Habitual food consumption, eating behavior and meal-timing among Jordanian adults with elevated Blood pressure: a cross-sectional population-based study

BACKGROUND

The prevalence of elevated blood pressure (BP) has been raised worldwide. Food consumption, eating habits, and nutritional lifestyle related to meal timing, skipping meals, and meal contents have recently received more attention in studies on BP and metabolic syndrome. Purpose: This study evaluated the association between habitual food consumption, eating behavior, and meal timing with BP among Jordanian adults.

METHODS

A cross-sectional study included 771 Jordanian adults. A food frequency questionnaire was completed. Data about eating habits, meal timing, and emotional eating were collected. BP was measured.

RESULTS

The prevalence of less than recommended intake of vegetables, milk, protein, and fruits was higher in participants with elevated BP (69.2%, 90.2%, 58.9%, and 25.5%, respectively) as compared to the normal BP group (p < 0.001). Consuming vegetables and milk less than the recommended was reported to significantly increase the likelihood of elevated BP by OR= (1.60, and 2.75 (95%CI: 1.06-2.40; 1.62-4.66). Hence, consuming more than recommended fruit reduced the risk of elevated BP by OR = 0.56 (95%CI: 0.38-0.82). A 63.2% of elevated BP participants have three meals daily, a higher percentage of intake of one (23.5%) and two (45.7%) snacks. However, they had a higher percentage of morning eaters (50.7%), had lunch between 1:00-6:00 PM (92.7%), and had dinner between 6:00 and 9:00 PM (68.1%).

CONCLUSIONS

Although Jordanian adults with elevated BP appear to have healthy eating habits and meal timing and frequency, their habitual food consumption falls short of the daily recommendations for milk, fruits, vegetables, and protein.

Associations of night eating with depressive symptoms among health sciences students living in a postconflict region

Populations affected by war may experience food insecurity, which could predispose them to eating disorders. A cross-sectional study was conducted among health sciences students in Northern Kosovo from November 2018 to March 2019. Data were collected using the sociodemographic Night Eating Questionnaire (NEQ), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). The study sample comprised 534 students. The prevalence of students who had at least mild depression (BDI ≥ 10) was 20.6%. More frequent night eating was consistently associated with a higher EDI score in the total sample as well as in the subgroup of students whose EDI score was ≥ 10. In addition, having poorer sleep quality and having more anxiety symptoms were associated with having stronger depressive symptoms. In a population of health sciences students who live in a post-conflict region, night eating is associated with having stronger depressive symptoms.

Chrononutrition during Pregnancy and Its Association with Maternal and Offspring Outcomes: A Systematic Review and Meta-Analysis of Ramadan and Non-Ramadan Studies

Much evidence suggests that food intakes and eating patterns are major determinants of the phase of peripheral circadian clocks, and desynchronization between them is thought to contribute to the development of metabolic disorders. However, much remains to be understood about how different dimensions of chrononutrition during pregnancy affect pregnant women's and their offspring's health outcomes. Therefore, we systematically reviewed and integrated all emerging evidence on chrononutrition during pregnancy (including meal skipping, meal frequency, night eating, and (Ramadan) fasting) and their relationships with maternal and offspring outcomes. The results suggest that meal skipping and night eating during pregnancy were generally associated with adverse pregnancy and birth outcomes, whereas no strong conclusion could be reached for meal frequency. In our meta-analysis, Ramadan fasting did not seem to be related with birth weight or gestational age at birth, but evidence for other mother-offspring outcomes was inconsistent. To further elucidate the effect of chrononutrition factors on maternal and offspring health outcomes, larger and well-conducted prospective cohort and interventional studies are needed. In addition, information on covariates such as physical activity, sleep, diet quality and quantity, fasting days, fasting period per day, and trimester exposure should also be collected and considered during analysis.

Exploring the bidirectional relationships between night eating, loss of control eating, and sleep quality in Chinese adolescents: A four-wave cross-lagged study

OBJECTIVE

This study examined the bidirectional relationships between sleep quality, loss of control (LOC) eating, and night eating in Chinese adolescents using longitudinal data over an 18-month study period.

