Relationship between sleep and obesity among U.S. and South Korean college students

Sleep quality of college students in Fujian and its influencing factors: A cross-sectional study

AIM

This study aims to investigate college students' sleep quality, explore the factors influencing it, and provide data support for further studies.

METHODS

College students in Fujian Province were chosen as the study sample using snowball sampling. Data was gathered from the participants through the utilization of a self-designed personal questionnaire, the Pittsburgh Sleep Quality Index(PSQI) scale, and the Mobile Phone Addiction Index (MPAI) scale. Binary logistic regression is utilized to assess the sleep quality of college students and identify risk factors.

RESULTS

A total of 971 participants were included in this study. The mean total PSQI score was 4.52 ± 3.17. There were 310 students with poor sleep quality and the detection rate was 32.0%. The multivariate logistic regression analysis showed that smoking (OR(Odds ratio):1.832(1.076,3.118)), electronic product addiction(OR:2.861(1.928,4.246)), personal history of acute illness(OR:2.328(1.671,3.244)) were identified as independent risk factors.In turn, education (OR:0.594(0.456,0,772)) and parents without sleep problems (OR:0.533(0.361,0.787)) were protective factors.

CONCLUSION

College students in Fujian have some sleep problems. We should pay attention to the relationship between smoking, electronic product addiction, personal history of acute illness and sleep quality. Health policymakers should consider these factors to improve college students' sleep quality.

Associations between mobile phone involvement, BMI levels, and sleep quality among Chinese university students: evidence from a multi-regional large-scale survey

Objective

This study aims to explore the association between mobile phone involvement, body mass index (BMI) levels, and the sleep quality of Chinese university students.

Methods

Using a cluster sampling method, we selected 17,085 university students from three universities in eastern, central, and western China as the study subjects. Demographic information such as age and sex were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Mobile Phone Involvement Questionnaire (MPIQ) were utilized to measure their sleep quality scores and mobile phone involvement scores, respectively. Pearson correlation analysis, two-way ANOVA, and multiple linear regression were employed to examine the relationship between BMI levels, mobile phone involvement, and sleep quality.

Results

The results show that 15.87% (2,712 participants) are classified as overweight, and 18.45% (3,151 participants) are classified as obese. Additionally, 35.87% (6,125 participants) exhibit mobile phone involvement, while 57.94% (9,899 participants) reported poor sleep quality. Pearson correlation analysis indicates a significant negative correlation (p < 0.01) between sleep quality and both BMI levels and mobile phone involvement. Two-way ANOVA shows the significant effect of BMI levels (p < 0.001) and mobile phone involvement (p < 0.001) on sleep quality, and there is no interaction effect between the two. Additionally, the sleep quality of overweight and obese individuals is significantly poorer than that of those with normal weight (p < 0.05), while the sleep quality of overweight individuals is significantly lower than that of obese individuals (p < 0.05). Multiple linear regression analysis indicates that, after controlling for age and gender, both BMI (β = -2.69) levels and mobile phone involvement (β = -1.34) are significantly negatively associated with sleep quality (p < 0.001), accounting for 19% of the variance in poor sleep quality.

Conclusion

This study found that BMI levels and mobile phone involvement are both independently associated with sleep quality among Chinese university students. However, among individuals with excess BMI, although their sleep quality is worse than individuals with normal weight, overweight individuals may have poorer sleep quality than obese individuals. This study also revealed high rates of overweight and obesity, with over half of participants reporting poor sleep quality, highlighting the need for targeted interventions to address weight management and mobile phone usage to improve sleep health in this population.

University Students' Sociodemographics, Physical Inactivity, and Inadequate and Poor-Quality Sleep Are Associated With Their Overweight/Obesity: Findings From a Case-Control Study in Bangladesh

Background and Aims

Evidence confirms a high prevalence of general and abdominal obesity among university students in Bangladesh. The primary objective of this case-control study was to examine the association between overweight/obesity and sleep patterns (including sleep duration and quality) among university students in Bangladesh. The secondary objective was to identify the sociodemographic and lifestyle-related factors that predict overweight/obesity in the study population.

Methods

The sociodemographics and body mass index (BMI) were gathered from a sample of 330 university students (setting: one public university in Bangladesh). Sleep health was measured by the 19-item Pittsburgh Sleep Quality Index (PSQI) and compared between the cases (BMI ≥ 23.0 kg/m2) and controls (BMI = 18.5-22.9 kg/m2). Bivariate and multiple stepwise regression analyses were performed.

Results

One hundred and sixty-five overweight/obesity students and 165 control subjects participated in the study. The peak age for overweight/obesity was 22-25 years in the students, and about 67% of the cases were poor-quality sleepers compared to 53% of the students in the control group. Multiple stepwise regression analysis showed that students' overweight/obesity was associated with being female (adjusted odds ratio, aOR = 2.12; 95% confidence interval, CI: 1.25, 3.61), short sleep duration ( ≤ 7 h/night) (aOR = 1.12, 95% CI: 1.04, 2.66), poor quality of sleep (aOR = 1.82, 95% CI: 1.16, 2.87), and physical inactivity (aOR = 1.89; 95% CI: 1.12, 3.55).

Conclusion

Key factors associated with overweight/obesity among Bangladeshi university students include age (22-25 years), gender (higher prevalence in female students), sleep duration and quality, and physical inactivity. These findings highlight the need for targeted interventions addressing sleep health, physical activity, and healthy lifestyles to mitigate overweight/obesity among university students.

Associations between sleep, energy balance, and obesity markers over 6 months in Black emerging adults-pilot study findings from the Sleep, Health Outcomes, and Body Weight (SHOW) study

Insufficient sleep (short sleep duration and poor sleep quality) is associated with obesity risk. Emerging adults (ages 18-28 years) have a greater risk of excess weight gain and insufficient sleep, and these risks are higher in Black individuals. Using a measurement burst design, we assessed associations between sleep with energy balance components and obesity marker changes over 6 months in 15 Black emerging adults (12 females; age: 21 ± 2.5 years; body mass index: 25.7 ± 4.5 kg/m2; body fat: 25.8 ± 11.9%). Since our sample was predominantly female (80%), we repeated our analyses for females only. Participants completed the following measurements at baseline (BLN) and 6 months later (6MO): 7 days of actigraphy-based sleep and physical activity energy expenditure (EE) and 2 nights of in-home polysomnography-based sleep; resting EE and thermic effect of food with indirect calorimetry; ad libitum energy intake (EI) via self-reported methods over 4 days and directly measured over 3 days with provided meals. Body weight (2.6 kg, p = 0.01) and waist circumference (2.4 cm, p = 0.03) increased from BLN to 6MO. Changes in actigraphy-based sleep duration were associated with changes in body weight (β = 0.03, standard error (SE) = 0.02, p = 0.04) and fat mass (β = 0.07, SE = 0.03 p = 0.03) in females only. Greater rapid eye movement sleep duration was associated with increases in resting EE (β = 2.24, SE = 0.84, p = 0.02). Greater slow-wave sleep was associated with increases in self-reported EI (β = 18.34, SE = 4.7, p < 0.01). Sleep may impact components of energy balance and risk of weight gain in Black emerging adults. Additional research is needed to confirm our pilot findings.

