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Larsen SC, O'Driscoll R, Horgan G, Mikkelsen MLK, Specht IO, Rohde JF, Turicchi J, Santos I, Encantado J, Duarte C, Ward LC, Palmeira AL, Stubbs RJ, Heitmann BL. Substituting sedentary time with sleep or physical activity and subsequent weight-loss maintenance. Obesity (Silver Spring) 2023; 31:515-524. [PMID: 36575137 PMCID: PMC10108206 DOI: 10.1002/oby.23631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE In this study, the associations between the substitution of sedentary time with sleep or physical activity at different intensities and subsequent weight-loss maintenance were examined. METHODS This prospective study included 1152 adults from the NoHoW trial who had achieved a successful weight loss of ≥5% during the 12 months prior to baseline and had BMI ≥25 kg/m2 before losing weight. Physical activity and sleep were objectively measured during a 14-day period at baseline. Change in body weight was included as the primary outcome. Secondary outcomes were changes in body fat percentage and waist circumference. Cardiometabolic variables were included as exploratory outcomes. RESULTS Using isotemporal substitution models, no associations were found between activity substitutions and changes in body weight or waist circumference. However, the substitution of sedentary behavior with moderate-to-vigorous physical activity was associated with a decrease in body fat percentage during the first 6 months of the trial (-0.33% per 30 minutes higher moderate-to-vigorous physical activity [95% CI: -0.60% to -0.07%], p = 0.013). CONCLUSIONS Sedentary behavior had little or no influence on subsequent weight-loss maintenance, but during the early stages of a weight-loss maintenance program, substituting sedentary behavior with moderate-to-vigorous physical activity may prevent a gain in body fat percentage.
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Affiliation(s)
- Sofus C Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ruairi O'Driscoll
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Graham Horgan
- Biomathematics and Statistics Scotland, Aberdeen, UK
| | - Marie-Louise K Mikkelsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ina O Specht
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Jeanett F Rohde
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Jake Turicchi
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Inês Santos
- CIDEFES, Universidade Lusófona, Lisbon, Portugal
| | | | - Cristiana Duarte
- School of Education, Language and Psychology, York St John University, York, UK
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | - R James Stubbs
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
- Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
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Giddens NT, Juneau P, Manza P, Wiers CE, Volkow ND. Disparities in sleep duration among American children: effects of race and ethnicity, income, age, and sex. Proc Natl Acad Sci U S A 2022; 119:e2120009119. [PMID: 35858412 DOI: 10.1073/pnas.2120009119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Children in the United States sleep less than the recommended amount and sleep deficiencies may be worse among disadvantaged children. Prior studies that compared sleep time in children of different race/ethnic groups mostly relied on questionnaires or were limited to small sample sizes. Our study takes advantage of the Adolescent Brain Cognitive Development study to compare total sleep time using a week of actigraphy data among American children (n = 4,207, 9 to 13 y old) of different racial/ethnic and income groups. We also assessed the effects of neighborhood deprivation, experience of discrimination, parent's age at child's birth, body mass index (BMI), and time the child fell asleep on sleep times. Daily total sleep time for the sample was 7.45 h and race/ethnicity, income, sex, age, BMI, were all significant predictors of total sleep time. Black children slept less than White children (∼34 min; Cohen's d = 0.95), children from lower income families slept less than those from higher incomes (∼16 min; Cohen's d = 0.44), boys slept less than girls (∼7 min; Cohen's d = 0.18), and older children slept less than younger ones (∼32 min; Cohen's d = 0.91); mostly due to later sleep times. Children with higher BMI also had shorter sleep times. Neither area deprivation index, experience of discrimination, or parent's age at child's birth significantly contributed to sleep time. Our findings indicate that children in the United States sleep significantly less than the recommended amount for healthy development and identifies significant racial and income disparities. Interventions to improve sleep hygiene in children will help improve health and ameliorate racial disparities in health outcomes.
