Changes in Children’s Sleep Duration on Food Intake, Weight, and Leptin
TL;DR: Compared with decreased sleep, increased sleep duration in school-age children resulted in lower reported food intake, lower fasting leptin levels, and lower weight.
Abstract: OBJECTIVE: To examine the effect of experimental changes in children’s sleep duration on self-reported food intake, food reinforcement, appetite-regulating hormones, and measured weight. METHODS: Using a within-subjects, counterbalanced, crossover design, 37 children, 8 to 11 years of age (27% overweight/obese) completed a 3-week study. Children slept their typical amount at home for 1 week and were then randomized to either increase or decrease their time in bed by 1.5 hours per night for 1 week, completing the alternate schedule on the third week. Primary outcomes were dietary intake as assessed by 24-hour dietary recalls, food reinforcement (ie, points earned for a food reward), and fasting leptin and ghrelin. The secondary outcome was child weight. RESULTS: Participants achieved a 2 hour, 21 minute difference in the actigraph defined sleep period time between the increase and decrease sleep conditions ( P P P P CONCLUSIONS: Compared with decreased sleep, increased sleep duration in school-age children resulted in lower reported food intake, lower fasting leptin levels, and lower weight. The potential role of sleep duration in pediatric obesity prevention and treatment warrants further study.
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01 Jan 2008
TL;DR: This work reviews the literature regarding short sleep duration as an independent risk factor for obesity and weight gain and suggests sleep deprivation may influence weight through effects on appetite, physical activity, and/or thermoregulation.
Abstract: Objective: The recent obesity epidemic has been accompanied by a parallel growth in chronic sleep deprivation. Physiologic studies suggest sleep deprivation may influence weight through effects on appetite, physical activity, and/or thermoregulation. This work reviews the literature regarding short sleep duration as an independent risk factor for obesity and weight gain.
1,172 citations
TL;DR: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence on pediatric obesity.
Abstract: Cosponsoring associations The European Society of Endocrinology and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. Objective To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. Participants The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer. Evidence This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The Task Force commissioned 2 systematic reviews and used the best available evidence from other published systematic reviews and individual studies. Consensus process One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and co-sponsoring organizations reviewed and commented on preliminary drafts of this guideline. Conclusion Pediatric obesity remains an ongoing serious international health concern affecting ∼17% of US children and adolescents, threatening their adult health and longevity. Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence. Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns. Pediatric comorbidities are common and long-term health complications often result; screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result. Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features. The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated. The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, as achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult. Although some behavioral and pharmacotherapy studies report modest success, additional research into accessible and effective methods for preventing and treating pediatric obesity is needed. The use of weight loss medications during childhood and adolescence should be restricted to clinical trials. Increasing evidence demonstrates the effectiveness of bariatric surgery in the most seriously affected mature teenagers who have failed lifestyle modification, but the use of surgery requires experienced teams with resources for long-term follow-up. Adolescents undergoing lifestyle therapy, medication regimens, or bariatric surgery for obesity will need cohesive planning to help them effectively transition to adult care, with continued necessary monitoring, support, and intervention. Transition programs for obesity are an uncharted area requiring further research for efficacy. Despite a significant increase in research on pediatric obesity since the initial publication of these guidelines 8 years ago, further study is needed of the genetic and biological factors that increase the risk of weight gain and influence the response to therapeutic interventions. Also needed are more studies to better understand the genetic and biological factors that cause an obese individual to manifest one comorbidity vs another or to be free of comorbidities. Furthermore, continued investigation into the most effective methods of preventing and treating obesity and into methods for changing environmental and economic factors that will lead to worldwide cultural changes in diet and activity should be priorities. Particular attention to determining ways to effect systemic changes in food environments and total daily mobility, as well as methods for sustaining healthy body mass index changes, is of importance.
734 citations
Cites background from "Changes in Children’s Sleep Duratio..."
...…pediatric sleep duration an average of 2 h 20 min (n = 37) There was decreased caloric intake by 134 kcal/d and lowered plasma leptin Hart et al., 2013 (129) + Three hundred eleven term infants; sleep duration at 9 mo, 18 mo, and 3 y of age There was no relationship between sleep…...
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TL;DR: Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being and there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.
Abstract: The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5–17 y...
503 citations
TL;DR: Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method after review of 864 published articles.
Abstract: Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appr...
387 citations
TL;DR: Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times.
Abstract: BACKGROUND
Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health.
METHODS
This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students.
RESULTS
Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes.
CONCLUSIONS
Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies.
209 citations
References
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01 May 2002
TL;DR: The 2000 CDC growth charts were developed with improved data and statistical procedures and now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States.
Abstract: Objectives This report provides detailed information on how the 2000 Centers for Disease Control and Prevention (CDC) growth charts for the United States were developed, expanding upon the report that accompanied the initial release of the charts in 2000. Methods The growth charts were developed with data from five national health examination surveys and limited supplemental data. Smoothed percentile curves were developed in two stages. In the first stage, selected empirical percentiles were smoothed with a variety of parametric and nonparametric procedures. In the second stage, parameters were created to obtain the final curves, additional percentiles and z-scores. The revised charts were evaluated using statistical and graphical measures. Results The 1977 National Center for Health Statistics (NCHS) growth charts were revised for infants (birth to 36 months) and older children (2 to 20 years). New body mass index-for-age (BMI-for-age) charts were created. Use of national data improved the transition from the infant charts to those for older children. The evaluation of the charts found no large or systematic differences between the smoothed percentiles and the empirical data. Conclusion The 2000 CDC growth charts were developed with improved data and statistical procedures. Health care providers now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States. It is recommended that these charts replace the 1977 NCHS charts when assessing the size and growth patterns of infants, children, and adolescents.