Characterising the activity, lifestyle behaviours and health outcomes of UK university students: an observational cohort study with a focus on gender and ethnicity

BACKGROUND

Health-related outcomes and behaviours in university students are known to be poor relative to the general population. The substantial contextual shifts related to the COVID-19 pandemic, combined with increased numbers of students from minoritised ethnicity backgrounds and presenting as trans and gender diverse (TGD), means that up-to-date information is unavailable. The primary aim of this study was therefore to characterise the current movement, dietary and lifestyle behaviours, mental health, and Body Mass Index (BMI) of UK university students and assess differences between genders and ethnic groups.

METHODS

An online, self-report survey was administered across three years (2021-2023). Three independent cohorts of university students' (n = 6,327) completed the survey on four key topic areas. One-way ANOVAs were used to assess differences between genders (men, women, TGD), and independent samples t-tests were used to assess differences between ethnic groups (White, Minoritised Ethnicity).

RESULTS

30% of students were not meeting physical activity guidelines, 54% were sedentary for ≥ 6 h·d- 1, 83% had poor diet quality, 51% were in high or increased risk groups for alcohol consumption, 18% experienced terrible or poor sleep quality, and 32% were overweight or obese. Gender differences were present for all variables other than walking physical activity (WPA) (P < 0.05), with men having better mental health and engaging in healthier movement and sleeping behaviours, whereas women had more healthful dietary and drinking behaviours, and TGD students had poorer outcomes compared to cis-gender students in most domains. Differences between White and minoritised ethnicity students were present for all variables other than sedentary behaviour, diet quality, WPA and BMI (P < 0.05); students of minoritised ethnicity engaged in better movement, drinking and sleep behaviours in addition to having more positive mental health than White students.

CONCLUSION

The findings of the current study provide an update on the landscape of UK university students' health and health-related behaviours. Overall, health-related outcomes and behaviours are poor in this population and these data suggest that gender and ethnicity play a role in determining students' health and health-related behaviours. Therefore, these factors should be considered when developing strategies to promote healthy living in the context of higher education.

Sleep, Health Outcomes and Body Weight (SHOW) study: a measurement burst design study on sleep and risk factors for obesity in black emerging adults in North Carolina, USA

INTRODUCTION

Black emerging adults (18-28 years) have the highest risk of short sleep duration and obesity. This increased risk may be partly explained by greater stress levels, which may result from race-related stress (racial discrimination and heightened race-related vigilance) or living in more disadvantaged home and neighbourhood environments. Insufficient sleep may also impact obesity risk via several weight-related mechanisms including energy balance, appetite and food reward, cortisol profiles and hydration status. This paper describes the rationale, design and methods for the Sleep, Health Outcomes and Body Weight (SHOW) study. This study aims to prospectively assess the effects of sleep, race-related stress and home/neighbourhood environments on weight-related mechanisms and obesity markers (body weight, waist circumference and fat mass) in 150 black emerging adults.

METHODS AND ANALYSIS

The SHOW study follows a measurement burst design that includes 3, 7-day data collection bursts (baseline, 6-month and 12-month follow-ups). Sleep is measured with three methods: sleep diary, actigraphy and polysomnography. Energy balance over 7 days is based on resting and postprandial energy expenditure measured via indirect calorimetry, physical activity via accelerometry and self-reported and ad libitum energy intake methods. Self-reported methods and blood biomarkers assess fasting and postprandial appetite profiles and a behavioural-choice task measures food reward. Cortisol awakening response and diurnal cortisol profiles over 3 days are assessed via saliva samples and chronic cortisol exposure via a hair sample. Hydration markers are assessed with 24-hour urine collection over 3 days and fasting blood biomarkers. Race-related stress is self-reported over 7 days. Home and neighbourhood environments (via the Windshield Survey) is observer assessed.

ETHICS AND DISSEMINATION

Ethics approval was granted by the University of North Carolina at Greensboro's Institutional Review Board. Study findings will be disseminated through peer-reviewed publications, presentations at scientific meetings and reports, briefs/infographics for lay and community audiences.

The Importance of Sleep in Overcoming Childhood Obesity and Reshaping Epigenetics

The development of childhood obesity is a complex process influenced by a combination of genetic predisposition and environmental factors, such as sleep, diet, physical activity, and socioeconomic status. Long-term solutions for decreasing the risk of childhood obesity remain elusive, despite significant advancements in promoting health and well-being in school and at home. Challenges persist in areas such as adherence to interventions, addressing underlying social determinants, and individual differences in response to treatment. Over the last decade, there has been significant progress in epigenetics, along with increased curiosity in gaining insights into how sleep and lifestyle decisions impact an individual's health. Epigenetic modifications affect the expression of genes without causing changes to the fundamental DNA sequence. In recent years, numerous research studies have explored the correlation between sleep and the epigenome, giving a better understanding of DNA methylation, histone modification, and non-coding RNAs. Although significant findings have been made about the influence of sleep on epigenetics, a notable gap exists in the literature concerning sleep-related genes specifically associated with childhood obesity. Consequently, it is crucial to delve deeper into this area to enhance our understanding. Therefore, this review primarily focuses on the connection between sleep patterns and epigenetic modifications in genes related to childhood obesity. Exploring the interplay between sleep, epigenetics, and childhood obesity can potentially contribute to improved overall health outcomes. This comprehensive review encompasses studies focusing on sleep-related genes linked to obesity.

Overweight and Obesity Is Associated with Higher Risk of Perceived Stress and Poor Sleep Quality in Young Adults

Background and Objectives: Overweight and obesity are growing public health challenges, particularly concerning young adults. University life presents a unique set of stressors that may influence weight management alongside sleep quality. In this cross-sectional study, we aimed to investigate the association between overweight or obesity, stress, and sleep quality in a large sample of Greek university students. Materials and Methods: The study recruited 2116 active students from across various Greek universities. Participants completed questionnaires on sociodemographics, academic performance, and physical activity levels using the International Physical Activity Questionnaire (IPAQ). Stress and sleep quality were assessed using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Body weight and height were directly measured to calculate Body Mass Index (BMI). Results: Our analysis of 2116 Greek university students revealed significant associations between various factors and overweight/obesity. Compared to their rural counterparts, young adults in urban areas had an 88% higher prevalence of overweight/obesity (p = 0.0056). Regular smokers were twice as likely to be overweight or obese (p = 0.0012). Notably, those with low physical activity levels displayed a more than two-fold increased risk (p = 0.0008) compared to those with moderate or high activity levels. Similarly, students with moderate or high perceived stress levels had a more than two-fold prevalence of overweight/obesity compared to those with low stress (p = 0.0005). Inadequate sleep quality was also associated with an 86% higher risk of overweight/obesity (p = 0.0007). Interestingly, good academic performance showed a 57% greater prevalence of overweight/obesity compared to very good/excellent performance (p = 0.0103). Conclusions: Our findings reveal that perceived stress and poor sleep quality are significant risk factors for overweight and obesity in this young adult population.

