Advertisement

Sleep Extension Increases the Effect of Caloric Restriction Over Body Weight and Improves the Chronic Low-Grade Inflammation in Adolescents With Obesity

      Abstract

      Purpose

      Diminution of sleep may be associated with obesity. However, evidence that extending sleep duration might favor weight loss is insufficient. The aim of this study was to compare the effect of dietary restriction with or without prescription of sleep extension on weight loss in adolescents with obesity.

      Methods

      A total of 52 adolescents with obesity (24 males and 28 females) received a diet with 500 calories restriction, randomly allocated to groups without (n = 27) and with sleep extension (n = 25) for 4 weeks. We collected data on anthropometry, caloric intake, and self-reported sleep diaries. Serum interleukin 6, tumor necrosis factor α, leptin, and insulin levels were quantified by enzyme-linked immunosorbent assay. Cortisol and 6-sulfatoxymelatonin excretions were measured in the first urine collection in the morning by liquid chromatography-mass spectrometry. Measurements were carried out at baseline and at the end of the intervention.

      Results

      After diet, weight decreased in both groups. Sleep extension, improved weight loss (p < .00001), and waist girth reduction (p = .00003), with diminution of insulin (p = .002) and interleukin 6 levels (p = .02). Caloric restriction was less effective in adolescent females. No differences in cortisol or 6-sulfatoxymelatonin excretion were found.

