dietary core study staff. We conducted a series of repeated-measure general linear models comparing averaged weekly dietary outcomes of interest by sleep condition. We also explored whether experimental order of the sleep conditions, family income, or adolescent gender, body mass index (BMI), or race moderated the main effects of sleep condition on dietary outcomes. Alpha was set at .05 for primary analyses and .01 for exploratory analyses.

Results

We observed a main effect of sleep on carbohydrates (p=.038) and added sugars (p=.009) consumed, as well as the glycemic index (p=.013) and glycemic load (p=.009) of foods consumed. We did not observe a main effect of sleep on total calories or total grams of fat or protein consumed. Exploratory analysis found no significant interactions of the moderators with sleep condition on dietary outcomes.

Conclusion

Adolescents are consuming more carbohydrates, added sugars, and foods higher in glycemic index and load when sleep restricted, compared to well-rested, despite eating comparable amounts of calories. Sleep restricted adolescents may be drawn to foods that provide quick releases of energy to counteract sleepiness experienced during the day.

Support

R01 HL120879

0331 Neurological Impact on the Reward Processing of Food Images Imposed by Mild Sleep Restriction in Adolescents

Introduction

Previous studies indicate that lack of sleep might increase risk for unhealthy eating and obesity. This is particularly important during adolescence, when most youth sleep less than the recommended 8-10 hours/night and dietary habits are developed that extend into adulthood. This study investigated the relationship between multi-night sleep restriction and the appeal of food, including neuroimaging to examine the impact on brain responses to food-related stimuli.

Methods

Healthy 14-17 year-old adolescents (n=39) completed an experimental sleep manipulation across consecutive five-night periods to compare nightly sleep of approximately 9 hours (healthy sleep duration) vs. about 6.3 hours (mild sleep restriction). At the end of each week, participants underwent functional MRI while performing a visual food appeal task. The task included 42 photos in each of four food categories (sweets, snacks, fast-food, meat/fruit/vegetable) and one non-food category. Photos were presented every 3 seconds in blocks of 7 within each category; 6 interleaved blocks per category. Teens rated the appeal of each block of photos. General linear modeling explained regional brain response according to categorical presentation time-courses.

Results

The pattern of brain responses to the different food types was similar across the two sleep conditions. However, the sleep manipulation led to significant regional effects when contrasting the totality of food vs non-food images. Specifically, when compared to non-food, food images overall resulted in greater activation in the ventral tegmental area (VTA) and substantia nigra (SN) during sleep restriction. Both regions have been previously shown to be involved in processing reward-related information.

Conclusion

Our findings suggest neuronal responses in reward circuitry for teens viewing food images are influenced by sleep duration. Sleep restriction may affect reward processing of food in teens by increasing brain activation in VTA/SN network components that underlie dopamine-mediated motivational drive.

Support

Supported by NIH R01HL120879

Links between sleep and daytime behaviour problems in children with Down syndrome

BACKGROUND

In the general population, sleep problems have an impact on daytime performance. Despite sleep problems being common among children with Down syndrome, the impact of sleep problems on daytime behaviours in school-age children with Down syndrome is an understudied topic. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports of daytime behaviour problems among school-age children with Down syndrome.

METHOD

Thirty school-age children with Down syndrome wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Their parent and teacher completed a battery of measures to assess daytime behaviour.

RESULTS

Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire, but not actigraph-measured sleep efficiency, was predictive of parent and teacher behavioural concerns on the Nisonger Child Behaviour Rating Form and the Vanderbilt ADHD Rating Scales. Actigraph-measured sleep period and parent-reported sleep duration on the Children's Sleep Habits Questionnaire was predictive of daytime parent-reported inattention. Actigraph-measured sleep period was predictive of parent-reported hyperactivity/impulsivity.

CONCLUSION

The study findings suggest that sleep problems have complex relationships to both parent-reported and teacher-reported daytime behaviour concerns in children with Down syndrome. These findings have implications for understanding the factors impacting behavioural concerns and their treatment in school-age children with Down syndrome.