The Relationship Between Academic Stress, Sleep Quality, and Psychological Wellbeing in Pasifika and New Zealand European Students at the University of Otago

BACKGROUND

Pasifika students in New Zealand are overrepresented in poor academic outcomes, and their academic challenges may potentially influence their wellbeing. We aim to: 1) compare the academic stress, sleep quality, and psychological wellbeing of Pasifika and New Zealand European (NZE) anatomy students at the University of Otago, and 2) determine if academic stress mediates the association between their psychological wellbeing and sleep quality.

METHODS

We launched a brief online survey to Pasifika and NZE students in our department. The survey included basic demographics, Perception of Academic Stress Scale, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, a short loneliness scale, a reduced morningness-eveningness scale, and the Epworth Sleepiness Scale.

RESULTS

Perceived academic stress were comparable between NZE and Pasifika students, but Pasifika students reported poorer sleep quality than NZE students (t(113) = 14.41, P < .001). In addition, Pasifika students reported more loneliness (t(119) = 8.933, P < .001), less anxiety symptoms (t(120) = 2.469, P = .015), and less of a morning person (t(121) = 2.618, P = .010) than NZE students, but they had comparable depressive symptoms and daytime sleepiness. After controlling for age, ethnicity and gender, we found that academic stress fully mediated the relationship between anxiety or depressive symptoms and poor sleep quality. Furthermore, academic stress partially mediated the relationship between loneliness and poor sleep quality in our cohort.

CONCLUSION

Our findings highlight the importance for academic institutions to support students' wellbeing, including ethnic minority students such as Pasifika students in New Zealand.

The Use of Nonmonetary Outcomes in Health-Related Delay Discounting Research: Review and Recommendations

Delay discounting (DD) refers to the tendency to devalue an outcome as a function of its delay. Most contemporary human DD research uses hypothetical money to assess individual rates of DD. However, nonmonetary outcomes such as food, substances of misuse, and sexual outcomes have been used as well, and have advantages because of their connections to health. This article reviews the literature on the use of nonmonetary outcomes of food, drugs, and sexual outcomes in relation to health and reinforcer pathologies such as substance use disorders, obesity, and sexual risk behaviors, respectively, and makes a case for their use in discounting research. First, food, substances, and sex may be more ecologically valid outcomes than money in terms of their connections to health problems and reinforcer pathologies. Second, consistent trends in commodity-specific (i.e., domain) effects, in which nonmonetary outcomes are discounted more steeply than money, enhance variation in discounting values. Third, commodity-specific changes in discounting with treatments designed to change health choices are described. Finally, methodological trends such as test-retest reliability, magnitude effects, the use of hypothetical versus real outcomes, and age-related effects are discussed in relation to the three outcome types and compared to trends with monetary discounting. Limitations that center around individual preferences, nonsystematic data, and deprivation are discussed. We argue that researchers can enhance their DD research, especially those related to health problems and reinforcer pathologies, with the use of nonmonetary outcomes. Recommendations for future directions of research are delineated.

Prevalence and Correlates of Health Risk Behaviors among University Students from a State in the Southern Region of Brazil

BACKGROUND

Surveys conducted in different regions of the world show that the prevalence rates of health risk behaviors (HRBs) in university students are sometimes higher than those found in non-university populations. This study aims to identify the prevalence rates and demographic and academic environment correlates associated with HRBs among Brazilian university students.

METHODS

In a cross-sectional epidemiological study, a random sample of 5310 university students answered an online questionnaire, with demographic (sex, age, skin color, marital status, and paid work) and academic setting information (housing type, size of campus, year, and shift of study), as well as items clustered in four HRB domains: personal safety and violence, sexual behavior and contraception, addictive substance use, eating habits, physical activity, and sleep. The data were analyzed statistically using bivariate analysis and hierarchical multiple regression.

RESULTS

The highest prevalence rates occurred in HRBs clustered in the domain of eating habits, physical activity, and sleep (>60%), while HRBs for personal security and violence were less prevalent (<15%). From 15% to 35% of university students assumed HRBs regarding addictive substance use, and approximately 50% reported risky sexual behavior. The university students most susceptible to HRBs were men, aged ≥ 22 years, living far from their family, studying on larger campuses, attending night classes, and with two or more years of study at the university.

CONCLUSION

The findings suggest that policies and interventions in the university context aimed at students' readiness to engage in a healthy lifestyle should target specific correlates associated with HRBs.

Associations of actigraphy-assessed sleep variables with adiposity and serum cardiometabolic outcomes in emerging adults

This study assessed associations of actigraphy-assessed sleep with adiposity and serum cardiometabolic outcomes in emerging adults, and whether sex and race modified these associations. Data on 147 emerging adults (age = 19.4 ± 1.3 years; body mass index = 26.4 ± 7.0 kg m-2 ; 59% female; 65% White) from RIGHT Track Health were used. Actigraphy-based sleep measures included sleep duration, sleep efficiency, sleep timing midpoint, day-to-day sleep duration and sleep timing midpoint variability. Combined sleep duration and sleep timing behaviours were also derived (early-bed/late-rise, early-bed/early-rise, late-bed/late-rise, late-bed/early-rise). Outcomes included body mass index and BodPod-assessed fat mass index, fasting serum leptin, C-reactive protein, and homeostatic model assessment-insulin resistance. Sleep duration was 5.4 h per night. We noted an inverse association between sleep duration and homeostatic model assessment-insulin resistance. The early-bed/early-rise group had greater body mass index, C-reactive protein and homeostatic model assessment-insulin resistance compared with the early-bed/late-rise group (referent). Sex modified associations of sleep efficiency with C-reactive protein; stratified results revealed positive association between sleep efficiency and C-reactive protein in males, but not females. Race modified associations of sleep duration with body mass index and leptin, and of sleep duration variability with C-reactive protein. Stratified analyses revealed inverse associations between sleep duration with body mass index and leptin in Black, multiracial/other race individuals only. Positive association between sleep duration variability and C-reactive protein was noted in White individuals only. Shorter sleep duration, particularly when combined with earlier sleep timing, is associated with greater adiposity and serum cardiometabolic outcomes. Additional studies are needed to assess individual- and contextual-level factors that may contribute to sex and race differences in sleep health and cardiometabolic risk in emerging adults.

Trends in sleep duration in the U.S. from 2004 to 2018: A decomposition analysis

Average sleep duration in the United States declined in recent years, and the decline may be linked with many biopsychosocial factors. We examine how a set of biopsychosocial factors have differentially contributed to the temporal trends in self-reported sleep duration across racial groups between 2004-2005 and 2017-2018. Using repeated nationally representative cross-sections from the National Health Interview Survey, we decompose the influence of biopsychosocial factors on sleep duration trends into two components. One component corresponds to coefficient changes (i.e., changes in the associations between behaviors or exposures and sleep duration) of key biopsychosocial factors, and the other part accounts for the compositional changes (i.e., changes in the distributions of exposures) in these biopsychosocial factors during the study period. We reveal that changes in the coefficients of some biopsychosocial factors are more important than compositional changes in explaining the decline in sleep duration within each racial/ethnic group. Our findings highlight racial differences manifest across multiple biopsychosocial domains that are shifting in terms of association and composition. Methodologically, we note that the standard regression approach for analyzing temporal trends neglects the role of coefficient changes over time and is thus insufficient for fully capturing how biopsychosocial factors may have influenced the temporal patterns in sleep duration and related health outcomes.

