Eating behavior traits and sleep as determinants of weight loss in overweight and obese adults

Objective:

To examine the associations between eating behavior traits and weight loss according to sleep quality and duration in adults enrolled in common weight-loss interventions.

Methods:

Participants included overweight and obese men and women (n=150) (mean±s.d. age, 38.8±8.6 years; mean±s.d. body mass index (BMI), 33.3±3.5 kg m⁻²) who were subjected to a dietary intervention over a period of 12–16 weeks. Anthropometric measurements, eating behavior traits (Three-Factor Eating Questionnaire), sleep quality (total Pittsburgh Sleep Quality Index (PSQI) score) and sleep duration (hours per night, self-reported from the PSQI) were assessed at both baseline and post intervention. Linear regression analysis was used to quantify the relationships between eating behavior traits and changes in anthropometric markers for all subjects and by sleep categories (short sleep: <7 h per night vs recommended sleep: ⩾7 h per night; poor sleep quality: ⩾5 PSQI score vs good sleep quality: <5 PSQI score). We adjusted for age, sex and baseline BMI in analyses.

Results:

Baseline eating behavior traits were modest predictors of weight-loss success, but they were all significantly associated with their changes over the weight-loss intervention (P<0.01). The diet intervention induced significant changes in eating behavior traits and even more for those having a non-favorable eating behavior profile at baseline. We observed that changes in flexible control and strategic dieting behavior were constantly negatively associated with changes in body weight and fat mass (P<0.05) for recommended duration sleepers. The change in situational susceptibility to disinhibition was positively associated with the change in fat mass and body weight for those having healthy sleeping habits (P<0.05). For poor quality sleepers, the change in avoidance of fattening foods was negatively associated with changes in adiposity (P<0.05).

Conclusion:

Eating behavior traits and sleep may act together to influence the outcome of weight-loss programs.     

The impact of sleep duration in obstructive sleep apnea patients

Purpose

Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease. Strong associations have been reported among sleep duration, hypertension, obesity, and cardiovascular mortality. The authors hypothesize that sleep duration may play a role in OSA severity. The aim of this study is to analyze sleep duration in OSA patients.

Methods

Patients who underwent overnight polysomnography were consecutively selected from the Sleep Clinic of Universidade Federal de São Paulo database between March 2009 and December 2010. All subjects were asked to come to the Sleep Clinic at 8:00 a.m. for a clinical evaluation and actigraphy. Anthropometric parameters such as weight, height, hip circumference, abdominal circumference, and neck circumference were also measured.

Results

One hundred thirty-three patients were divided into four groups based on total sleep time, sleep efficiency, sleep latency, and wake after sleep onset: very short sleepers (n?=?11), short sleepers (n?=?21), intermediate sleepers (n?=?56), and sufficient sleepers (n?=?45). Apnea–hypopnea index (AHI) was higher in very short sleepers (50.18?±?30.86 events/h) compared with intermediate sleepers (20.36?±?14.68 events/h; p?=?0.007) and sufficient sleepers (23.21?±?20.45 events/h; p?=?0.02). Minimal and mean arterial oxygen saturation and time spent below 90 % oxygen saturation exhibited worse values in very short sleepers. After adjustment for gender, age, AHI, and body mass index, mean oxygen saturation was significantly associated to total sleep time (p?=?0.01).

Conclusions

In conclusion, the present study suggests that sleep duration may be associated to low mean oxygen saturation in OSA patients.     

Is overweight/obesity associated with short sleep duration in older women?

BACKGROUND AND AIM: No study to date has documented the association between short sleep duration and the risk for obesity in older people. Therefore, the aim of this study was to examine cross-sectional associations between short sleep duration and variations in body fat indices in older women. METHODS: Anthropometric and body composition measurements, resting energy expenditure, daily energy expenditure, daily energy intake, plasma lipid-lipoprotein profile, and self-reported sleep duration were determined in a sample of 90 women of 50 years and above. RESULTS: The odds ratios for overweight/obesity were comparable in subjects reporting <7 hours and >or=7 hours of sleep per day, with or without adjustment for age, daily energy expenditure and daily energy intake. The results did not permit to observe any significant difference between the two sleeper groups for all the variables investigated. The correlations between sleep duration and adiposity indices were also non significant. CONCLUSIONS: Short sleep duration does not predict an increased risk of being overweight/obese in older women. This observation, together with our previously reported results in younger subjects, suggests that the sleep-body fat relationship progressively becomes less detectable with increasing in age.     