METHOD

Four-waves of data measurement (Waves 1-4), at 6-month intervals, were conducted with 2566 adolescents aged 11-17 years at baseline. A set of questionnaires were used to assess night eating, LOC eating, and sleep quality at each wave of data collection. Cross-lagged models were applied to analyze the bidirectional relationships between night eating, LOC eating, and sleep quality.

RESULTS

Results indicated that higher night eating scores consistently predicted poorer sleep quality and higher LOC eating scores at Waves 1, 2, and 3. Furthermore, poorer sleep quality predicted higher night eating scores at Wave 1 and Wave 3, and higher LOC eating scores predicted higher night eating scores at Wave 1 and Wave 2.

DISCUSSION

These findings highlight that night eating, LOC eating, and sleep quality were interrelated across time in Chinese adolescents. Improving sleep quality and reducing LOC eating might be promising in the prevention of night eating in adolescents. Similarly, reducing night eating might be promising in improving sleep quality and reducing LOC eating in adolescents.

PUBLIC SIGNIFICANCE

This study explored the bidirectional relationship between night eating, LOC eating, and sleep quality in Chinese adolescents using cross-lagged models. Findings indicate bidirectional relationships between these variables and highlight the potential utility in incorporating sleep, LOC eating, and night eating interventions in eating pathology prevention designs for adolescents.

A matter of time: A systematic scoping review on a potential role of the circadian system in binge eating behavior

Background

Emerging research suggests that food intake timing, eating behavior and food preference are associated with aspects of the circadian system function but the role that the circadian system may play in binge eating (BE) behavior in humans remains unclear.

Objective

To systematically evaluate the evidence for circadian system involvement in BE behavior.

Methods

Systematic searches of PubMed, EMBASE, and Scopus were performed for reports published from inception until May 2020 (PROSPERO Registration CRD42020186325). Searches were conducted by combining Medical Subject Headings related to the circadian system, BE behavior, and/or interventions. Observational and interventional studies in humans with BE behavior published in peer-review journals in the English language were included. Studies were assessed using quality and risk of bias tools (AXIS, ROB 2.0, or ROBINS).

Results

The search produced 660 articles, 51 of which were included in this review. Of these articles, 46 were observational studies and 5 were interventional trials. Evidence from these studies suggests that individuals with BE behavior tend to have more food intake, more binge cravings, and more BE episodes later in the day. Hormonal and day/night locomotor activity rhythm disturbances may be associated with BE behavior. Furthermore, late diurnal preference ("eveningness") was associated with BE behavior and chronobiological interventions that shift the circadian clock earlier (e.g., morning bright light therapy) were found to possibly decrease BE behavior. Substantive clinical overlap exists between BE and night eating behavior. However, there is a significant knowledge gap regarding their potential relationship with the circadian system. Limitations include the lack of studies that use best-established techniques to assess the chronobiology of BE behavior, heterogeneity of participants, diagnostic criteria, and study design, which preclude a meta-analytic approach.

Conclusion

Current evidence, although limited, suggests that the circadian system may play a role in the etiology of BE behavior. Further mechanistic studies are needed to fully characterize a potential role of the circadian system in BE behavior. A chronobiological approach to studying BE behavior may lead to identification of its neurobiological components and development of novel therapeutic interventions.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020186325], identifier [CRD42020186325].

Night Eating Among Latinos With Diabetes: Exploring Associations With Heart Rate Variability, Eating Patterns, and Sleep

OBJECTIVES

We explored associations between night eating and health outcomes in Latinos with type 2 diabetes.

METHODS

Participants (n = 85) completed surveys, were measured for anthropometrics, provided blood samples, and wore Holter monitors for 24 hours to assess heart rate variability.

