Sleep Restriction and the Adolescent Diet: Impact and Mechanisms

摘要 预防肥胖已经成为国家健康的当务之急，而且可能还特别重要 尤其是在青春期。青少年在饮食选择中养成持久的生活方式 以及可以为终生肥胖奠定基础的活动水平，因此该领域识别新的 影响青少年生活方式的可改变因素。这项研究测试了一个有希望的新目标 预防工作。我们的小组收集了基于先前在儿童和儿童中的相关发现的试点数据 成年人的实验结果表明，睡眠限制(SR)会导致青少年摄入更多卡路里 而不增加他们的体力活动。如果这些先导发现在更大、更明确的研究中得到证实， 可以通过减轻SR的策略来加强预防肥胖的努力，众所周知，SR是 在青少年中很常见。此外，我们在青少年中的初步发现将先前的成人研究扩展到 表明这种效应的机制是甜食/甜点食物奖励价值的特别增加， 使它们被吃得更多，被更积极地感知，并引发更多的激活 SR过程中fMRI的奖赏相关脑区。对这些试验结果的确认将通知该综合体 肥胖的生物行为基础，并确定针对以下情况的次要干预点 由于特殊情况或顽固性睡眠障碍，青少年睡眠不足。然而， 在实现这些好处之前，实地必须克服我们知识基础中的重大差距。我们的飞行员 研究得出了耐人寻味的发现，但规模太小，方法有限，不能确定。其他 儿科的发现几乎完全来自相关研究，极大地限制了因果推断。 成人SR的发现也很难应用于青少年，因为有多种方法和 发展因素。我们建议通过一项强大的机械学研究来克服这些限制 在青春期的高危时期，平衡实验的严谨性和现实世界的相关性。健康的，非 肥胖的14-17岁青少年将接受一项实验性睡眠操作的随机交叉试验 5个晚上的时段(模拟一周)，比较(A)~9小时的夜间睡眠，建议 健康睡眠vs.(B)~6.3小时，这是许多青少年在上学之夜(SR)经历的。实验室对青少年的评估 对特定食物的感知和大脑反应将与真实世界的饮食和 活动模式以确定测试(A)SR对健康青少年卡路里摄入量和活动的影响， (B)SR对高热量食物的有益品质的影响，以及(C)热量变化之间的联系 摄入量和令人满意的食物质量。分析将进一步探索肥胖的风险因素是否确定 这些青少年特别容易受到SR对卡路里摄入量的影响。调查结果将直接 对改善肥胖预防和发现肥胖复杂生物行为的启示 机械装置。

Abstract Obesity prevention has become a national health imperative, and may be exceptionally important yet particularly difficult during adolescence. Adolescents develop enduring lifestyle patterns in their dietary choices and activity levels that can set the stage for life-long obesity, so it is essential that the field identify novel modifiable factors that impact the lifestyle patterns of adolescents. This study tests a promising new target for prevention efforts. Our group has collected pilot data that builds upon prior correlational findings in children and experimental findings in adults to suggest that sleep restriction (SR) causes adolescents to eat more calories without increasing their physical activity. If these pilot findings are confirmed in a larger, more definitive study, obesity prevention efforts could be augmented by strategies to alleviate SR, which is known to be extremely common among adolescents. Further, our pilot findings with adolescents extend prior adult research to suggest that the mechanism for this effect is a particular increase in the reward value of sweet/ dessert foods, causing them to be eaten in greater amounts, to be perceived more positively, and to elicit more activation of reward-related brain regions on fMRI during SR. Confirmation of these pilot findings will inform the complex biobehavioral foundations of obesity, and identify secondary points of intervention for occasions when an adolescent's sleep is inadequate due to unusual circumstances or to an intractable sleep disorder. However, before such benefits can be realized, the field must overcome significant gaps in our knowledge base. Our pilot studies yielded intriguing findings, but were too small and methodologically limited to be definitive. Other pediatric findings have come almost exclusively from correlational studies, greatly limiting causal inferences. Adult SR findings also are difficult to apply to adolescents because of multiple methodological and developmental factors. We propose to overcome these limitations with a well-powered mechanistic study that balances experimental rigor with real-world relevance during the high-risk period of adolescence. Healthy, non- obese 14-17 year-olds will undergo a randomized cross-over trial of an experimental sleep manipulation across 5-night periods (simulating a school week), comparing nightly sleep of (a) ~9 hr, the recommendation for healthy sleep vs. (b) ~6.3 hr, which many teens experience on school nights (SR). Lab assessments of teens' perception of, and brain responses to, specific foods will be paired with measures of real-world dietary and activity patterns to definitively test (a) the effect of SR on the caloric intake and activity of healthy adolescents, (b) the effect of SR on the rewarding quality of calorie-dense foods, and (c) the link between changes in caloric intake and the rewarding quality of food. Analyses will further explore whether risk factors for obesity identify which adolescents are especially vulnerable to the effect of SR on caloric intake. Findings will have direct implications for improving obesity prevention and for discoveries into obesity's complex biobehavioral mechanisms.