Relationship between problematic smartphone use and sleep problems: The roles of sleep-related compensatory health beliefs and bedtime procrastination

Objective

Concerns regarding sleep problems in emerging adults and their antecedents, such as problematic smartphone use (PSU), have been growing. This study tested the association between PSU and sleep problems and further investigated the mechanisms of this relationship based on the theory of compensatory health beliefs (CHBs).

Methods

This study included 999 participants (74.87% female) in China, aged 17 to 25 years (M = 21.16; standard deviation = 1.60), who voluntarily filled in an anonymous survey.

Results

The findings showed positive correlations between sleep problems and PSU, sleep-related CHBs, and bedtime procrastination (rs = .25-.52, p < .001). Furthermore, the positive link between PSU and sleep problems was mediated by bedtime procrastination alone (β=.21, 95% confidence interval (CI) [.17, .26]) or a serial path of sleep-related CHBs and bedtime procrastination (β=.04, 95% CI [.02, .05]).

Conclusion

This study provides a new perspective to understand the internal mechanism underlying the PSU-sleep problem link. Interventions for sleep disorders ought to consider the theoretical guidelines of the CHBs model to reduce the risk of bedtime procrastination and sleep disorders in emerging adults.

The impact of virtual reality scenes on stress response characteristics of individuals with different personality traits

Virtual reality based physical stress (VRPS) paradigms could eliminate the influence of social factors on participants, and it may be a desirable tool to explore the impact of personality traits on stress levels. In this study, we attempt to explore the effects of VRPS on stress response among individuals with different personality traits. Forty male participants with an average age of 22.79 ± 0.41 years were divided into two groups based on Harm Avoidance (HA) scores of Tridimensional Personality Questionnaire (TPQ), referred to as the Low-HA group and the High-HA group. The stress levels of the participants were assessed using salivary α-amylase (sAA) activity and heart rate variability (HRV) indices pre- and post-stress. The influence of personality traits on stress response among different groups was analyzed. VRPS significantly affected the sAA activity and HRV indicators of both groups. During and after stress, there were significant differences in sAA activity and HRV indicators between the two groups. The sAA levels and HRV indices of the Low-HA group were lower than those of the High-HA group. Furthermore, sAA levels and HRV indices were correlated with the scores of TPQ. VRPS scenarios elicit different stress responses on individuals with different harm avoidance personality traits. Stress evaluation based on VR scenarios presents potential in personality trait assessments, particularly for distinguishing between individuals with low and high HA tendencies.

Sleep duration, sleep quality and the risk of being obese: Evidence from the Australian panel survey

BACKGROUND

Sleep difficulty is an unmet public health concern affecting a vast proportion of the world's population. Poor sleep duration (short or long sleep length) and quality affect more than half of older people. Sleep difficulty is associated with negative health outcomes such as obesity and reduced longevity. We aimed to assess whether poor sleep duration and quality are significant risk factors for obesity in adults aged 15 and over in Australia by examining a nationally representative panel data.

METHODS

We used three waves (waves 13, 17, and 21) of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey data. The study applied generalized estimating equations (GEE) logistic regression model to assess the relationship between sleep duration and quality with obesity.

RESULTS

The study found that the odds of being obese was significantly higher amongst the study participants with poor sleep duration (adjusted odds ratio [aOR]: 1.24, 95% confidence interval [CI]: 1.16-1.32) and poor sleep quality (aOR: 1.29, 95% CI: 1.02-1.38) compared with their counterparts who had good sleep duration and quality, respectively.

CONCLUSION

Having short or long sleep at night and poor sleep quality are associated with an increased risk of obesity. Obesity poses a significant threat to the health of Australian adults. Enacting policies that raise public awareness of the significance of good sleep hygiene and encouraging healthy sleeping habits should be considered to address the alarming rise in the obesity rate.

Associations of multiple sleep dimensions with overall and abdominal obesity among children and adolescents: a population-based cross-sectional study

BACKGROUND

The relationship of insufficient sleep with the increased risk of obesity has been reported, but less is known about other sleep dimensions in the sleep-obesity associations.

OBJECTIVES

To assess the associations of multiple sleep dimensions with overall and abdominal obesity among Chinese students.

METHODS

This was a cross-sectional study involving 10,686 Han students aged 9-18 from Chinese National Survey on Students' Constitution and Health (CNSSCH). We collected sex, age, regions, parental educational levels, physical activity duration and sleep-related information by questionnaire survey, and also conducted anthropometric measurements including height, weight and waist circumference (WC). Unadjusted and adjusted binary logistic regression models were used to estimate the associations of sleep-related dimensions with obesity-related indicators.

RESULTS

Short sleep duration was associated with higher body mass index (BMI), larger WC and higher waist-to-height ratio (WHtR) in 9-12 and 16-18 age groups, whereas prolonged sleep duration on weekday was associated with higher BMI in 13-15 age group. Non-habitual midday napping and midday napping ≤0.5 h/d (vs 0.5 to 1 h/d) increased the risk of higher BMI in 13-15 age group, and the former was also associated with larger WC in 9-12 age group. Late bedtime was associated with larger WC and higher WHtR in 9-12 age group and with higher BMI and WHtR in 13-15 age group. Students aged 9-12 with social jet lag ≥2 h were found to have greater BMI after adjustment (Odds Ratio: 1.421; 95% confidence interval: 1.066-1.894).

CONCLUSIONS

Short or overlong sleep duration, late bedtime and great social jet lag were associated with higher prevalence of overall or abdominal obesity, while moderate midday napping can effectively decrease the risk. Those findings may assist in developing preventive strategies to combat obesity epidemic.

A Questionnaire-Based Cross-Sectional Study of Insomnia among Middle-Aged Adults from Greece's Northeastern Fringe, Thrace

Background, aim: Insomnia constitutes a common and very debilitating disorder in modern societies. A better understanding of the etiologies and risk factors, modifiable or not, of insomnia is essential for a swifter diagnosis and a more appropriate treatment, mitigating its toll on individuals and society. To this purpose, the present study assessed the prevalence of insomnia in a randomly-selected adult population and its relation with a diverse range of socio-demographic characteristics and medical conditions. Methods:A sample of 771 participants aged 24 to 89 years (mean age 58±13 years; 42.7% women) was randomly selected from the general population of Thrace, a prefecture in Northeastern Greece with special cultural considerations, using a two-stage stratified sampling scheme. The Greek version of the Athens Insomnia Scale (AIS) was utilized to evaluate the presence of insomnia. Moreover, the Berlin Questionnaire for Obstructive Sleep Apnea and the Epworth Sleepiness Scale for Excessive Daytime Sleepiness were also utilized. Results:A total of 141 study participants (18.3%) were found to suffer from insomnia. Impaired sleep maintenance was reported as the most frequent symptom (62%). The following independent statistically significant risk factors emerged (p-value <0.05): BMI ≥35 (aOR=2.91), divorced or widowed individuals (aOR=2.23), female gender (aOR=1.76), age >70 years (aOR=1.61), snoring (aOR=1.61), midday sleep (aOR=1.58) and presence of chronic disease (aOR=1.55). Conclusion:The prevalence of isomnia in Thrace aligns with similar studies conducted in Greece and internationally. A multitude of socio-demographic characteristics and diseases, especially chronic, predispose to insomnia.