RESULTS

Participant mean age was 60.0 years, hemoglobin A1c was 8.7%, most preferred Spanish (92%), and had less than a high school education (76%). Compared with their counterparts who denied night eating, night eaters had lower heart rate variability in the low (Cohen's d = -0.55; P = 0.04) and very-low-frequency bands (d = -0.54, P = 0.05), and reported more emotional eating (d = 0.52, P = 0.04), and poorer sleep quality (Cohen's h = 0.64). They did not differ on beverage intake or depressive symptoms. In regression that included depressive symptoms, associations between night eating and outcomes became nonsignificant.

CONCLUSIONS AND IMPLICATIONS

Night eaters demonstrated worse health outcomes. If results are replicated, nutrition education for this population might focus on night eating.

Association of Night Eating Habits with Health-Related Quality of Life (HRQoL) in University Students

University students have dietary habits such as irregular eating habits, night eating habits (NEHs), and alcohol drinking, which can lead to nutritional problems. Especially, NEHs may increase the risk of chronic diseases and reduce the health-related quality of life (HRQoL). The purpose of this study was to investigate associations between NEHs and HRQoL and to evaluate if their associations may differ according to gender. Data were obtained from Eulji University March-April 2018. Participants were recruited via advertisements in school. The questionnaire, including socio-demographic factors, dietary and NEHs, and HRQoL was self-administered by participants. We found that, in males, when subjects with night eating frequency ≥1 time/week, the HRQoL showed a tendency to deteriorate compared to those with night eating frequency <1 time/week. In females, when the subject answered that they consumed a lot of night meal intake, their HRQoL was significantly deteriorated compared to those who answered that they consumed a moderate or small. Therefore, we confirmed that there is a slight difference in the factors of NEHs that affect the HRQoL by gender.

Disordered Eating among People with Schizophrenia Spectrum Disorders: A Systematic Review

Disordered eating, or abnormal eating behaviours that do not meet the criteria for an independent eating disorder, have been reported among people with schizophrenia. We aimed to systemati-cally review literature on disordered eating among people with schizophrenia spectrum disorder (SSD). Seven databases were systematically searched for studies that described the prevalence and correlates of disordered eating among patients with SSD from January 1984 to 15 February 2021. Qualitative analysis was performed using the National Institutes of Health scales. Of 5504 records identified, 31 studies involving 471,159 subjects were included in the systematic review. The ma-jority of studies (17) rated fair on qualitative analysis and included more men, and participants in their 30s and 40s, on antipsychotics. The commonest limitations include lack of sample size or power calculations, poor sample description, not using valid tools, or not adjusting for con-founders. The reported rates were 4.4% to 45% for binge eating, 16.1% to 64%, for food craving, 27% to 60.6% for food addiction, and 4% to 30% for night eating. Positive associations were re-ported for binge eating with antipsychotic use and female gender, between food craving and weight gain, between food addiction and increased dietary intake, and between disordered eating and female gender, mood and psychotic symptoms. Reported rates for disordered eating among people with SSD are higher than those in the general population. We will discuss the clinical, treatment and research implications of our findings.

The association between later eating rhythm and adiposity in children and adolescents: a systematic review and meta-analysis

CONTEXT

Childhood adiposity, an important predictor of adult chronic disease, has been rising dramatically. Later eating rhythm, termed night eating, is increasing in adults but rarely studied in younger ages.

OBJECTIVE

The objective of this study was to review the association between later eating rhythm and adiposity in children and adolescents. The aspects of later eating being considered included: energy intake (for evening main meal, evening snack, whole evening period, and around bedtime); timing (any food eaten at later timing); and meal frequency in the evening/night (evening main meal skipping, evening snack consumption).

DATA SOURCES

Five databases (the Cochrane Library, CINAHL, Embase, MEDLINE (via OVID), and Web of Science) were searched for eligible articles published prior to and including August 2020.

DATA EXTRACTION

Data extraction and quality assessment were conducted by 2 reviewers independently.

