Does chronotype modify the relationship between sleep and BMI in adolescents?

描述（由申请人提供）：在青春期逆转和/或预防肥胖会产生显著的心脏代谢回报。然而，90%的肥胖青少年成为肥胖的成年人。这突出了肥胖一旦发生逆转的困难。此外，预防儿童肥胖症的进展缓慢。尽管出现了令人鼓舞的趋势，但少数群体和社会经济地位较低的青年与非少数群体、较富裕的青年之间的差距日益扩大，威胁到我们今后减少健康差距的能力。针对青少年进行肥胖预防，对于遏制高肥胖率大有希望。睡眠和肥胖之间存在理论、实验和流行病学支持。然而，并非所有短睡眠者都超重/肥胖，反之亦然，现有的研究报告不一致的结果。 这项在新泽西州一个社会经济水平较低的种族多样化学区进行的观察性研究旨在探讨睡眠时间类型是否会改变青少年睡眠不足与肥胖之间的关联。这项研究将是探索这种关联的首批研究之一。它将涉及与学校护士、医生、保健教师、学区行政人员、家长教师协会和整个社区的合作努力，从而体现了强大的社区伙伴关系。它阐明了未来的护士科学家如何为预防/逆转青少年肥胖的生物行为方法提供证据。该提案与申请人的长期目标一致，即探索影响青少年肥胖和睡眠的时间生物学因素，并建立旨在预防/减少儿童肥胖和当前/未来健康差距的跨学科研究计划。 这项研究的结果将影响政策和临床实践。青少年昼夜节律对夜间光照的敏感性增加了晚钟型的倾向。因此，城市规划和发展政策应设法限制青少年在夜间暴露于光线。街道照明、现场照明和社区标志应限制和/或设计为在指定区域内排放低于指定阈值的勒克斯。学校和社区的体育政策，限制高中游戏/实践在深夜在点燃运动场/体育馆也将是必要的。家长/学生教育加上有效的策略，以限制夜间暴露于发光技术也将是重要的。在整个青春期筛查晚时钟型将确定那些最危险的有害代谢影响。干预措施，如父母 强制的就寝时间、早晨的光照和对高中晚些开始时间的支持将有助于保持昼夜节律的一致性，从而限制具有晚时钟型的青少年的有害健康影响，例如BMI增加。

DESCRIPTION (provided by applicant): Reversing and/or preventing obesity during adolescence yields significant cardio-metabolic rewards. Yet, 90% of obese adolescents become obese adults. This highlights the difficulty in reversing obesity once onset occurs. Additionally, progress in preventing childhood obesity has been slow. Despite promising trends, the widening gulf between minorities and lower socio-economic youth and their non-minority, more affluent counterparts threatens our ability to reduce health disparities in the future. Targeting adolescents for obesity prevention holds great promise for stemming high obesity rates. Theoretical, experimental, and epidemiological support for an association between sleep and obesity exists. However, not all short sleepers are overweight/obese and vice versa and extant studies report inconsistent findings. This observational study in a lower socio-economic racially diverse school district in NJ seeks to explore whether chronotype modifies the association between short sleep and obesity in adolescents. This study will be one of the first to explore this association. It will involve collaborative efforts with school nurses, physicians, heath teachers, school district administrators, the parent teacher association, and the community at large, thus exemplifying a strong community partnership. It exemplifies how future nurse scientists may lead the way in providing evidence for bio-behavioral approaches to preventing/reversing obesity in adolescents. This proposal is consistent with the applicant's long-term goal to explore chronobiological factors impacting adolescent obesity and sleep and to establish a program of interdisciplinary research aimed at preventing/reducing childhood obesity and current/future health disparities. Findings from this study will influence policy and clinical practice. Sensitivity of adolescent circadian rhythms to evening light exposure increases the propensity for later chronotypes. Therefore, urban planning and development policies should seek to limit the exposure to light at night by adolescents. Street lighting, field lighting, and community signage should be limited and/or designed to emit lux below a specified threshold in specified areas. School and community athletic policies limiting high school games/practices during late evening hours in lit athletic fields/gymnasiums will also be warranted. Parent/student education coupled with effective strategies for limiting nighttime exposure from light emitting technology will also be important. Screening for late chronotype throughout adolescence will identify those at greatest risk for deleterious metabolic effects. Interventions such as parentally enforced bedtimes, morning light exposure, and support for later high school start times will help maintain circadian alignment limiting deleterious health effects, such as increased BMI, in adolescents with late chronotypes.