Socialization, Relaxation, and Leisure across the Day by Social Determinants of Health: Results from the American Time Use Survey, 2014-2016

This study used the American Time Use Survey (ATUS) to examine socialization, relaxation, and leisure activities throughout the day as related to social determinants of health (SDOH). The study population was adults aged 25 years and older who participated in the ATUS in 2014-2016, the most recent years for collecting SDOH. Descriptive analyses provide characteristics of the study population. Graphical analyses display socialization by SDOH across the hours of the day based on adjusted regression models. Quasi-binomial models analyzed the association between the numbers of minutes of various activities and SDOH. Associations between SDOH and sleeplessness (yes or no) were explored using logistic regression. For much of the day, being female, having less education, living in poverty, and having food insecurity were associated with more time socializing and relaxing. The major activities under socializing and relaxation are watching television and movies. Having a college degree was strongly associated with increased minutes of sports activity, whereas living in poverty and food insecurity were associated with fewer minutes. Less education, living in poverty, and having food insecurity were associated with sleeplessness. A possible mechanism of the effects of SODH on health is by its altering of the patterns of daily life.

Altered motivation states for physical activity and 'appetite' for movement as compensatory mechanisms limiting the efficacy of exercise training for weight loss

Weight loss is a major motive for engaging in exercise, despite substantial evidence that exercise training results in compensatory responses that inhibit significant weight loss. According to the Laws of Thermodynamics and the CICO (Calories in, Calories out) model, increased exercise-induced energy expenditure (EE), in the absence of any compensatory increase in energy intake, should result in an energy deficit leading to reductions of body mass. However, the expected negative energy balance is met with both volitional and non-volitional (metabolic and behavioral) compensatory responses. A commonly reported compensatory response to exercise is increased food intake (i.e., Calories in) due to increased hunger, increased desire for certain foods, and/or changes in health beliefs. On the other side of the CICO model, exercise training can instigate compensatory reductions in EE that resist the maintenance of an energy deficit. This may be due to decreases in non-exercise activity thermogenesis (NEAT), increases in sedentary behavior, or alterations in sleep. Related to this EE compensation, the motivational states associated with the desire to be active tend to be overlooked when considering compensatory changes in non-exercise activity. For example, exercise-induced alterations in the wanting of physical activity could be a mechanism promoting compensatory reductions in EE. Thus, one's desires, urges or cravings for movement-also known as "motivation states" or "appetence for activity"-are thought to be proximal instigators of movement. Motivation states for activity may be influenced by genetic, metabolic, and psychological drives for activity (and inactivity), and such states are susceptible to fatigue-or reward-induced responses, which may account for reductions in NEAT in response to exercise training. Further, although the current data are limited, recent investigations have demonstrated that motivation states for physical activity are dampened by exercise and increase after periods of sedentarism. Collectively, this evidence points to additional compensatory mechanisms, associated with motivational states, by which impositions in exercise-induced changes in energy balance may be met with resistance, thus resulting in attenuated weight loss.

Food insecurity is associated with the sleep quality and quantity in adults: a systematic review and meta-analysis

OBJECTIVE

We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (≥18 years).

DESIGN

The current study represented a systematic review and meta-analysis of observational studies.

SETTING

Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI.

PARTICIPANTS

Data from ten eligible observational studies, including 83 764 participants, were included.

RESULTS

FI was associated with an increased risk of poor sleep quality (OR = 1·45; 95 % CI (1·24, 1·70), I2 = 95, P < 0·001, n 7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1·31; 95 % CI (1·16, 1·48), I2 = 0 %, P < 0·001, n 5), moderate (OR = 1·49; 95 % CI (1·32, 1·68), I2 = 0 %, P < 0·001, n 5) and severe (OR = 1·89; 95 % CI (1·63, 2·20), I2 = 0 %, P < 0·001, n 5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1·39; 95 % CI (1·05, 1·83), I2 = 91 %, P = 0·002, n 3) and trouble staying asleep (OR = 1·91; 95 % CI (1·37, 2·67), I2 = 89 %, P < 0·001, n 3). Moreover, FI was associated with the odds of shorter (OR = 1·14; 95 % CI (1·07, 1·21), I2 = 0 %, P < 0·001, n 4) and longer sleep duration (OR = 1·14; 95 % CI (1·03, 1·26), I2 = 0 %, P = 0·010, n 4).

CONCLUSIONS

Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.

Sleep Duration, Body Mass Index, and Dietary Behaviour among KSU Students

BACKGROUND

Adolescents who receive an adequate amount of sleep benefit from a positive health status. Previous studies have documented several health consequences connected with obesity as well as short sleep duration among adolescents. Poor sleep quality with obesity and uncontrolled diet can lead to chronic diseases in the future. This study aimed to examine the link between eating habits, sleep duration, and body mass index (BMI) among King Saud University (KSU) students.

METHODS

The study was cross-sectional and conducted from February to May 2021 on 311 recruited students (male and female) of KSU premises. Pittsburgh Sleep Quality Index questionnaire was used to describe sleep duration linked with a dietary pattern that included fruit and vegetable intake. The questionnaire consists of two sections of 15 and 10 questions each. The questionnaire was created using the Google Forms tool and distributed through social media platforms like Twitter and WhatsApp. The obtained data was transferred into excel to perform the statistical analysis.

RESULTS

The mean total of students who participated in this study was 21.45 ± 23.11. Female students (72.3%) were actively involved in this study. About 30.2% of students were found to be overweight and obese. Around 67.8% of students had insufficient sleep, 32.2% had adequate sleep, and over 70% of students fell asleep within 30 min of going to bed. A total of 71.7% of students showed good sleep quality, whereas 28.3% reported poor sleep quality. BMI was categorized into four groups: 17.7% of individuals were underweight, 52.1% were of normal weight threshold, 20.6% were overweight, and 9.6% were obese. On a regular basis, 12.5% of students consume vegetables and 6.4% fruits daily. The results of this study show that only 8% of students eat breakfast, whereas 62.1% eat lunch, and 29.9% eat dinner.

CONCLUSION

This study concludes that short sleep duration was associated with obesity among KSU students. This association was also found between sleep duration and dietary factors, specifically in the consumption of fruits and vegetables in terms of eating behaviour.

Poor sleep pattern is associated with metabolic disorder during transition from adolescence to adulthood

OBJECTIVE

The purpose of this study was to investigate whether sleep pattern is associated with metabolic disorders among young adults.