Association between sleep duration in early pregnancy and risk of gestational diabetes mellitus: a prospective cohort study

AimsAs cohort studies of the impact of sleep duration during early pregnancy on gestational diabetes mellitus (GDM) are lacking, our study aimed to explore the association between sleep duration in the first trimester and GDM in one region of mainland China.MethodsFor this prospective cohort study, sleep duration data were collected from 3692 pregnant women at the first prenatal care appointment before 14 weeks of gestation. Multivariable log-binomial regression models were used to analyze the association of sleep duration with GDM after adjusting for demographic characteristics, health status (such as family history of diabetes, history of GDM, prepregnancy body mass index, gestational weight gain) and lifestyle habits (such as physical activity, dietary intakes).ResultsOur cohort included 166 (4.5%) short sleepers and 505 (14%) long sleepers. Shorter sleep duration was more likely to be observed in women aged ≥35 years who were multiparous, and had previous pregnancy, insufficient gestational weight gain, engaged in more vigorous physical activity, drank alcohol, were vegan and/or never took folic-acid supplements. Compared with normal sleepers (29%), the prevalence of GDM was significantly higher in short sleepers (38%; P = 0.01), but not in long sleepers (31%; P = 0.224). In the multivariable model, women with short sleep durations during early pregnancy had a 32% greater risk of GDM [adjusted risk ratio (aRR): 1.32, 95% CI: 1.06–1.63], whereas long sleepers did not (aRR: 1.09, 95% CI: 0.94–1.26).ConclusionShort sleep duration during early pregnancy is associated with an increased risk of GDM. This suggests that more attention should be paid to controlling the development of GDM in pregnant women with insufficient sleep.     

Sleep Disturbance and Total Sleep Time in Persons Living with HIV: A Cross-Sectional Study

Short and long sleep durations have been associated with inflammation and chronic diseases. To study the association between sleep duration/quality and HIV disease severity, a cross-sectional study was conducted in patients living with HIV (PLWHs) using self-administered questionnaires assessing total sleep time, insomnia (ICSD-3 criteria), and poor sleep quality (PSQI?>?5). Multivariable logistic regression identified the factors associated with sleep disorders and with HIV features. 640 Parisian ambulatory PLWHs were included. The prevalence of insomnia was 50 and 68% of patients had a PSQI?>?5. Patients with CD4 count?<?500 cells/mm³ were more likely to be long sleepers (>?8 h/day) (OR 1.49; 95% CI [1.10–1.99]: p?<?0.01), and less likely to be short sleepers (<?6 h/day) (OR 0.69; 95% CI[0.50–0.96]; p?=?0.04) or to experience insomnia (OR 0.59; 95% CI[0.40–0.86]; p?<?0.01). HIV features were not associated with a PSQI?>?5. Thus, insomnia and impaired sleep quality were highly prevalent in well-controlled PLWHs and the severity of HIV infection was associated with long sleep times.     

Association between Sleep Duration and Hypertension among Adults in Southwest China