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Li A, Li X, Zhou T, Ma H, Heianza Y, Williamson DA, Smith SR, Bray GA, Sacks FM, Qi L. Sleep Disturbance and Changes in Energy Intake and Body Composition During Weight Loss in the POUNDS Lost Trial. Diabetes 2022; 71:934-944. [PMID: 35202470 PMCID: PMC9044134 DOI: 10.2337/db21-0699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022]
Abstract
To examine associations between sleep disturbance and changes in weight and body composition and the mediating role of changes of appetite and food cravings in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) 2-year weight-loss diet intervention trial, this study included 810 overweight or obese individuals with baseline sleep disturbance assessment who were randomly assigned one of four diets varying in macronutrient composition. Changes in body weight and fat distribution were assessed by DEXA and computed tomography during the 2-year intervention. Participants were asked to provide sleep disturbance levels (no, slight, moderate, or great) at baseline and to recall their sleep disturbances since last visit at 6, 12, 18, and 24 months. Weight loss during the first 6 months was followed by 1.5 years of steady weight regain. Participants with greater sleep disturbance from baseline to 6 months showed significant losses of body weight (Ptrend <0.001) and waist circumference (Ptrend = 0.002) at 6 months, after multivariate adjustment. Compared with individuals without sleep disturbance at all from baseline to 6 months, those with slight, moderate, or great sleep disturbance showed an elevated risk of failure to lose weight (-5% or more loss) at 6 months, when the maximum weight loss was achieved, with an odds ratio of 1.24 (95% CI 0.87, 1.78), 1.27 (95% CI 0.75, 2.13), or 3.12 (95% CI 1.61, 6.03), respectively. In addition, we observed that the repeatedly measured levels of sleep disturbance over 2 years were inversely associated with the overall weight loss rate (weight changes per 6 months) (Ptrend <0.001). Further, sleep disturbances during weight loss from baseline to 6 months and weight regain from 6 months to 24 months were significantly predictive of total fat, total fat mass percent, and trunk fat percent changes during the 2 years. Our results also indicated that food cravings for carbohydrates/starches, fast food fats, and sweets; cravings, prospective consumption, hunger of appetite measurements; and dietary restraint, disinhibition, and hunger subscales measured at 6 months significantly mediated the effects of sleep disturbance on weight loss. In conclusion, our results suggested that more severe sleep disturbance during weight loss was associated with an elevated risk of failure to lose weight during the dietary intervention. Food cravings and eating behaviors may partly mediate these associations.
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Affiliation(s)
- Ang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Donald A. Williamson
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Steven R. Smith
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - George A. Bray
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Frank M. Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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4
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Huhn S, Axt M, Gunga HC, Maggioni MA, Munga S, Obor D, Sié A, Boudo V, Bunker A, Sauerborn R, Bärnighausen T, Barteit S. The Impact of Wearable Technologies in Health Research: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e34384. [PMID: 35076409 PMCID: PMC8826148 DOI: 10.2196/34384] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Wearable devices hold great promise, particularly for data generation for cutting-edge health research, and their demand has risen substantially in recent years. However, there is a shortage of aggregated insights into how wearables have been used in health research. Objective In this review, we aim to broadly overview and categorize the current research conducted with affordable wearable devices for health research. Methods We performed a scoping review to understand the use of affordable, consumer-grade wearables for health research from a population health perspective using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. A total of 7499 articles were found in 4 medical databases (PubMed, Ovid, Web of Science, and CINAHL). Studies were eligible if they used noninvasive wearables: worn on the wrist, arm, hip, and chest; measured vital signs; and analyzed the collected data quantitatively. We excluded