METHODS

We measured sleep patterns using multiple sleep behaviors in an ongoing prospective cohort among college students (n = 1,151). At baseline, 729 college students provided fasting blood samples and human body morphological measurements for quantification of metabolic parameters. Then, 340 participants continued to take metabolic parameters measurements at a 2-year follow-up. Sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Metabolic scores were derived for four metabolic parameters including body mass index (BMI), waist circumference (WC), fasting blood sugar (FBG), and insulin. Multivariate linear regression model was applied to analyze the association between sleep pattern types and metabolic parameters and metabolic scores.

RESULTS

In the baseline survey, we found that a total of 41 (4.1%) participants had poor sleep patterns. Then, metabolic scores were significantly higher among college students with poor sleep patterns, compared with those who with healthy sleep patterns at baseline (1.00 ± 0.96 vs. 0.78 ± 0.72, p < 0.05) and 2-year follow-up (0.34 ± 0.65 vs. 1.50 ± 1.64, p < 0.05). After covariates were adjusted, poor sleep pattern (β = 0.22, 95% CI: 0.06~2.53, p = 0.001) was associated with elevated metabolic scores at the 2-year follow-up.

CONCLUSIONS

The elevated metabolic burden observed in college students with poor sleep patterns highlights the need to identify and address sleep problems in order to minimize the long-term impact on disease vulnerability.

Üniversite Öğrencilerinde Vücut Kompozisyonu ve Antropometrik Ölçümlerin Uyku Süresi ve Uyku Kalitesiyle İlişkisi

Amaç: Bu çalışmada üniversite öğrencilerinde vücut kompozisyonu ve antropometrik ölçümlerin uyku süresi ve uyku kalitesiyle ilişkisinin incelenmesi amaçlanmıştır.Yöntem: Kesitsel tipteki çalışma bir fakültede öğrenim gören, araştırmaya katılmayı kabul eden ve dahil edilme kriterlerini karşılayan Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Fakültesinin 310 öğrencisiyle yürütülmüştür. Araştırmanın verileri Tanıtıcı Bilgi Formu ve Pittsburg Uyku Kalitesi İndeksi’ni içeren anket formu kullanılarak yüz yüze görüşme yöntemiyle toplanmıştır. Öğrencilerin vücut kompozisyonlarının belirlenmesinde Biyoelektrik İmpedans Analizi (BİA) ile yağsız vücut kütlesi, vücut yağ ve kas kütlesi incelenmiş, Beden Kütle İndeksi (BKİ), bel çevresi, Bel Kalça Oranı (BKO), Bel Boy Oranı (BBO) ve triseps, supskapular, biseps, suprailiak Deri Kıvrım Kalınlıkları (DKK) değerlendirilmiştir. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, Student’s t testi ve Pearson korelasyon analizi kullanılmıştır.Bulgular: Öğrencilerin uyku süresi ortalama 7,10±1,66 saattir, %74,8’i kötü uyku kalitesine sahiptir. Her iki cinsiyette yağsız vücut kütlesi (kg) ve vücut kas kütlesi (kg) ile uyku kalitesi skoru arasında istatistiksel olarak anlamlı, negatif yönlü zayıf ilişki, erkek öğrencilerde ise suprailiak DKK ve biseps DKK ile uyku kalitesi arasında istatistiksel olarak anlamlı, pozitif yönlü zayıf ilişki saptanmıştır (p&lt;0,05).Sonuç: Üniversite öğrencilerinin uyku süreleri önerilen düzeydedir, buna karşın öğrencilerin dörtte üçü kötü uyku kalitesine sahiptir. Kız ve erkek öğrencilerde yağsız vücut kütlesi (kg) ve vücut kas kütlesi (kg) azaldıkça uyku kalitesi kötüleşmekte, erkek öğrencilerde ise suprailiak DKK ve biseps DKK arttıkça uyku kalitesi kötüleşmektedir.  

Diet self-management: A qualitative study of college students' experiences and perspectives

Background

Overweight and obesity among college students have become an emergent public health concern, which may be effectively prevented by diet self-management (DSM). The purpose of this explorative study was to explore college students' experiences and perspectives on diet self-management (DSM), as well as its influencing factors.

Method

Thirty-three college students were recruited from different universities in China. A qualitative method was used to conduct semi-structured interviews with audio recording to explore their DSM experience and factors that influence DSM. Data were analyzed using thematic analysis to develop themes related to DSM.

Result

In the perception of what "good DSM" means, three themes and ten subthemes were identified: characteristics of good DSM (including 5 subthemes: regularity, balanced diet, no picky eating, good eating habits, and scientificity), method of good DSM (including three subthemes: self-control, adjusting, and making plans), and content of good DSM (including two subthemes: nutrition management and safety management). The influencing factors of DSM can be categorized into four levels of themes and 34 subthemes: individual, family, school, and social levels.

Conclusion

The results of this qualitative research highlighted the complexity and multi-dimension of DSM and its influencing factors. Our findings may help to inform diverse and needs-based intervention approaches to improve DSM and promote healthy diet among college students so as to prevent overweight and obesity.

Weight Control Registry Using Korean Medicine: A Protocol for a Prospective Registry Study

Lifestyle and physical characteristics affect body weight, and understanding these factors improves the precision of weight loss treatment. Many obese patients in Korea are receiving Korean medicine (KM) treatment, including herbal medicine and acupuncture, for weight loss. However, the real-world data (RWD) are insufficient in terms of being longitudinal and diverse. Weight Control Registry using KM is a prospective registry study that enrolls patients receiving KM treatment for weight loss and collects RWD from multiple clinics. The patients who are eligible for this study are aged 19-65 years, receive KM weight loss treatment, understand the study objectives, and consent voluntarily. Clinical data of patient characteristics and KM treatment patterns will be regularly collected until 2026. The longitudinal accumulation of various RWD will establish a high-quality study database for KM weight loss treatment. With this study, we expect to contribute to understanding the current trend of weight loss treatment with KM and solve further questions regarding this treatment.

Association between Poor Quality of Sleep and Metabolic Syndrome in Ghanaian University Students: A Cross-Sectional Study

Aim. This study aimed to determine the association between quality of sleep and metabolic syndrome (MetS) and physical activity level in young adults at the University of Ghana. Method. In a cross-sectional design, 340 university students, aged between 20-30 years were recruited. Quality of sleep was assessed using the Pittsburgh Sleep Quality index (PSQI) and physical activity with the short form of the International Physical Activity Questionnaire (IPAQ-SF). Poor quality of sleep was defined as a global PSQI score>5 and low physical activity level as those not meeting the criteria for vigorous-moderate physical activity. Anthropometric features and blood pressures were measured, and fasting blood samples were collected from the participants to measure plasma levels of glucose, lipid profile, urea, and creatinine. MetS was defined using the Joint Scientific Statement criteria. Results. In our study population of young adults from Ghana, the prevalence of poor quality of sleep as measured by PSQI was 54.1%, and MetS was 12.4%. MetS was associated with poor quality of sleep in females [ $\text{OR}\left(95\%\text{CI}\right)=2.11$ (1.04–4.25), $p=0.038$ ] and entire study participants [2.18 (1.09–4.37) $p=0.029$ ] in both crude and adjusted models; no association was found in male participants. Low physical activity status was not associated with poor sleep status. Obesity [1.32 (1.02–3.56), $p=0.043$ ], but not overweight [0.99 (0.58–2.34), $p=0.862$ ], was associated with poor quality of sleep. Conclusion. Young adults in a Ghanaian university have a high prevalence of poor quality of sleep and is associated with MetS and obesity. Physical activity status was not associated with poor quality of sleep.

Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention

BACKGROUND/OBJECTIVES

To examine the association between indices of sleep quantity and quality with dietary adherence, physical activity adherence, and weight loss during a behavioral weight loss intervention.

METHODS

Adults (n = 156) with overweight and obesity (40 ± 9 years, 84% female, BMI: 34.4 ± 4.2 kg/m²) participated in an 18-month behavioral weight loss intervention which prescribed a reduced calorie diet (1200-1800 kcal/d) and increased physical activity (300 min/wk). Body weight, indices of sleep (SenseWear armband; SWA), energy intake (EI, 3-day food records), and moderate-to-vigorous physical activity (SWA) were measured at baseline, 6, 12, and 18 months. Linear mixed effects models examined the association between sleep and weight change over time. Additional models were adjusted for covariates including age, BMI, sex, race, ethnicity, study completion, randomization, EI, and physical activity. Secondary analyses examined the association between sleep and adherence to diet and physical activity recommendations.

RESULTS

Mean weight loss was 7.7 ± 5.4, 8.4 ± 7.9, and 7.1 ± 9.0 kg at 6, 12, and 18 months, respectively. Lower sleep efficiency, higher wake after sleep onset (WASO), more awakenings, and higher sleep onset latency (SOL) were significantly associated with attenuated weight loss (p < 0.05). Lower sleep efficiency, more awakenings, and higher SOL remained significantly associated with blunted weight loss after adjustment for covariates (p < 0.05). Later waketime, longer time in bed, longer sleep duration, higher WASO, more awakenings, and higher SOL were associated with lower odds of achieving ≥300 min/wk of moderate-to-vigorous physical activity, adjusted for covariates (FDR p < 0.05).

CONCLUSIONS

Future studies should evaluate whether incorporating strategies to improve sleep health within a behavioral weight loss intervention leads to improved adherence to diet and physical activity recommendations and enhanced weight loss.

CLINICAL TRIALS IDENTIFIER

NCT01985568.

Impacts of COVID-19 lockdown on time allocation for sedentary and physical activities - The context of Indian university students

Introduction

Covid-19 pandemic has impacted individuals' time allocation decisions. As it is known that university students display behaviors different from the general population, very few studies have examined their activity participation and time allocation behavior during the pandemic. The present study investigates the changes in time allocations to sedentary, physically active, and eat-sleep activities before and during the pandemic.

Methods

The study hypothesizes that active mode (walk, bicycle) and transit users would compensate for the physical efforts by increasing physical activities at home during the lockdown. Students' perception of personal well-being, anxiety, and individual leisure during the pandemic and their impacts on time allocation decisions after controlling for demographic variables and temporal effects are also explored. A pan India behavioral data of 203 samples collected using an online survey conducted between May to July 2020, during India's lockdown phase, is used for analysis. A series of segmented analyses (using ANOVA's and Kruskal-Wallis Test) and empirical modeling (linear mixed-effect regression) were conducted based on the time use distribution.

Results

Findings showed that university students from low-income households and students who own a bicycle show a higher tendency to spend time in physical activities during lockdown periods. Students accessing college using active modes (before lockdown) allocate less time to sedentary and eat-sleep activities than physical activities during the lockdown period. Students' perception of Leisure items among those who use active modes is significantly different from those of private and public mode users.

Conclusions

From a policy viewpoint, such investigation would help implicitly understand and publicize the health benefits of active modes and transit and encourage their use. For instance, policymakers and transport planners can temporarily allocate less-used motorized streets (due to the pandemic) to students who prefer walking and cycling as universities still function online in India.

The association between modified Nordic diet with sleep quality and circadian rhythm in overweight and obese woman: a cross-sectional study

OBJECTIVE

Previous studies have shown an association between diet quality and sleep quality. The objective of this study was to investigate the association between modified Nordic diet with sleep quality and circadian rhythm in overweight and obese woman.

METHODS

We enrolled 399 overweight and obese women (body mass index (BMI): 25-40 kg/m²), aged 18-48 years, in this cross-sectional study. For each participant, anthropometric measurements, biochemical tests, and food intake were evaluated. Sleep quality and circadian rhythm was measured by Pittsburgh Sleep Quality Index (PSQI) and morning-evening questionnaire (MEQ) questionnaire. Modified Nordic diet score was measured using a validated 147-item food frequency questionnaire (FFQ).

RESULTS

Overall, 51.7% of the subjects were good sleepers (the Pittsburgh Sleep Quality Index (PSQI) < 5) while 48.3% were poor sleepers (PSQI ≥ 5). Moreover, participants were divided into five groups of MEQ, namely, completely morning 8 (2.4%), rarely morning 82 (24.8%), normal 196 (59.2%), rarely evening 43 (13%), and completely evening 2 (0.6%). After controlling for confounders, there was a significant association between poor sleep quality and the modified Nordic diet (OR = 0.80, %95 CI = 0.66-0.98, P = 0.01). Moreover, a significant positive association was observed between the completely morning and modified Nordic diet (OR = 1.80, %95 CI = 0.54-6.00, P = 0.03), in addition to a significant inverse association between the completely evening type and modified Nordic diet (OR = 0.16, %95 CI = 0.002-5.41, P = 0.02).

CONCLUSIONS

The present study indicated that higher adherence to a modified Nordic diet reduces poor sleep quality. Also, the completely morning type was associated with higher adherence to a modified Nordic diet, and completely evening type was associated with lower adherence to a modified Nordic diet.

LEVELS OF EVIDENCE

Level IV, evidence obtained from multiple time series analysis.

WITHDRAWN: Primary school math anxiety and physical and mental health using mental health risk assessment

Ahead of Print article withdrawn by publisher.

Sleep, Physical Activity, and Diet of Adults during the Second Lockdown of the COVID-19 Pandemic in Greece

The aim of the present study was to evaluate the possible correlations between sleep, physical activity, and diet in the general population of Greece during the second lockdown due to COVID-19 pandemic. A web-based questionnaire including 28 items was completed by 494 adults (age 31.5 ± 12.4 years). Half of the participants (49.8%) reported good, 44.1% moderate, and 6.1% bad quality of sleep, whereas 17.2% answered that the quality of sleep improved, 56.5% did not change, and 26.3% worsened compared to a normal week. Compared to normal, sleep duration in lockdown increased by 0.24 h (95% CI; 0.13, 0.35; p < 0.001, d = 0.198). More under-weight (32.4%) and obese (34.1%) respondents reported worsened quality of sleep in lockdown compared with normal (25.6%) and overweight participants (22.7%) (p = 0.006, Cramer's φ = 0.191). A small effect for BMI group on sleep duration was observed (p = 0.011, η2 = 0.023), where overweight and obese slept less (-0.44 h and -0.66 h, respectively) than normal weight participants. Subjects with the highest percentage of increased food consumption reported decreased sleep duration (p = 0.012) and worsened sleep quality (p = 0.003). Compared with a normal week, physical activity of a high and moderate intensity decreased for 43.0% and 37.0% of participants, did not change in 32.9% and 36.1% of participants, and increased in 24.1% 26.9%, respectively, whereas walking time decreased in 31.3%, did not change in 27.3%, and increased in 41.5% of participants. Increased high and moderate intensity physical activity was related with an improvement in sleep quality (p < 0.001). Those with decreasing walking time reported the highest percentage of decreased sleep quality (p = 0.006) and worsened sleep quality (p = 0.016). In conclusion, both quality and quantity of sleep were impaired during the second lockdown and the observed changes were associated with diet and physical activity.