Objective:This study aimed to evaluate the association between sleep duration and hypertension among adults in southwest China.Methods:Baseline variables were collected from a representative sample of 20,053 adults aged 23–98 years in southwest China who received physical examinations from January 2019 to December 2020. All participants were categorized into either a hypertension group or a non-hypertension group. Sleep duration was classified as short (<6 h/day), normal (6–8 h/day),or long (>8 h/day). Baseline variables were compared between individuals with and without hypertension by rank-sum tests for two independent samples or χ² tests for nonparametric data. Multivariate logistic regression analysis was performed to evaluate the association between sleep duration and hypertension.Results:The overall incidence of hypertension was 51.2%. Unadjusted analysis showed that the risk of hypertension was higher in individuals with short (<6h/day) or long (>8h/day) sleep durations compared with those with a normal (6–8 h/day) sleep duration. The risk of hypertension was significantly increased by 30.1% in participants with a long (>8h/day) sleep duration compared with those with a normal (6–8h/day) sleep duration (OR = 1.301, P < 0.010, 95%CI = 1.149–1.475). The risk of hypertension was also increased by 1.1% in participants with a short (<6h/day) sleep duration compared with participants with a normal (6–8h/day) sleep duration, but the difference was not significant (OR = 1.011, P = 0.849, 95%CI = 0.905–1.129). After fully adjusting for confounding factors (model 4), the risk of hypertension was increased significantly (by 25%) in individuals with a short (<6h/day) sleep duration (OR = 1.25, P = 0.02, 95%CI = 1.036–1.508) but not in those with a long (>8h/day) sleep duration (17.5% increase) compared with participants with a normal (6–8h/day) sleep duration (OR = 1.175, P = 0.144, 95%CI = 0.946–1.460).Conclusion:The results of this study indicate that a short (<6h/day) sleep duration is related to an increased risk of hypertension, suggesting that sleep helps to protect against hypertension.     

A longer biological night in long sleepers than in short sleepers

Habitual sleep duration varies greatly among individuals. The physiological basis of this variation is unknown. We sought to determine whether individual differences in sleep duration are associated with systematic differences in the duration of the biological night that is programmed by the circadian pacemaker and reflected in the nocturnal interval of circadian rhythms in neuroendocrine function, body temperature, and arousal. Ten young, healthy long sleepers (sleep duration >9 h) and 14 short sleepers (<6 h) were studied under constant environmental conditions and in the absence of sleep. The nocturnal intervals of high plasma melatonin levels, increasing cortisol levels, low body temperature, and increasing sleepiness were longer in long sleepers than in short sleepers. The maxima in cortisol and sleepiness exhibited a close relationship to habitual wake-up time, which occurred approximately 2.5 h later in long sleepers than in short sleepers. It is concluded that the circadian pacemaker programs a longer biological night in long sleepers than in short sleepers. We propose that individual differences in the circadian pacemaker's program may contribute to the variability of sleep duration in the general population. The persistence or inertia of an individual's circadian program, as was evident in constant conditions, may underlie the commonly experienced difficulty of changing habitual sleep duration willfully.     

Reduced risk for overweight and obesity in 5- and 6-y-old children by duration of sleep--a cross-sectional study

OBJECTIVE: To assess the relationship between sleep duration and adiposity in 5- and 6-y-old Bavarian children. DESIGN: Cross-sectional study. SUBJECTS: A total of 6862 German children aged 5-6 y participating in the obligatory health examination in Bavaria, southern Germany. MEASUREMENTS: Routine data were collected on the height and weight of children at the time of school entry in six public health offices in 1999 and in another two in 2000. Body fat mass was estimated by BIA performed in three of those offices. An extensive questionnaire was given to all children's parents in order to assess risk factors for overweight and obesity. The main outcome measures were overweight, defined by a body mass index (BMI) above the 90th centile and obesity, defined by a BMI above the 97th centile for the German children in Bavaria. Excessive body fat was defined as fat mass above the 90th centile for all German children seen in this survey. The main exposure was usual sleeping hours on week days. RESULTS: The prevalence of obesity decreased by duration of sleep: < or =10 h, 5.4% (95% CI 4.1-7.0), 10.5-11.0 h, 2.8% (95% CI 2.3-3.3), and > or =11.5 h, 2.1% (95% CI 1.5-2.9). Similar relations were found with the prevalence of overweight and excessive body fat. These effects could not be explained by confounding due to a wide range of constitutional, sociodemographic and lifestyle factors. The adjusted odds ratio for obesity were: for sleeping 10.5-11.0 h, 0.52 (95% CI 0.34-0.78) and 0.46 (95% CI 0.28-0.75) for sleeping 11.5 h. CONCLUSION: The effect of sleep duration on obesity in children reflects a higher body fat composition and appears to be independent of other risk factors for childhood obesity.     