The relationship between CVLT-C process scores and measures of executive functioning: lack of support among community-dwelling adolescents

In an effort to characterize how a child goes about learning and recalling information, the developers of the California Verbal Learning Test for Children (CVLT-C) provided normative data related to both learning outcome and learning process. The present study examined the assertion that CVLT-C process indices relate to executive functioning in a sample of community-dwelling adolescents. Contrary to predictions, measures of executive functioning typically correlated poorly with measures of learning process, despite displaying significant correlations with measures of learning outcome. Although further research is recommended, these findings do not support the clinical interpretation of CVLT-C process indices as reflections of executive functioning.

Normative and psychometric data on the body image assessment--revised

After falling into disfavor in the early 1990s, the construct of body image, as measured by body-size estimation (BSE) techniques, has been the focus of increasing interest in the eating disorder literature because of recent theoretical, empirical, and methodological advances. However, no published BSE measure to date has been shown to be psychometrically sound, well normed, inexpensive, and straightforward. This article provides normative and psychometric data for an adapted silhouette BSE measure. Comprehensive normative data are presented on college women's cognitively and affectively based body-size estimates, as well as their desired body size and related discrepancy indexes (cognitive vs. desired, affective vs. desired, affective vs. cognitive). Preliminary data indicate that indexes from the new measure are moderately reliable over time, consistent with their theoretical link to fluctuations in body-related attitudes. Data also support the convergent validity of the measures. Affectively based BSE, alone or as part of a discrepancy measure with desired body size, was most strongly related to measures of eating pathology, body focus, body dissatisfaction, and depressed affect.

The third factor of the WISC-III: it's (probably) not freedom from distractibility

OBJECTIVE

This study examined the ecological validity, construct validity, and diagnostic utility of the third factor of the WISC-III, heuristically labeled "Freedom From Distractibility" (FFD).

METHOD

A sample of 200 children, aged 6 to 11 years, with attention-deficit hyperactivity disorder (ADHD) completed the WISC-III, the Wide Range Achievement Test-Revised, and the Test of Variables of Attention. Objective parent and teacher report measures of attention and hyperactivity were completed.

RESULTS

Mean FFD scores were significantly lower than other WISC-III factor scores. The diagnostic utility of FFD is limited, however, as the majority of these children did not show a significant relative weakness on this index. Correlational analyses failed to support the concurrent, ecological, or construct validity of the FFD. FFD scores were not correlated with a measure of sustained visual attention. Findings suggest that among children with ADHD, a low FFD score may be associated with the presence of a learning disability or poor academic performance. This finding was maintained after level of general intelligence was statistically controlled.

CONCLUSIONS

Clinicians and researchers should not view FFD as a reliable or valid index of attention or as a diagnostic screening measure for identifying children with ADHD.

Is body focus restricted to self-evaluation? Body focus in the evaluation of self and others

OBJECTIVE

Clinicians have suggested that the core pathology of the eating disorders is an extreme body focus in self-evaluation. This study investigated whether women who focus on their own bodies place a similar focus on body shape when evaluating others and expect others to have a strong body focus in their self-evaluations.

METHOD

Eighty-four undergraduate women completed the Eating Attitudes Test (EAT-26), which largely measures body focus in self-evaluation. Each was also shown a series of photographs of women and asked what aspects of the photos they first noticed and how the depicted women felt about themselves. Finally, each responded to scenarios in which they or a hypothetical woman overate or dieted.

RESULTS

High EAT-26 scores were associated with an elevated number of "fat" or "thin" feelings attributed to women in the slides and a marginally greater number of body-related observations made about the slides. High EAT-26 scores were also associated with inferred negative feelings of others after overeating and positive feelings of others after dieting. In fact, the relationships between EAT-26 scores and feelings in response to hypothetical overeating and dieting situations were no stronger when applied to the self than when applied to others. However, when presented with a situation in which they overate, participants showed stronger relationships between their EAT-26 scores and their expected weight change and dieting behavior than they predicted would occur for others after an identical period of overeating.