studies that did not use wearables for outcome assessment and prototype studies, devices that cost >€500 (US $570), or obtrusive smart clothing. Results We included 179 studies using 189 wearable devices covering 10,835,733 participants. Most studies were observational (128/179, 71.5%), conducted in 2020 (56/179, 31.3%) and in North America (94/179, 52.5%), and 93% (10,104,217/10,835,733) of the participants were part of global health studies. The most popular wearables were fitness trackers (86/189, 45.5%) and accelerometer wearables, which primarily measure movement (49/189, 25.9%). Typical measurements included steps (95/179, 53.1%), heart rate (HR; 55/179, 30.7%), and sleep duration (51/179, 28.5%). Other devices measured blood pressure (3/179, 1.7%), skin temperature (3/179, 1.7%), oximetry (3/179, 1.7%), or respiratory rate (2/179, 1.1%). The wearables were mostly worn on the wrist (138/189, 73%) and cost <€200 (US $228; 120/189, 63.5%). The aims and approaches of all 179 studies revealed six prominent uses for wearables, comprising correlations—wearable and other physiological data (40/179, 22.3%), method evaluations (with subgroups; 40/179, 22.3%), population-based research (31/179, 17.3%), experimental outcome assessment (30/179, 16.8%), prognostic forecasting (28/179, 15.6%), and explorative analysis of big data sets (10/179, 5.6%). The most frequent strengths of affordable wearables were validation, accuracy, and clinical certification (104/179, 58.1%). Conclusions Wearables showed an increasingly diverse field of application such as COVID-19 prediction, fertility tracking, heat-related illness, drug effects, and psychological interventions; they also included underrepresented populations, such as individuals with rare diseases. There is a lack of research on wearable devices in low-resource contexts. Fueled by the COVID-19 pandemic, we see a shift toward more large-sized, web-based studies where wearables increased insights into the developing pandemic, including forecasting models and the effects of the pandemic. Some studies have indicated that big data extracted from wearables may potentially transform the understanding of population health dynamics and the ability to forecast health trends.
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Affiliation(s)
- Sophie Huhn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Miriam Axt
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment, Berlin, Germany
| | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment, Berlin, Germany.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Ali Sié
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Centre de Recherche en Santé Nouna, Nouna, Burkina Faso
| | | | - Aditi Bunker
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Harvard Center for Population and Development Studies, Cambridge, MA, United States.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
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5
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Blankenship JM, Rosenberg RC, Rynders CA, Melanson EL, Catenacci VA, Creasy SA. Examining the Role of Exercise Timing in Weight Management: A Review. Int J Sports Med 2021; 42:967-978. [PMID: 34034354 PMCID: PMC8591839 DOI: 10.1055/a-1485-1293] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many adults cite exercise as a primary strategy for losing weight, yet exercise alone is modestly effective for weight loss and results in variable weight loss responses. It is possible that some of the variability in weight loss may be explained by the time of day that exercise is performed. Few studies have directly compared the effects of exercise performed at different times of the day (i. e., morning versus evening exercise). Results from these existing studies are mixed with some studies demonstrating superior weight and fat mass loss from morning exercise, while other studies have found that evening exercise may be better for weight management. Exercise timing may alter modifiable lifestyle behaviors involved in weight management, such as non-exercise physical activity, energy intake, and sleep. The purpose of this review is to summarize evidence for and against time-of-day dependent effects of exercise on weight management. Although limited, we also review studies that have examined the effect of exercise timing on other lifestyle behaviors linked to body weight regulation. While exercise at any time of day is beneficial for health, understanding whether there is an optimal time of day to exercise may advance personalized treatment paradigms for weight management.