Association between sleep duration and sleep quality with sugar and sugar-sweetened beverages intake among university students

Background and aim

Both short sleep duration and intake of sugar or sugar-sweetened beverages (SSBs) are associated with weight gain; but the linkage between sleep characteristics and sugar or SSBs intake was less studied. We aimed to evaluate the associations of sleep duration and sleep quality with sugar and SSBs intake among Iranian adults.

Method

This cross-sectional study consisted of 395 adults chosen among students of Isfahan University of Medical Sciences, based on a multistage cluster random sampling method. Sleep characteristics and dietary intakes and were assessed using the Pittsburgh Sleep Quality Index (PSQI) and a 147-item validated food frequency questionnaire, respectively.

Results

Mean age and percentage of women in the study population were 22.79 (year) and 51.8%, respectively. No significant difference was observed between sleep duration and sugar intake, but short sleepers (< 6 h/d) had higher consumption of SSBs intake (86.54 vs. 65.73 g/day; P = 0.05) in comparison with those who had more than 8 h/d of sleep. Poor quality sleepers had significantly higher intake of SSBs compared with those with good quality of sleeping (87.09 vs. 56.73 g/day; P = 0.004). No significant correlation was found between sleep duration and SSBs intake. However, sleep quality score was positively correlated with SSBs intake (r_p:0.14, P = 0.007) in whole population, such that higher quality score (defined as poor sleep quality) was correlated with greater consumption of SSBs. Similar results were found in younger individuals (r_p:0.27, P = 0.002) and non-obese participants (r_p:0.14, P = 0.006).

Conclusion

We found that sleep duration was not associated with sugar or SSBs intake in Iranian adults. Poor sleep quality was correlated with high consumption of SSBs, especially in younger and non-obese individuals. More prospective investigations are required to confirm these findings.

     

Sleep duration and health in young adults

BACKGROUND: Both long and short sleep durations have been associated with negative health outcomes in middle-aged and older adults. This study assessed the relationship between sleep duration and self-rated health in young adults. METHODS: Using anonymous questionnaires, data were collected from 17 465 university students aged 17 to 30 years who were taking non-health-related courses at 27 universities in 24 countries. The response rate was greater than 90%. Sleep duration was measured by self-report; the health outcome was self-rated health; and age, sex, socioeconomic background, smoking, alcohol consumption, body mass index, physical activity, depression (Beck Depression Inventory), recent use of health services, and country of origin were included as covariates. RESULTS: Sixty-three percent of respondents slept for 7 to 8 hours; 21% were short sleepers (6%, <6 hours; 15%, 6-7 hours); and 16% were long sleepers (10%, 8-10 hours; 6%, >10 hours). Compared with the reference category (7-8 hours), the adjusted odds ratio of poor health was 1.56 (95% confidence interval [CI], 1.22-1.99) for respondents sleeping 6 to 7 hours and 1.99 (95% CI, 1.31-3.03) for those sleeping less than 6 hours. The same significant pattern was seen when the results were analyzed separately by sex. When respondents from Japan, Korea, and Thailand (characterized by relatively short sleep durations) were excluded, the adjusted odds ratios were 1.33 (95% CI 1.03-1.73) and 1.62 (95% CI, 1.06-2.48) for those sleeping 6 to 7 hours and less than 6 hours, respectively. There were no significant associations between self-rated health and long sleep duration. CONCLUSION: Our data suggest that short sleep may be more of a concern than long sleep in young adults.     

Does poor sleep impair cognition during aging? Longitudinal associations between changes in sleep duration and cognitive performance among older Mexican adults

Alterations in sleep patterns are common among older adults; further, short and long sleep durations have been linked with impaired cognitive performance in older individuals. Yet most research examining these relationships has been cross-sectional, limited to high-income nations, and has failed to consider how changes in sleep duration may impact cognitive decline. The present longitudinal study uses nationally-representative data to test whether changes in sleep length among “healthy” baseline sleepers are associated with reduced cognitive function in older Mexican adults (>50 years old) at follow-up.Data were drawn from the first and second waves of the World Health Organization’s Study on global AGEing and adult health. Self-report data captured sleep duration over two nights, and five cognitive tests (immediate and delayed verbal recall, forward and backward digit span, and verbal fluency) were used to measure various cognitive domains and create a composite z-score of cognitive performance. Linear regressions were performed to assess associations between sleep length changes and cognitive decline, controlling for relevant lifestyle and health factors.Increased sleep durations at follow-up among individuals who reported intermediate sleep durations (6–9 h/night) at baseline were significantly associated with greater rates of decline in overall cognitive function. Longer sleepers also trended toward greater rates of decline for attention/working memory and executive function. This study suggests that long sleep durations are a risk factor for certain types of impaired cognition among older adults living in a middle-income country. These findings are clinically important given the growing rates of dementia and aging populations globally.     