A cross-sectional evaluation of the relationship between social jetlag and diet quality

The aim of this study was to compare anthropometric measures of obesity and sleep qualities in individuals with/without social jetlag (SJL). In addition, it was aimed to compare the energy, macronutrient intake and diet qualities of individuals with/without SJL during school and non-school days. This study comprised 710 university students with mean age 21.58 ± 1.41 years. The presence of SJL was acknowledged if there was a difference of more than 1 hour between the middle of sleep time on school day and on non-school day. While the physical activity levels (PALs) of the individuals were determined with a 24-hour physical activity record, measurements such as waist circumference, neck circumference and body mass index were recorded for anthropometric measurements. Pittsburgh Sleep Quality Index was used to determine the sleep quality of the individuals. Energy, macronutrients intake, and diet quality were calculated from the 24-h dietary recall of the individuals, and recorded for the school days and non-school days. In this study, 76% of the individuals (n = 542) were determined as exposed to SJL. Although there was no significant difference in their PALs, individuals with SJL had a higher waist (p < .05) and neck (p < .05) circumference, as well as higher body mass index (p < .05). Individuals with SJL were found to have significantly poor sleep quality (OR:1.109, p < .031) and sleep latency (OR:1.130, p < .001) after adjustment for confounding factors. When compared to school days, in the individuals with SJL, energy (p < .001), fat (p < .001), saturated fatty acids (SFA) (p < .001), and mono unsaturated fatty acids (MUFA) (p < .001) were significantly increased; however, fiber intake (p < .001) was significantly reduced on non-school days. Although there was no significant difference in the diet quality scores between the groups on the school days, the diet quality of the individuals without SJL on non-school days was increased significantly (p < .05). In conclusion, SJL was associated with sleep loss, increased body mass index, and lowered diet quality in university students.

Genetics of Sleep and Insights into Its Relationship with Obesity

Considerable recent advancements in elucidating the genetic architecture of sleep traits and sleep disorders may provide insight into the relationship between sleep and obesity. Despite the considerable involvement of the circadian clock in sleep and metabolism, few shared genes, including FTO, were implicated in genome-wide association studies (GWASs) of sleep and obesity. Polygenic scores composed of signals from GWASs of sleep traits show largely null associations with obesity, suggesting lead variants are unique to sleep. Modest genome-wide genetic correlations are observed between many sleep traits and obesity and are largest for snoring.Notably, U-shaped positive genetic correlations with body mass index (BMI) exist for both short and long sleep durations. Findings from Mendelian randomization suggest robust causal effects of insomnia on higher BMI and, conversely, of higher BMI on snoring and daytime sleepiness. Bidirectional effects between sleep duration and daytime napping with obesity may also exist. Limited gene-sleep interaction studies suggest that achieving favorable sleep, as part of a healthy lifestyle, may attenuate genetic predisposition to obesity, but whether these improvements produce clinically meaningful reductions in obesity risk remains unclear. Investigations of the genetic link between sleep and obesity for sleep disorders other than insomnia and in populations of non-European ancestry are currently limited. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk

Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.

Calidad de sueño y antojo por azúcares en médicos residentes durante la pandemia de COVID-19 en el Perú

Antecedentes

Durante la pandemia de COVID-19 los trabajadores de salud, especialmente los médicos residentes, atraviesan grandes niveles de presión emocional, carga laboral, riesgo de contagio, aislamiento familiar y cansancio físico. Estos factores podrían asociarse a alteraciones del sueño, como duración insuficiente y calidad insatisfactoria. Aunque no hay un estudio específico sobre problemas de sueño en esta población en Perú.

Métodos

Estudio observacional, prospectivo y transversal analítico realizado en 107 médicos residentes que laboraban en hospitales de referencia nacional del Perú. Para medir la calidad de sueño se utilizó el índice de Pittsburgh (IP) y se incluyeron preguntas sobre antojo por alimentos. El cuestionario fue estrictamente confidencial, se obtuvo el consentimiento informado de cada participante. Se realizó un análisis univariado, bivariado y multivariado.

Resultados

La edad media fue 32,37 años, el 54,6% fueron mujeres, el 52,3% trabajaban en áreas COVID-19, el 55,1% fueron desplazados a otras áreas ajenas a las de su especialidad, 13,1% habían padecido COVID-19, el 11,2% habían estado en confinamiento domiciliario. El 68,2% refirieron que tenían la necesidad de comer más (79,45% por azúcares simples). La media de tiempo de sueño fue de 5,90 horas, la media del puntaje del índice de Pittsburgh (IP) fue de 8,03. El 89,71% presentaron problemas de sueño (IP > 4). Se encontró asociación entre problema de sueño (IP > 4) y la necesidad de comer más (p < 0,001, OR 12,78 [2,58-63,21]) y realizar otras actividades con presentar problema de sueño (IP > 4) (p = 0,037; OR = 4,34).

Conclusión

Los médicos residentes tienen una alta prevalencia de problemas del sueño durante la pandemia de COVID-19, que se asocia a realizar actividades diferentes dentro de su formación, y además estos problemas se asocian a una mayor necesidad de comer.

Impact of Stress Levels on Eating Behaviors among College Students

Weight gain is a common phenomenon among college students, especially those in their first year of university. Transitioning from high school to the college environment might increase perceived stress levels, thus affecting dietary behaviors and metabolism to promote overweight and obesity. The purpose of this study was to investigate the physical activities and dietary behaviors of college students in the context of their perceived stress levels. In addition, the demographic characteristics of the students were compared to ascertain their impact on dietary behaviors. Self-reported questionnaires were distributed to college students on campus in Korea. Perceived stress was measured by the 10-item Perceived Stress Scale (PSS-10), the scores for which were evaluated by independent t-tests to compare the dietary behaviors of the high- and low-perceived stress groups. Exploratory factor analysis was performed and Cronbach’s alphas were computed to assess the validity and internal consistency of the PSS-10 measurement items. Differences in the physical activities and dietary behaviors of the college students based on demographics such as sex, academic year, and residence type were found. Several dietary behaviors were significantly different between students with low and high perceived stress levels. Students with high perceived stress levels exhibited increased unhealthy dietary behaviors such as ready-prepared meal consumption (p < 0.001). These results suggest that stress management should be offered to college students. In addition, programs should be provided to help first-year students adjust to the college environment in order to promote healthy dietary behaviors.