Eating-Related Self-Regulation and Its Neural Substrates as Mechanisms Underlying the Sleep/Eating Behavior Association in Children with Overweight/Obesity: An Ecological Momentary Assessment Study

项目概要/摘要 睡眠不足和超重状态会导致整个生命周期的不良健康结果， 包括心脏代谢疾病的风险。横断面数据表明，超重/肥胖儿童 比正常的同龄人更容易出现睡眠障碍。虽然这件事的本质 相关性可能是双向的，前瞻性研究表明，睡眠影响体重调节， 通过多种生理和心理途径。特别是，睡眠不足与更大的 儿童的能量摄入和饮食质量下降。尽管解释了 睡眠和饮食行为知之甚少，睡眠限制已被发现影响大脑过程 与食物的奖励价值和自我调节有关，其行为表现可能会增加 对次优饮食行为的易感性和随后的体重增加。先前研究的局限性 机制是，它的大部分已经在成人和实验室环境中进行，从而调用 质疑研究结果的生态有效性。另外，关于儿童睡眠限制/延长的研究 自然环境依赖于对饮食行为的回顾性报告，包括全国各地的儿童。 重量谱，并有限的关注基本机制，特别是神经基板。更清楚 了解睡眠/饮食相关的瞬时机制可以改善发育 和/或改善睡眠相关的干预措施，特别是那些在参与风险时真实的提供的干预措施， 在适应不良的饮食中是最高的。拟议中的R 01研究将检查睡眠， 饮食相关的自我调节，以及自然环境中的饮食行为。社区儿童， 超重或肥胖者（n=120）将接受一个自然的方案，包括评估典型的睡眠， 饮食模式（第1周），然后是睡眠限制或延长（第2周和第3周，间隔7天） 洗脱），后者发生在随机交叉设计中。整个研究期间的评估 将涉及每天的睡眠模式的活动记录测量;每天重复的饮食行为自我报告， 进食相关自我调节的行为评估;以及间歇性24小时饮食回忆， 每日实时食物摄影参与者将在研究期间完成基于fMRI的神经激活评估。 在每一周的睡眠限制和延长后，进行与饮食相关的自我调节任务。整体 目的是评估睡眠延长与限制对饮食相关自我调节的短期影响 （包括行为和神经表现）和自然主义饮食行为。这些数据将澄清时间 以及睡眠导致的饮食行为和自我调节机制的变化轨迹 模式.这项拟议的研究有明显的潜力，以促进科学和临床的理解， 睡眠不足和适应不良饮食之间的前瞻性关联机制， 青年和知情的干预措施，以减轻他们积累的个人和社会负担。

PROJECT SUMMARY/ABSTRACT Insufficient sleep and excess weight status contribute to adverse health outcomes across the lifespan, including risk for cardiometabolic disease. Cross-sectional data suggest that children with overweight/obesity are more likely to experience sleep disturbances than their non-overweight peers. Although the nature of this association may be bidirectional, prospective studies indicate that sleep impacts body weight regulation through multiple physiological and psychological pathways. In particular, insufficient sleep is related to greater energy intake and reduced diet quality in children. Although mechanisms explaining the association between sleep and eating behavior are poorly understood, sleep restriction has been found to impact brain processes related to reward valuation of food and self-regulation, the behavioral manifestations of which may increase susceptibility to suboptimal dietary behaviors and subsequent weight gain. A limitation of prior research on mechanisms is that much of it has been conducted in adults and in laboratory settings, thereby calling into question the ecological validity of the findings. Alternatively, studies on sleep restriction/extension in children’s natural environments have relied on retrospective reporting of eating behavior, included children across the weight spectrum, and had limited focus on underlying mechanisms, particularly neural substrates. A clearer understanding of momentary mechanisms involved in the sleep/eating association could improve development and/or refinement of sleep-related interventions, particularly those delivered in real time when risk for engaging in maladaptive eating is highest. The proposed R01 study will examine prospective associations among sleep, eating-related self-regulation, and eating behavior in the natural environment. Community-based children with overweight or obesity (n=120) will undergo a naturalistic protocol involving assessment of typical sleep and eating patterns (week 1), followed by sleep restriction or extension (weeks 2 and 3, separated by a 7-day wash-out), the latter occurring within a randomized crossover design. Assessment throughout the study period will involve daily actigraphy measurement of sleep patterns; repeated daily self-reports on eating behavior and behavioral assessment of eating-related self-regulation; and intermittent 24-hour dietary recalls informed by daily real-time food photography. Participants will complete fMRI-based assessment of neural activation during an eating-related self-regulation task after each week-long period of sleep restriction and extension. Overall aims are to assess short-term effects of sleep extension versus restriction on eating-related self-regulation (including behavioral and neural performance) and naturalistic eating behavior. These data will clarify timing and trajectory of changes in eating behavior and self-regulatory mechanisms as a consequence of sleep patterns. The proposed study has clear potential to advance scientific and clinical understanding of mechanisms involved in the prospective associations between inadequate sleep and maladaptive eating in youth and inform interventions to alleviate their cumulative personal and societal burden.