DATA ANALYSIS

Forty-seven studies were included, all of which were observational. Meta-analysis showed positive associations between both higher energy intake around bedtime (odds ratio [OR] 1.19, 95% CI 1.06, 1.33) and evening main meal skipping (OR 1.30, 95% CI 1.14, 1.48), and adiposity. There was evidence to suggest that consuming evening snacks reduced adiposity, but it was very weak (OR 0.80, 95% CI 0.62, 1.05). No association was seen between eating later and adiposity (OR 1.04, 95% CI 0.68, 1.61). In the narrative analysis, approximately half of the studies suggested that there was no association between later eating rhythm and adiposity, either as a whole or within exposure subsets.

CONCLUSION

The magnitude of the relationship between later eating rhythm and adiposity is very small, and may vary depending on which aspects of later eating rhythm are under consideration; however, the evidence for this conclusion is of very low certainty. Further research with a more consistent definition of "later timing", and longitudinal studies in different populations, may lead to different conclusions.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42019134187.

Habitual Night Eating Was Positively Associated With Progress of Arterial Stiffness in Chinese Adults

Background

Night eating has been associated with an elevated risk of obesity, dyslipidemia, and cardiovascular disease. However, there is no longitudinal study on whether habitual night eating, regardless of diet quality and energy intake, is associated with arterial stiffness, a major etiological factor in the development of cardiovascular disease.

Methods and Results

The study included 7771 adult participants without cardiovascular disease, cancer, or diabetes mellitus prior to dietary assessment by a validated food frequency questionnaire in 2014 through 2015. Participants were categorized into 3 groups based on self‐reported night‐eating habits: never or rarely, some days (1–5 times per week), or most days (6+ times per week). Arterial stiffness was assessed by brachial‐ankle pulse wave velocity at baseline and repeatedly during follow‐ups. Mean differences and 95% CIs in the yearly change rate of brachial‐ankle pulse wave velocity across the 3 groups were calculated, adjusting for age, sex, socioeconomic status, total energy intake, diet quality, sleep quality, and other cardiovascular disease risk factors. At baseline, 6625 (85.2%), 610 (7.8%), and 536 (6.9%) participants reported night eating as never or rarely, some days, or most days, respectively. During a mean 3.19 years, we observed a positive association between night‐eating frequency and progression of arterial stiffness (P trend=0.01). The adjusted difference in brachial‐ankle pulse wave velocity change rate between the group that ate at night most days and the group that never or rarely ate at night was 14.1 (95% CI, 0.6–27.5) cm/s per year. This association was only significant in women, but not in men (P interaction=0.03).

Conclusions

In an adult population free of major chronic diseases, habitual night eating was positively associated with the progression of arterial stiffness, a hallmark of arteriosclerosis and biological aging.

Registration

URL: https://www.chictr.org.cn; Unique identifier: ChiCTR‐TNRC‐11001489.

Chrononutrition during Pregnancy: A Review on Maternal Night-Time Eating

Evidence from women working night shifts during pregnancy indicates that circadian rhythm disruption has the potential to adversely influence pregnancy outcomes. In the general population, chronodisruption with the potential to affect pregnancy outcomes may also be seen in those with high energy intakes in the evening or at night. However, maternal night eating during pregnancy remains understudied. This narrative review provides an overview of the prevalence, contributing factors, nutritional aspects and health implications of night eating during pregnancy. We derived evidence based on cross-sectional studies and longitudinal cohorts. Overall, night eating is common during pregnancy, with the estimated prevalence in different populations ranging from 15% to 45%. The modern lifestyle and the presence of pregnancy symptoms contribute to night eating during pregnancy, which is likely to coexist and may interact with multiple undesirable lifestyle behaviors. Unfavorable nutritional characteristics associated with night eating have the potential to induce aberrant circadian rhythms in pregnant women, resulting in adverse metabolic and pregnancy outcomes. More research, particularly intervention studies, are needed to provide more definite information on the implications of night eating for mother-offspring health.

Night-Eating Syndrome and Depressive Symptoms in College Freshmen: Fitness Improvement Tactics in Youths (FITYou) Project

Background

Emerging evidence has shown that night-eating syndrome is correlated to depressive symptoms. However, these studies were mainly small-scale investigations.