DISCUSSION

Extrapolating findings to a clinical population, women with eating disorders may focus on others' body shapes as well as their own. These women may also expect others to be as emotionally invested in their own body shapes as they are themselves, but may not expect others to be as prone to gain weight or to diet as strictly as they do. Treatment for this somewhat recalcitrant belief system is discussed, as are directions for future research.

Low-end specificity of four depression measures: findings and suggestions for the research use of depression tests

Past research has found that very low scorers on the Beck Depression Inventory (BDI) tend to respond in a "fake-good" manner on the Minnesota Multiphasic Personality Inventory (MMPI) validity scales. This findings was interpreted as evidence of poor "low-end specificity." This study replicated and extended this work by evaluating the low-end specificity of four popular depression measures. The evidence of problems with low-end specificity was strong for the BDI and marginal for the Profile of Mood States depression subscale. Interestingly, MMPI scores in the "normal" range were associated with "fake-good" responding, whereas very low and high scores were not. There was no evidence of an association between fake-good responding and scores on Exner's Depression Index for the Rorschach. Implications of these findings and guidelines for dealing with problems with low-end specificity in research are discussed.

The Attention to Body Shape Scale: A New Measure of Body Focus

An abnormal degree of attention to one's body shape has been implicated in the development and maintenance of eating pathology. This article reports on three preliminary reliability and validity studies of the Attention to Body Shape Scale (ABS). Although brief, the ABS was found to be internally consistent and relatively stable over 2 weeks for both women and men. As expected, women were more body-focused on the ABS than were men. Preliminary validation studies on college women had encouraging results. Lending evidence of convergent validity, the ABS correlated with measures of eating pathology and dietary restraint. Moreover, although the ABS correlated with a measure of general-appearance orientation, regression analyses showed that the former was more closely linked than the latter to eating pathology. As evidence of discriminant validity, the ABS failed to correlate with dysphoria, body weight, or the tendency to eat in response to emotional or environmental pressures. As predicted by theory, high scores on the ABS were associated with body-image distortion. However, contrary to predictions, the ABS failed to moderate the impact of induced anxiety on body image on two of three measures. The implications of these findings and suggestions for future work are discussed.

Identification of "binge-prone" women: an experimentally and psychometrically validated cluster analysis in a college population

This study investigated the escape model of binge eating through a cluster analysis using standardized measures. A sample of 126 undergraduate women underwent a manipulation of their level of cognition and were asked to "taste-test" several flavors of ice cream. Questionnaire data from these women were entered into a cluster analysis. Two groups emerged: women in the "binge-prone" group were significantly more depressed, had lower self-esteem, had more chaotic and extreme eating patterns, and were more self-conscious than those in the control group. In validation work, binge-prone women were shown to report elevated levels of bulimic symptomatology and, when in the presence of a food they enjoyed, to respond to increases in level of cognition by eating more. These results were consistent with some, but not all, of the components of the escape model.

Bulimia nervosa and depression: a theoretical and clinical appraisal in light of the binge-purge cycle

This review seeks to familiarize clinicians with several major theoretical perspectives on the relationship between bulimia nervosa and depression. It begins by clarifying the affective changes which occur within the binge-purge cycle. Six hypotheses relating negative affect to bulimia nervosa are then reviewed in light of these changes, with their strengths, weaknesses and clinical implications clearly outlined. The author concludes that, although none of these perspectives has received universal support, recent hypotheses which focus upon specific portions of the binge-purge cycle are best suited to integration. These include the restraint, escape and hopelessness hypotheses. An integrative model is proposed to account for data across the binge-purge cycle, to assist in understanding the maintenance of bulimia nervosa, and to guide clinical intervention.