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Affiliation(s)
- Jennifer M. Blankenship
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Corey A. Rynders
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Geriatrics, VA Eastern Colorado Health Care System, Aurora, CO
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
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6
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Hawkins MS, Levine MD, Buysse DJ, Abebe KZ, Hsiao WH, McTigue KM, Davis EM. Sleep Health Characteristics among Adults Who Attempted Weight Loss in the Past Year: NHANES 2017-2018. Int J Environ Res Public Health 2021; 18:10170. [PMID: 34639473 DOI: 10.3390/ijerph181910170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/23/2022]
Abstract
Background: The purpose of this study was to characterize sleep health in adults who attempted weight loss in the prior year. Methods: We analyzed data from the National Health and Nutrition Examination Survey 2017–2018 exam cycle. We included 4837 US adults who did (n = 1919) or did not (n = 2918) attempt weight loss in the past year. Participants self-reported their sleep regularity, satisfaction, sleepiness, timing, and duration, which we defined as “good” based on the prior literature. We characterized sleep health by weight loss attempts status, current BMI and weight change among participants who attempted weight loss. Results: On average, participants reported good sleep health in 3.21 ± 1.14 out of the five sleep domains. A total of 13% of participants had good sleep health in all five domains. The prevalence of sleep regularity (52%) was lowest, and the prevalence of infrequent sleepiness was highest (72%), relative to other sleep domains. In models adjusting for BMI, sleep health was similar in participants who did and did not attempt weight loss. Among adults who attempted weight loss, good sleep health was inversely associated with current BMI and self-reported weight change. Discussion: This study’s findings highlight the importance of considering sleep health when engaging with adults attempting weight loss.
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Knell G, Li Q, Morales-Marroquin E, Drope J, Gabriel KP, Shuval K. Physical Activity, Sleep, and Sedentary Behavior among Successful Long-Term Weight Loss Maintainers: Findings from a U.S. National Study. Int J Environ Res Public Health 2021; 18:ijerph18115557. [PMID: 34067414 PMCID: PMC8196944 DOI: 10.3390/ijerph18115557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022]
Abstract
Despite adults’ desire to reduce body mass (weight) for numerous health benefits, few are able to successfully lose at least 5% of their starting weight. There is evidence on the independent associations of physical activity, sedentary behaviors, and sleep with weight loss; however, this study provided insight on the combined effects of these behaviors on long-term body weight loss success. Hence, the purpose of this cross-sectional study was to evaluate the joint relations of sleep, physical activity, and sedentary behaviors with successful long-term weight loss. Data are from the 2005–2006 wave of the National Health and Examination Survey (NHANES). Physical activity and sedentary behavior were measured with an accelerometer, whereas sleep time was self-reported. Physical activity and sleep were dichotomized into meeting guidelines (active/not active, ideal sleep/short sleep), and sedentary time was categorized into prolonged sedentary time (4th quartile) compared to low sedentary time (1st–3rd quartiles). The dichotomized behaviors were combined to form 12 unique behavioral combinations. Two-step multivariable regression models were used to determine the associations between the behavioral combinations with (1) long-term weight loss success (≥5% body mass reduction for ≥12-months) and (2) the amount of body mass reduction among those who were successful. After adjustment for relevant factors, there were no significant associations between any of the independent body weight loss behaviors (physical activity, sedentary time, and sleep) and successful long-term weight loss. However, after combining the behaviors, those who were active (≥150 min MVPA weekly), regardless of their sedentary time, were significantly (p < 0.05) more likely to have long-term weight loss success compared to the inactive and sedentary referent group. These results should be confirmed in longitudinal analyses, including investigation of characteristics of waking (type, domain, and context) and sleep (quality metrics) behaviors for their association with long-term weight loss success.