Purpose

This study aimed to examine the association of night-eating syndrome with depressive symptoms among college students using a large-scale sample.

Methods

A cross-sectional study, which was a part of the Fitness Improvement Tactics in Youth Project, was conducted in 2017. The current study included 3278 college freshmen from Shenyang, China. They completed self-administered questionnaires and provided their sociodemographic and lifestyle information. Night-eating syndrome was assessed using the night-eating questionnaire (NEQ). Depressive symptoms were measured using the Self-rating Depression Scale (SDS).

Results

Of participants, 5.4% had night-eating syndrome (NEQ score ≥30), and 21.3% had depressive symptoms (SDS score ≥53). Prevalence of night-eating syndrome was higher in male than female students (p = 0.006). Logistic regression analysis indicated that students with night-eating syndrome had a higher prevalence of depressive symptoms than those without the syndrome after adjusting covariates (odds ratios [95% CI]: 3.28 [2.40, 4.48], p < 0.001). Consistent results were found when night-eating syndrome was defined as NEQ score ≥25. In addition, analysis of covariance showed a significant association between NEQ quartiles and SDS score (mean [95% CI]: Q1, 44.4 [43.8, 45.0]; Q2, 43.4 [42.7, 44.0]; Q3, 44.4 [43.7, 45.1]; Q4, 47.5 [46.9, 48.2], p < 0.001 for linear and quadratic trend).

Conclusion

This study showed an association between night-eating syndrome and depressive symptoms among Chinese college freshmen.

Association of Night Eating with Depression and Depressive Symptoms in Korean Women

This study examined the associations of night eating with depression and depressive symptoms in Korean adults. The study used a nationally representative sample of 31,690 Korean adults (≥19 years old) from the Korea National Health and Nutrition Examination Survey from 2008 to 2013. The participants were divided into two groups based on status of night eating: night eaters (consuming ≥25% of total daily energy intake between 21:00 and 06:00) and non-night eaters. Depression was defined based on diagnosis by a doctor, whereas depressive symptoms were defined as feelings of sadness or desperation for more than two weeks in the last one year. Multivariable logistic regression analyses were performed to examine the relationship between night eating and odds of depression and depressive symptoms after controlling for age, education, income, marital status, drinking, smoking, day of recalled intake, physical activity, body mass index, menopausal status (women only), total energy intake, and sleep duration. A total of 14.3% of Korean adults were night eaters. Night eaters were more likely to be men, young, less educated, single, drinkers, current smokers, and not employed (all ps < 0.05). In women, night eaters had higher odds of depression (adjusted odds ratio [AOR], 1.33; 95% confidence interval [CI], 1.02–1.75; p for trend = 0.0389) and depressive symptoms (AOR, 1.20; 95% CI, 1.01–1.41; p for trend = 0.0382) compared with non-night eaters. However, no associations of night eating with depression and depressive symptoms were found in men. Night eaters had higher odds of depression and depressive symptoms only in Korean women. Future studies are warranted to elucidate the underlying psychological and behavioral mechanisms that in turn may shed light on the factors influencing both night eating and odds of depression and depressive symptoms.

Associations of Meal Timing and Frequency with Obesity and Metabolic Syndrome among Korean Adults

Emerging studies indicate that meal timing is linked to cardiometabolic risks by deterioration of circadian rhythms, however limited evidence is available in humans. This large-scale cross-sectional study explored the associations of meal timing and frequency with obesity and metabolic syndrome among Korean adults. Meal timing was defined as nightly fasting duration and morning, evening, and night eating, and meal frequency was estimated as the number of daily eating episodes using a single-day 24-hour dietary recall method. Meal frequency was inversely associated with prevalence of abdominal obesity, elevated blood pressure, and elevated triglycerides in men only. Independent of the nightly fasting duration and eating episodes, morning eating was associated with a lower prevalence of metabolic syndrome (odds ratio (OR), 0.73; 95% confidence interval (CI), 0.57–0.93 for men and OR, 0.69; 95% CI, 0.54–0.89 for women) than no morning eating, whereas night eating was associated with a 48% higher prevalence of metabolic syndrome (OR, 1.48; 95% CI, 1.15–1.90) than no night eating in men only. Longer fasting duration and less sleep were associated with obesity and metabolic syndrome. These findings suggest that overall eating patterns, including energy distribution across the day, eating frequency, and sleep duration, rather than fasting duration alone, are related to cardiometabolic risks in free-living Korean adults.