6,477 citations
TL;DR: Serum leptin concentrations are correlated with the percentage of body fat, suggesting that most obese persons are insensitive to endogenous leptin production.
Abstract: Background Leptin, the product of the ob gene, is a hormone secreted by adipocytes. Animals with mutations in the ob gene are obese and lose weight when given leptin, but little is known about the physiologic actions of leptin in humans. Methods Using a newly developed radioimmunoassay, we measured serum concentrations of leptin in 136 normal-weight subjects and 139 obese subjects (body-mass index, >27.3 for men and >27.8 for women; the body-mass index was defined as the weight in kilograms divided by the square of the height in meters). The measurements were repeated in seven obese subjects after weight loss and during maintenance of the lower weight. The ob messenger RNA (mRNA) content of adipocytes was determined in 27 normal-weight and 27 obese subjects. Results The mean (±SD) serum leptin concentrations were 31.3±24.1 ng per milliliter in the obese subjects and 7.5±9.3 ng per milliliter in the normal-weight subjects (P<0.001). There was a strong positive correlation between serum leptin concentration...
6,350 citations
Journal Article•
TL;DR: Created with improved data and statistical curve smoothing procedures, the United States growth charts represent an enhanced instrument to evaluate the size and growth of infants and children.
Abstract: Objectives—This report presents the revised growth charts for the United States. It summarizes the history of the 1977 National Center for Health Statistics (NCHS) growth charts, reasons for the revision, data sources and statistical procedures used, and major features of the revised charts. Methods—Data from five national health examination surveys collected from 1963 to 1994 and five supplementary data sources were combined to establish an analytic growth chart data set. A variety of statistical procedures were used to produce smoothed percentile curves for infants (from birth to 36 months) and older children (from 2 to 20 years), using a two-stage approach. Initial curve smoothing for selected major percentiles was accomplished with various parametric and nonparametric procedures. In the second stage, a normalization procedure was used to generate z-scores that closely match the smoothed percentile curves. Results—The 14 NCHS growth charts were revised and new body mass index-for-age (BMI-for-age) charts were created for boys and girls (http://www.cdc.gov/growthcharts). The growth percentile curves for infants and children are based primarily on national survey data. Use of national data ensures a smooth transition from the charts for infants to those for older children. These data better represent the racial/ethnic diversity and the size and growth patterns of combined breast- and formula-fed infants in the United States. New features include addition of the 3rd and 97th percentiles for all charts and extension of all charts for children and adolescents to age 20 years. Conclusion—Created with improved data and statistical curve smoothing procedures, the United States growth charts represent an enhanced instrument to evaluate the size and growth of infants and children.
5,160 citations
TL;DR: In this study, 12 young, healthy, normal-weight men exhibited reductions in the satiety hormone leptin, increases in the hunger hormone ghrelin, and increases in hunger after 2 nights of only 4 hours of sleep compared with after two nights of 10 hours ofSleep, suggesting inadequate sleep seems to influence the hormones that regulate satiety and hunger.
Abstract: Sleep-deprived healthy persons experience increased hunger. They also have increased blood levels of leptin and decreased levels of ghrelin (hormones that regulate satiety and hunger). These hormon...
2,178 citations
TL;DR: In this article, a meta-analysis was carried out to assess whether the evidence supports the presence of a relationship between short sleep duration and obesity at different ages, and to obtain a quantitative estimate of the risk in order to assess the consistency and potential public health relevance.
Abstract: IN THE LAST FEW DECADES THERE HAS BEEN A SIGNIFICANT INCREASE IN THE PREVALENCE OF OBESITY WORLDWIDE AND THE WORLD HEALTH organization has declared it a global epidemic.1 Obesity in childhood is a cause of psychosocial problems including low self esteem,2 and frequently continues into adulthood3 where it is a cause of major morbidity and mortality including cardiovascular disease and type 2 diabetes. At the same time there has been a reduction in sleep time. National surveys in USA have shown a decline in self-reported sleep duration over the past 50 years by 1.5 to 2 hours.4 This sleep curtailment has been attributed to lifestyle changes.
Several studies have reported associations between duration of sleep (short as well as long) and ill-health, including relationships with self-reported well-being,5 morbidity and mortality,6–12 and with chronic conditions including type 2 diabetes, respiratory disorders, hypertension, and obesity.13–18 The associations between short duration of sleep and obesity, in particular, have stimulated a debate given the potential implications for children19,20 as well as adults.21,22 However, given the variety of studies and the large differences in the target populations, it is difficult to draw immediate conclusions on the consistency of the association, the direction of causality and the likely mechanisms involved. The aims of this article are to (i) systematically review published population-based studies, (ii) to carry out a meta-analysis to assess whether the evidence supports the presence of a relationship between short sleep duration and obesity at different ages, and (iii) to obtain a quantitative estimate of the risk in order to assess the consistency and potential public health relevance
1,809 citations