Insomnia with objective short sleep duration and incident hypertension: the penn state cohort

Insomnia with objective short sleep duration appears to be a biologically more severe phenotype of the disorder. No longitudinal study to date has examined the association of this type of insomnia with incident hypertension using polysomnography. From a random, general population sample of 1741 adults of the Penn State Cohort, 1395 were followed-up after 7.5 years, and 786 did not have hypertension at baseline. Hypertension was determined by a self-report of receiving treatment for high blood pressure. Chronic insomnia was defined as a complaint of insomnia lasting ≥1 year, whereas poor sleep was defined as moderate-to-severe sleep difficulties. All of the subjects underwent 8-hour polysomnography. Sleep-disordered breathing (SDB) was defined as an obstructive apnea/hypopnea index ≥5. We used the median polysomnographic percentage of sleep time to define short sleep duration (ie, <6 hours). We controlled for sex, race, age, caffeine, cigarettes and alcohol consumption, depression, sleep-disordered breathing, diabetes mellitus, obesity, and blood pressure in our analyses. Compared with normal sleepers who slept ≥6 hours, the highest risk for incident hypertension was in chronic insomniacs with short sleep duration (odds ratio, 3.8 [95% CI, 1.6-9.0]). The risk for incident hypertension in poor sleepers with short sleep duration was significantly increased but became marginally significant after controlling for obesity (odds ratio, 1.6 [95% CI, 0.9-2.8]). Chronic insomnia with short sleep duration is associated with an increased risk for incident hypertension in a degree comparable to sleep-disordered breathing. Objective short sleep duration in insomnia may serve as a useful predictor of the biological severity of the disorder.     

The mediating role of low-grade inflammation on the prospective association between sleep and cognitive function in older men and women: 8-year follow-up from the English Longitudinal Study of Ageing

Suboptimal sleep patterns predict poorer cognitive function in older adults and induce inflammatory responses. Inflammation could also adversely affect cognitive function. This study explored whether systemic inflammation may be one biological mechanism through which sleep influences cognitive performance. Participants were 4877 men and women from the English Longitudinal Study of Ageing who were followed-up for 8 years starting at wave 4 (2008-09), through wave 6 (2012-13), and until wave 8 (2016–17). Sleep quality and duration were measured with self-reported questionnaires. Cognitive function was assessed objectively with tests of verbal fluency, memory (immediate and delayed recall) and time orientation. Analyses were stratified by sex and adjusted for socio-economic circumstances, health behaviours, limiting long-standing illness, medication, depressive symptoms, and baseline inflammation and cognition. In men, in comparison with optimal sleep duration, short sleep (≤6 h: β = -0.343, C.I. -0.611 to -0.076; >6-7 h: β = -0.263, C.I. -0.506 to -0.020) and long sleep (β = -0.536, C.I. -1.019 to -0.053) measured at baseline predicted lower scores in delayed memory recall at follow-up. In women, sleep duration was unrelated to cognitive performance at follow-up, and in both sexes, there was no relationship between sleep quality and follow-up cognitive performance. There was no evidence of mediating effects of inflammatory markers in the relationship between sleep measures and cognitive performance in both sexes. In conclusion, baseline short and long sleep duration is associated with follow-up cognitive performance in older men, but we found no evidence of any mediating effects of inflammation.     