Comparison of clinical features between primary and drug-induced sleep-related eating disorder

PURPOSE

The aim of this study was to ascertain the clinical characteristics of drug-induced sleep-related eating disorder (SRED).

PATIENTS AND METHODS

We retrospectively reviewed the medical records of 30 patients with primary SRED (without any comorbid sleep disorders and who were not taking any possible causative medications), and ten patients with drug-induced SRED (occurrence of SRED episodes after starting nightly medication of sedative drugs, which completely resolved after dose reduction or discontinuation of the sedatives).

RESULTS

All patients with drug-induced SRED took multiple types of sedatives, such as benzodiazepines or benzodiazepine receptor agonists. Clinical features of drug-induced SRED compared with primary SRED were as follows: higher mean age of onset (40 years old in drug-induced SRED vs 26 years old in primary SRED), significantly higher rate of patients who had total amnesia during most of their SRED episodes (75.0% vs 31.8%), significantly lower rate of comorbidity of night eating syndrome (0% vs 63.3%), and significantly lower rate of history of sleepwalking (10.0% vs 46.7%). Increased doses of benzodiazepine receptor agonists may be responsible for drug-induced SRED.

CONCLUSION

The clinical features of drug-induced SRED were different from those of primary SRED, possibly reflecting differences in the underlying mechanisms between these two categories of SREDs.

The ticking clock of Cayo Santiago macaques and its implications for understanding human circadian rhythm disorders

The circadian clock disorders in humans remain poorly understood. However, their impact on the development and progression of major human conditions, from cancer to insomnia, metabolic or mental illness becomes increasingly apparent. Addressing human circadian disorders in animal models is, in part, complicated by inverse temporal relationship between the core clock and specific physiological or behavioral processes in diurnal and nocturnal animals. Major advantages of a macaque model for translational circadian research, as a diurnal vertebrate phylogenetically close to humans, are further emphasized by the discovery of the first familial circadian disorder in non‐human primates among the rhesus monkeys originating from Cayo Santiago. The remarkable similarity of their pathological phenotypes to human Delayed Sleep Phase Disorder (DSPD), high penetrance of the disorder within one branch of the colony and the large number of animals available provide outstanding opportunities for studying the mechanisms of circadian disorders, their impact on other pathological conditions, and for the development of novel and effective treatment strategies. Am. J. Primatol. 78:117–126, 2016. © 2016 The Authors. American Journal of Primatology published by Wiley Periodicals, Inc.

Optimal management of night eating syndrome: challenges and solutions

Night Eating Syndrome (NES) is a unique disorder characterized by a delayed pattern of food intake in which recurrent episodes of nocturnal eating and/or excessive food consumption occur after the evening meal. NES is a clinically important disorder due to its relationship to obesity, its association with other psychiatric disorders, and problems concerning sleep. However, NES often goes unrecognized by both health professionals and patients. The lack of knowledge regarding NES in clinical settings may lead to inadequate diagnoses and inappropriate treatment approaches. Therefore, the proper diagnosis of NES is the most important issue when identifying NES and providing treatment for this disorder. Clinical assessment tools such as the Night Eating Questionnaire may help health professionals working with populations vulnerable to NES. Although NES treatment studies are still in their infancy, antidepressant treatments and psychological therapies can be used for optimal management of patients with NES. Other treatment options such as melatonergic medications, light therapy, and the anticonvulsant topiramate also hold promise as future treatment options. The purpose of this review is to provide a summary of NES, including its diagnosis, comorbidities, and treatment approaches. Possible challenges addressing patients with NES and management options are also discussed.