      Conclusions

      A sleep extension favors weight loss in adolescents under caloric restriction and improves inflammation and metabolic conditions, thus supporting a possible additional benefit to diet in the treatment of obesity in adolescents.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Journal of Adolescent Health
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Matthews K.A.
        • Dahl R.E.
        • Owens J.F.
        • et al.
        Sleep duration and insulin resistance in healthy black and white adolescents.
        Sleep. 2012; 35: 1353-1358
      1. Encuesta Nacional de Salud Pública.
        (Available at:) (Accessed January 11, 2020)
        • Ohkuma T.
        • Fujii H.
        • Iwase M.
        • et al.
        Impact of sleep duration on obesity and the glycemic level in patients with type 2 diabetes: The Fukuoka Diabetes Registry.
        Diabetes Care. 2013; 36: 611-617
        • Patel S.
        • Hu F.
        Short sleep duration and weight gain: A systematic review.
        Obesity (Silver Spring). 2008; 16: 643-653
        • Chaput J.P.
        Sleep patterns, diet quality and energy balance.
        Physiol Behav. 2013; 134: 86-91
        • Hazzaa M.A.
        • Abdulrahman O.M.
        • Nada A.A.
        • et al.
        Prevalence of short sleep duration and its association with obesity among adolescents 15- to 19-year olds: A cross-sectional study from three major cities in Saudi Arabia.
        Ann Thorac Med. 2012; 7: 133-139
        • Markwald R.R.
        • Melanson E.L.
        • Smith M.R.
        • et al.
        Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain.
        Proc Natl Acad Sci USA. 2013; 110: 5695-5700
        • Spaeth A.M.
        • Dinges D.F.
        • Goel N.
        Effects of experimental sleep restriction on weight gain, caloric intake, and meal timing in healthy adults.
        Sleep. 2013; 36: 981-990
        • Coborn J.E.
        • Houser M.M.
        • Perez-Leighton C.E.
        • Teske J.A.
        Role of sex and the environment in moderating weight gain due to inadequate sleep.
        Curr Obes Rep. 2017; 6: 397-404
        • Short M.A.
        • Gradisar M.
        • Lack L.C.
        • et al.
        Estimating adolescent sleep patterns: Parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy.
        Nat Sci Sleep. 2013; 5: 23-26
        • McHill A.W.
        • Wright Jr., K.P.
        Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease.
        Obes Rev Suppl. 2017; 18: 15-24
        • Beebe D.W.
        • Simon S.
        • Summer S.
        • et al.
        Dietary intake following experimentally restricted sleep in adolescents.
        Sleep. 2013; 36: 827-834
        • Nedeltcheva A.V.
        • Kilkus J.M.
        • Imperial J.
        • et al.
        Insufficient sleep undermines dietary efforts to reduce adiposity.
        Ann Intern Med. 2010; 153: 435-441
        • Gonnissen H.
        • Hulshof T.
        • Westerterp-Plantenga M.
        Chronobiology, endocrinology, and energy- and food-reward homeostasis.
        Obes Rev. 2013; 14: 405-416
        • Zhang J.
        • Ma R.C.
        • Kong A.P.
        • et al.
        Relationship of sleep quantity and quality with 24-hour urinary catecholamines and salivary awakening cortisol in healthy middle-aged adults.
        Sleep. 2011; 34: 225-233
        • Meier-Ewert H.K.
        • Ridker P.M.
        • Rifai N.
        • et al.
        Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk.
        J Am Coll Cardiol. 2004; 43: 678-683
        • Beam Dowd J.
        • Goldman N.
        • Weinstein M.
        Sleep duration, sleep quality, and biomarkers of inflammation in a Taiwanese population.
        Ann Epidemiol. 2011; 21: 799-806
        • Logue E.E.
        • Bourguet C.C.
        • Palmieri P.A.
        • et al.
        The better weight-better sleep study: A pilot intervention in primary care.
        Am J Health Behav. 2012; 36: 319-334
        • Tasali E.
        • Chapotot F.
        • Wroblewski K.
        • Schoeller D.
        The effects of extended bedtimes on sleep duration and food desire in overweight young adults: A home-based intervention.
        Appetite. 2014; 80: 220-224
        • Pizinger T.M.
        • Aggarwal B.
        • St-Onge M.P.
        Sleep extension in short sleepers: An evaluation of feasibility and effectiveness for weight management and cardiometabolic disease prevention.
        Front Endocrinol (Lausanne). 2018; 9: 392
        • Broussard J.L.
        • Ehrmann D.A.
        • Van Cauter E.
        • et al.
        Impaired insulin signaling in human adipocytes after experimental sleep restriction a randomized, crossover study.
        Ann Intern Med. 2012; 157: 549-557
        • Cole T.J.
        • Bellizzi M.C.
        • Flegal K.M.
        • Dietz W.H.
        Establishing a standard definition for child overweight and obesity worldwide: International survey.
        BMJ. 2000; 320: 1240-1243
        • Wang X.
        • Sparks J.R.
        • Bowyer K.P.
        • et al.
        Influence of sleep restriction on weight loss outcomes associated with caloric restriction.
        Sleep. 2018; 41
        • Taheri S.
        • Ling L.
        • Austin D.
        • et al.
        Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index.
        Plos Med. 2004; 1: e62
        • Leproult R.
        • Deliens G.
        • Gilson M.
        • Peigneux P.
        Beneficial impact of sleep extension on fasting insulin sensitivity in adults with habitual sleep restriction.
        Sleep. 2015; 38: 707-715
        • Al Khatib H.K.
        • Hall W.L.
        • Creedon A.
        • et al.
        Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: A potential strategy for decreasing intake of free sugars? A randomized controlled pilot study.
        Am J Clin Nutr. 2018; 107: 43-53
        • Henst R.H.P.
        • Pienaar P.R.
        • Roden L.C.
        • Rae D.E.
        The effects of sleep extension on cardiometabolic risk factors: A systematic review.
        J Sleep Res. 2019; 28: e12865
        • Roberts R.E.
        • Duong H.T.
        Is there an association between adolescent sleep restriction and obesity.
        J Psychosom Res. 2015; 79: 651-656
        • Theorell-Haglöw J.
        • Lindberg E.
        Sleep duration and obesity in adults: What are the connections?.
        Curr Obes Rep. 2016; 5: 333-343
        • Cipolla-Neto J.
        • Amaral F.G.
        • Afeche S.C.
        • et al.
        Melatonin, energy metabolism and obesity: A review.
        J Pineal Res. 2014; 56: 371-381
        • Irwin M.R.
        • Olmstead R.
        • Carroll J.E.
        Sleep disturbance, sleep duration, and inflammation: A systematic review and meta-analysis of cohort studies and experimental sleep deprivation.
        Biol Psychiatry. 2015; 80: 40-52
        • Snell E.K.
        • Adam E.K.
        • Duncan G.J.
        Sleep and the body mass index and overweight status of children and adolescents.
        Child Dev. 2007; 78: 309-323
        • Van Gaal L.F.
        • Mertens I.L.
        • Christophe E.
        Mechanisms linking obesity with cardiovascular disease.
        Nature. 2006; 444: 875-880
        • Grandner M.A.
        • Hale L.
        • Moore M.
        • Patel N.P.
        Mortality associated with short sleep duration: The evidence, the possible mechanisms, and the future.
        Sleep Med Rev. 2010; 14: 191-203
        • Kazemi R.
        • Motametzade M.
        • Golmohammadi R.
        • et al.
        Field study of effects of night shifts on cognitive performance, salivary melatonin, and sleep.
        Saf Health Work. 2018; 9: 203-209
        • Xu Y.
        • López M.
        Central regulation of energy metabolism by estrogens.
        Mol Metab. 2018; 15: 104-115
        • Besedovsky L.
        • Lange T.
        • Haack M.
        The sleep-immune crosstalk in health and disease.
        Physiol Rev. 2019; 99: 1325-1380