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Affiliation(s)
- Gregory Knell
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, TX 75390, USA
- Children’s Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX 75024, USA
- Correspondence: ; Tel.: +01-972-546-2943
| | - Qing Li
- Department of Intramural Research, American Cancer Society, Atlanta, GA 30303, USA;
| | - Elisa Morales-Marroquin
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA;
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, TX 75390, USA
| | - Jeffrey Drope
- Department of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60608, USA;
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Kerem Shuval
- The Cooper Institute, Dallas, TX 75230, USA;
- Department of Epidemiology, School of Public Health, University of Haifa, Haifa 3498838, Israel
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8
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Larsen SC, Turicchi J, Christensen GL, Larsen CS, Jørgensen NR, Mikkelsen MLK, Horgan G, O’Driscoll R, Michalowska J, Duarte C, Scott SE, Santos I, Encantado J, Palmeira AL, Stubbs RJ, Heitmann BL. Hair Cortisol Concentration, Weight Loss Maintenance and Body Weight Variability: A Prospective Study Based on Data From the European NoHoW Trial. Front Endocrinol (Lausanne) 2021; 12:655197. [PMID: 34659105 PMCID: PMC8511813 DOI: 10.3389/fendo.2021.655197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 09/13/2021] [Indexed: 01/23/2023] Open
Abstract
UNLABELLED Several cross-sectional studies have shown hair cortisol concentration to be associated with adiposity, but the relationship between hair cortisol concentration and longitudinal changes in measures of adiposity are largely unknown. We included 786 adults from the NoHoW trial, who had achieved a successful weight loss of ≥5% and had a body mass index of ≥25 kg/m2 prior to losing weight. Hair cortisol concentration (pg/mg hair) was measured at baseline and after 12 months. Body weight and body fat percentage were measured at baseline, 6-month, 12-month and 18-month visits. Participants weighed themselves at home ≥2 weekly using a Wi-Fi scale for the 18-month study duration, from which body weight variability was estimated using linear and non-linear approaches. Regression models were conducted to examine log hair cortisol concentration and change in log hair cortisol concentration as predictors of changes in body weight, change in body fat percentage and body weight variability. After adjustment for lifestyle and demographic factors, no associations between baseline log hair cortisol concentration and outcome measures were observed. Similar results were seen when analysing the association between 12-month concurrent development in log hair cortisol concentration and outcomes. However, an initial 12-month increase in log hair cortisol concentration was associated with a higher subsequent body weight variability between month 12 and 18, based on deviations from a nonlinear trend (β: 0.02% per unit increase in log hair cortisol concentration [95% CI: 0.00, 0.04]; P=0.016). Our data suggest that an association between hair cortisol concentration and subsequent change in body weight or body fat percentage is absent or marginal, but that an increase in hair cortisol concentration during a 12-month weight loss maintenance effort may predict a slightly higher subsequent 6-months body weight variability. CLINICAL TRIAL REGISTRATION ISRCTN registry, identifier ISRCTN88405328.
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Affiliation(s)
- Sofus C. Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- *Correspondence: Sofus C. Larsen,
| | - Jake Turicchi
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | | | | | - Niklas R. Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marie-Louise K. Mikkelsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
| | - Graham Horgan
- Biomathematics and Statistics Scotland, Aberdeen, United Kingdom
| | - Ruairi O’Driscoll
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Joanna Michalowska
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Cristiana Duarte
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Sarah E. Scott
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Inês Santos
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisbon, Portugal
| | - Jorge Encantado
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), Instituto Superior de Psicologia Aplicada (ISPA) - Instituto Universitário, Lisbon, Portugal
| | - Antonio L. Palmeira
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisbon, Portugal
| | - R. James Stubbs
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Berit L. Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, NSW, Australia
- Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
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9
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Abstract
PURPOSE OF REVIEW Sleep and obesity share a bidirectional relationship, and weight loss has been shown to enhance sleep. Aiming to extend sleep on its own or as part of a lifestyle intervention may attenuate health consequences of short sleep. This review highlights several sleep extension approaches, discusses feasibility of each, and summarizes findings relevant to obesity. RECENT FINDINGS Sleep extension in response to experimental sleep restriction demonstrates partial rescue of cardiometabolic dysfunction in some but not all studies. Adequate sleep on a nightly basis may be necessary for optimal health. While initial sleep extension interventions in habitually short sleepers have been met with obstacles, preliminary findings suggest that sleep extension or sleep hygiene interventions may improve glycemic control, decrease blood pressure, and enhance weight loss. Sleep extension has the potential to attenuate obesity risk and cardiometabolic dysfunction. There is tremendous opportunity for future research that establishes a minimum threshold for sleep extension effectiveness and addresses logistical barriers identified in seminal studies.
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Affiliation(s)
- Kristin K Hoddy
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | - Kaitlin S Potts
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | - John P Kirwan
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
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