Race/ethnicity, sleep duration, and diabetes mellitus: analysis of the National Health Interview Survey

BackgroundThe effect of race/ethnicity on the risk of diabetes associated with sleep duration has not been systematically investigated. This study assessed whether blacks reporting short (<6 hours) or long (>8 hours) sleep durations were at greater risk for diabetes than their white counterparts. In addition, this study also examined whether the influence of race/ethnicity on associations between abnormal sleep durations and the presence of diabetes were independent of individuals' sociodemographic and medical characteristics.MethodsA total of 29,818 Americans (age range: 18-85 years) enrolled in the 2005 National Health Interview Survey, a cross-sectional household interview survey, provided complete data for this analysis.ResultsOf the sample, 85% self-ascribed their ethnicity as white and 15% as black. The average age was 47.4 years, and 56% were female. Results of univariate regression analysis adjusting for medical comorbidities showed that black and white participants who reported short sleep duration (<6 hours) were more likely to have diabetes than individuals who reported sleeping 6 to 8 hours (odds ratios 1.66 and 1.87, respectively). Likewise, black and white participants reporting long sleep duration (>8 hours) had a greater likelihood of reporting diabetes compared with those sleeping 6 to 8 hours (odds ratios 1.68 and 2.33, respectively). Significant interactions of short and long sleep with black and white race were observed. Compared with white participants, greater diabetes risk was associated with being short or long sleepers of black race.ConclusionThe present findings suggest that American short and long sleepers of black race may be at greater risk for diabetes independently of their sociodemographic profile or the presence of comorbid medical conditions, which have been shown to influence habitual sleep durations. Among black individuals at risk for diabetes, healthcare providers should stress the need for adequate sleep.     

Low-intensity physical activity benefits blood lipids and lipoproteins in older adults living at home

OBJECTIVE: to examine the influence of low-intensity, habitual physical activity on blood lipids and lipoproteins and other cardiovascular risk factors in older adults living at home. DESIGN: cross-sectional observational study. PARTICIPANTS: a convenience sample of healthy, older adults (n = 155) who were mainly non-Hispanic, white (96.8%), female (65.2%) and on medications for cardiometabolic-related disorders (60.6%) and had an average age of 74.2 +/- 0.5 years. METHODS: we used a question from the Yale Physical Activity Survey to assess the typical number of hours per day spent in motion during the past month, collapsing responses into <5 and > or = 5 h/day. We determined blood lipids, lipoproteins and glucose with Kodak Ektachem serum oxidase assays or finger stick using the Cholestech LDX system enzymatic technique, and measured blood pressure by auscultation. Waist circumference was the indicator of abdominal fat distribution and body mass index the measure of overall adiposity. RESULTS: after adjusting for age, sex, adiposity, postprandial state, medication use and method of blood sampling, greater amounts of daily accumulated movement were associated with more favourable blood lipid-lipoprotein profiles. Subjects reporting > or = 5 h of daily movement had higher levels of high-density lipoprotein cholesterol [mean difference (95% confidence interval): 0.23 mmol/l (0.07, 0.39); P = 0.002] and a lower ratio of total to high-density lipoprotein cholesterol [average difference: -0.92 (-1.36, -0.48); P = 0.003]. They had lower levels of low-density lipoprotein cholesterol [mean difference: -0.39 mmol/l (-0.80, 0.03); P = 0.074)] and a lower ratio of triglyceride to high-density lipoprotein cholesterol [mean difference: -1.31 (-2.50, -0.12); P = 0.059]. Total cholesterol was similar in the two groups (P > 0.05). The mean blood glucose was 1.49 mmol/l lower (-2.67, -0.31) in the more active group (P = 0.02), independent of age, sex, adiposity, medication use and postprandial state. CONCLUSIONS: low-intensity, habitual physical activity is a sufficient stimulus to enhance blood lipids/lipoproteins and glucose in older adults, independent of abdominal and overall adiposity.     

The influence of sex and age on the relationship between sleep duration and metabolic syndrome in Korean adults

Aims

To investigate the influence of sex and age on the relationship between sleep duration and metabolic syndrome in a nationally representative population.

Methods

We used data from the Korea National Health and Nutrition Examination Survey (2001–2010) and enrolled 24,511 participants aged 20–79 years. Sleep duration was categorized into five groups: ≤5, 6, 7 (referent), 8, and ≥9 h/day. Age was categorized into three groups: younger (20–39 y), middle-aged (40–59 y), and older (60–79 y). The association between sleep duration and metabolic syndrome was assessed in the total, separately in men and women, then in six groups based on sex and age.