Characteristics and perspectives of night-eating behaviour in a severely obese population

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

Night-eating syndrome (NES) can be a feature of severe obesity. NES is a dysfunction of circadian rhythm and is associated with impaired sleep.

WHAT THIS STUDY ADDS

Night eaters with severe obesity are more likely to be low in mood and unemployed compared with non-night eaters. Night eaters with severe obesity describe compulsive and uncontrolled eating. Research interest in night-eating syndrome (NES) has grown in recent years in line with increased rates of obesity. This study used a mixed-methods approach to investigate its characteristics in severe obesity. Eighty-one individuals (mean [standard deviation] age 44.6 [11.6] years, [body mass index] 50.0 [10.7] kg m(-2) ; 43% men) from a hospital-based UK obesity clinic were interviewed for NES based on 2003 criteria. Full and partial NES were combined into one night-eating behaviour (NEB) group (n = 31). Demographic and clinical characteristics were compared with those of non-NEB individuals (n = 50). NEB characteristics were also identified through exploratory thematic analysis of interview data. NEB individuals had lower mood (P = 0.01) and were less likely to be employed (P = 0.03). Differences in mean age and reported sleep duration were not significant. Thematic analysis of patient perceptions of NEB highlighted the potential heterogeneity of NEB development: NEB developed in childhood, adolescence and adulthood. Individuals reported long-standing and current sleep difficulties, negative affect and conflictful relationships. Night eating was solitary, compulsive and uncontrolled, and daytime eating patterns were chaotic. Accounts of awareness of night eating were conflicting. Severely obese night eaters are characterized by low mood and lack of employment. Further studies are required to explore behavioural and cognitive influences on night eating in severe obesity.

Insomnia is frequent in schizophrenia and associated with night eating and obesity

BACKGROUND

Sleep difficulties are common in schizophrenia, however these complaints are often overshadowed by more prominent clinical concerns. The point prevalence of insomnia in this population is not well documented. Poor sleep is associated with lower quality of life, impaired cognition, and weight gain.

OBJECTIVES

The objectives of this study are to evaluate the prevalence of insomnia in schizophrenia and to explore the relationship of sleep to cognition, quality of life, and clinical variables.

METHOD

175 outpatients with schizophrenia or schizoaffective disorder were assessed for insomnia. Participants were evaluated for sleep difficulties, sleep patterns, body mass index, and psychiatric symptoms. Participants were also administered a brief cognitive assessment of processing speed.

RESULTS

44% of the sample currently met the criteria for clinical insomnia. An additional 4% were successfully treated with medications. Insomnia was associated with depression and was an independent predictor of lower quality of life. Insomnia was also associated with high rates of night eating and patients with severe insomnia were significantly more obese. The type of antipsychotic did not account for the difference in body mass index. No difference between group means in cognition was detected, although those with severe insomnia did perform least well.

CONCLUSION

Clinical insomnia in outpatients with schizophrenia is highly prevalent and has a negative impact on quality of life and psychiatric symptoms. This study offers additional support to the association between poor sleep and higher weight, as well as indicating a potential link to night eating in this population. Assessment for sleep difficulties should be a routine part of clinical care.

Prevalence of night eating in obese and nonobese twins

The aim of this study was to assess the prevalence of night eating (NE) and associated symptoms in a population-based sample of Swedish twins. A total of 21,741 individuals aged 20-47 years completed a questionnaire in 2005/2006. NE was defined as >/=25% of daily food intake after the evening meal and/or awakening at least once per week with eating episodes. The prevalence of NE was 4.6% in men and 3.4% in women. Among obese men and women, the prevalence was 8.4 and 7.5%, respectively. Men and women with NE had 3.4 and 3.6 times higher risk of binge eating compared to individuals without NE. The risk of sleep-related problems was 1.6-3.4 times higher in men and 2.5-3.3 times higher in women with NE compared to those without NE. This epidemiological study has estimated the prevalence of NE in a twin population. It revealed that NE is 2.5 and 2.8 times more common in obese men and women compared to normal weight men and women. Furthermore that NE is associated with binge eating and sleep-related problems.