Results

The prevalence of metabolic syndrome by sleep category demonstrated a U-shaped pattern in the total population. However, after adjusting for age, education, occupation, exercise, smoking, alcohol, and body mass index, the prevalence of metabolic syndrome increased in long sleepers (OR 1.31; 95% CI 1.14–1.51) but not in short sleepers (OR 1.00; 95% CI 0.89–1.11). The relationship between sleep duration and metabolic syndrome varied by sex and age–long sleep (≥9 h/day) was positively associated with metabolic syndrome only in younger (OR 2.13; 95% CI 1.38–3.28) and middle-aged (OR 1.63; 95% CI 1.21–2.21) women. Short sleep (≤5 h/day) was not associated with metabolic syndrome in any sex and age groups. However, extremely short sleep (≤4 h/day) was associated with metabolic syndrome in middle-aged men (OR 1.76, 95% CI 1.05–2.96).

Conclusion

These data suggest that sex and age significantly modify the relationship between sleep duration and metabolic syndrome.     

Adipocytokines and incident diabetes mellitus in older adults: the independent effect of plasminogen activator inhibitor 1

BACKGROUND: Adipose tissue produces "adipocytokines" of uncertain clinical significance. METHODS: We analyzed the relationships among adiposity, adipocytokines, glycemia, and incident diabetes mellitus in 2356 white and black adults aged 70 to 79 years in the Health, Aging, and Body Composition Study who did not have diabetes at baseline. We measured the levels of adipocytokines adiponectin, leptin, interleukin 6, tumor necrosis factor alpha, and plasminogen activator inhibitor 1. Regional fat area was determined by means of computed tomography. New diabetes was defined as a self-reported diagnosis of diabetes or as a fasting plasma glucose level of 126 mg/dL or greater (>/=7.0 mmol/L) at the second, fourth, or sixth annual examination. RESULTS: A total of 143 participants (14.1 cases per 1000 person-years) developed diabetes across 5 years. Visceral fat area (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.10-1.60 per standard deviation increase) and body mass index (white individuals: OR, 1.65; 95% CI, 1.26-2.15 per standard deviation increase; black individuals: OR, 1.22; 95% CI, 0.99-1.51 per standard deviation increase) independently predicted incident diabetes. Adiponectin, leptin, and plasminogen activator inhibitor 1 attenuated the relationship between adiposity and diabetes. After controlling for body mass index, visceral fat, fasting glucose, fasting insulin, high-density lipoprotein cholesterol, triglycerides, and hypertension at baseline, plasminogen activator inhibitor 1 was the only adipocytokine independently associated with increased odds of diabetes (OR, 1.35; 95% CI, 1.01-1.81). Fasting glucose level at baseline remained a strong predictor of incident diabetes, whereas associations with body mass index and visceral fat were attenuated. CONCLUSIONS: Adipocytokines and glycemia partially account for the relationship between adiposity and risk of type 2 diabetes due to adiposity. Plasminogen activator inhibitor 1 may be a useful predictor of diabetes in addition to measurements of body fat.     

Gender-specific associations of sleep duration with uncontrolled blood pressure in middle-aged patients

Objective: The present study was designed to evaluate the associations between sleep duration and uncontrolled blood pressure in a hospital-based sample of middle-aged adults. Methods: Between March 2012 and December 2012, a cross-sectional survey was conducted among the hypertensive outpatients of Anzhen Hospital and a community hospital in Beijing, China. Eligible participants were adults aged 35–55 years with an established diagnosis of hypertension and had been on standard antihypertensive drug treatment for at least 6 months. An interviewer-led questionnaire was used to collect the participants’ demographic, lifestyle and dietary information, as well as medical histories. Usual sleep durations were categorized as <7?h, 7–8?h and >8?h per night. Logistic regression models were used to assess gender-specific associations between sleep duration and uncontrolled hypertension, with adjustment for age, gender, family history, diabetes, smoking, alcohol consumption and physical activity. Results: A total of 3038 participants were finally investigated. Among them, 1569 (51.6%) patients had their blood pressure uncontrolled. In men, no significant association was found between sleep duration categories and uncontrolled hypertension. In women, compared with those sleeping <7?h, longer sleepers tended to have a lower risk of uncontrolled hypertension for sleeping 7–8 hours (odds ratio [OR] 0.537, 95% confidence interval [CI], 0.370–0.780) and sleeping >8?h (OR 0.316, 95% CI, 0.202–0.494), respectively. Conclusion: Modest associations between short sleep duration and uncontrolled hypertension were seen in middle-aged women but not in men in the hypertensive population.     

Learning about the energy density of liquid and semi-solid foods

Background:People learn about a food's satiating capacity by exposure and consequently adjust their energy intake.Objective:To investigate the effect of energy density and texture on subsequent energy intake adjustments during repeated consumption.Design:In a randomized crossover design, participants (n=27, age: 21±2.4?years, body mass index: 22.2±1.6?kg?m(-2)) repeatedly consumed highly novel foods that were either low-energy-dense (LE: 30?kcal per 100?g) or high-energy-dense (HE: 130?kcal per 100?g), and either liquid or semi-solid, resulting in four product conditions. In each condition, a fixed portion of test food was consumed nine times as an obligatory part of breakfast, lunch and dinner on 3 consecutive days. All meals continued with an ad libitum buffet; food items for evening consumption were provided and the intake (kcal per day) was measured.Results:Buffet intake depended on energy density and day of consumption of the test foods (day*energy interaction: P=0.02); daily buffet intake increased from day 1 (1745±577?kcal) to day 3 (1979±567?kcal) in the LE conditions; intake did not change in the HE conditions (day 1: 1523±429?kcal, day 3: 1589±424?kcal). Food texture did not affect the intake (P=0.56).Conclusions:Intake did depend on energy density of the test foods; participants increased their buffet intake over days in response to learning about the satiating capacity of the LE foods, but did not change buffet intake over days when repeatedly consuming a HE food as part of their meal. The adjustments in intake were made irrespective of the food texture.     

Distinct associations between energy balance and the sleep characteristics slow wave sleep and rapid eye movement sleep

Context:Epidemiologically, an inverse relationship between body mass index (BMI) and sleep duration is observed. Intra-individual variance in the amount of slow wave sleep (SWS) or rapid eye movement (REM) sleep has been related to variance of metabolic and endocrine parameters, which are risk factors for the disturbance of energy balance (EB).Objective:To investigate inter-individual relationships between EB (EB=∣energy intake-energy expenditure∣, MJ/24?h), SWS or REM sleep, and relevant parameters in normal-weight men during two 48?h stays in the controlled environment of a respiration chamber.Subjects and methods:A total of 16 men (age 23±3.7 years, BMI 23.9±1.9?kg?m(-2)) stayed in the respiration chamber twice for 48?h to assure EB. Electroencephalography was used to monitor sleep (2330-0730 hrs). Hunger and fullness were scored by visual analog scales; mood was determined by State Trait Anxiety Index-state and food reward by liking and wanting. Baseline blood and salivary samples were collected before breakfast. Subjects were fed in EB, except for the last dinner, when energy intake was ad libitum.Results:The subjects slept on average 441.8±49?min per night, and showed high within-subject reliability for the amount of SWS and REM sleep. Linear regression analyses showed that EB was inversely related to the amount of SWS (r=-0.43, P<0.03), and positively related to the amount of REM sleep (r=0.40, P<0.05). Relevant parameters such as hunger, reward, stress and orexigenic hormone concentrations were related to overeating, as well as to the amount of SWS and REM sleep, however, after inclusion of these parameters in a multiple regression, the amount of SWS and REM sleep did not add to the explained variance of EB, which suggests that due to their individual associations, these EB parameters are mediator variables.Conclusion:A positive EB due to overeating, was explained by a smaller amount of SWS and higher amount of REM sleep, mediated by hunger, fullness, State Trait Anxiety Index-state scores, glucose/insulin ratio, and ghrelin and cortisol concentrations.