Lack of sleep in teens increases obesity

A study shows that teens who do not get enough sleep have an increased risk of becoming obese.

Teenagers who don't get enough sleep may wake up to worse consequences than nodding off during chemistry class. According to new research, risk of being obese by age 21 was 20 percent higher among 16-year-olds who got less than six hours of sleep a night, compared with their peers who slumbered more than eight hours. (The Centers for Disease Control and Prevention recommends nine to ten hours of sleep for teenagers.)

Researchers at the Mailman School of Public Health at Columbia University and the University of North Carolina Gillings School of Public Health are the first to examine the effect of sleeplessness on obesity in teenagers over time, providing the strongest evidence yet that lack of sleep raises risk for an elevated BMI. Results appear in Journal of Pediatrics.

Shakira F. Suglia, ScD, assistant professor of Epidemiology at the Mailman School, and colleagues analyzed health information from more than 10,000 American teens and young adults, ages 16 and 21, as part of the National Longitudinal Study of Adolescent Health. Information on height and weight and sleep was collected during home visits in 1995 and 2001.

Nearly one-fifth of the 16-year-olds reported getting less than six hours of sleep. This group was 20 percent more likely to be obese by age 21, compared to their peers who got more than eight hours of sleep. While lack of physical activity and time spent watching television contributed to obesity, they did not account for the relationship between sleeplessness and obesity.

"Lack of sleep in your teenage years can stack the deck against you for obesity later in life," says Suglia. "Once you're an obese adult, it is much harder to lose weight and keep it off. And the longer you are obese, the greater your risk for health problems like heart disease, diabetes, and cancer."

"The message for parents is to make sure their teenagers get more than eight hours a night," adds Suglia. "A good night's sleep does more than help them stay alert in school. It helps them grow into healthy adults."

Daytime sleepiness and fatigue are known to affect what and how people eat, by altering appetite and stimulating cravings. Energy levels may also play a role. For the sleep-deprived, ordering calorie-dense fast food is easier than preparing a nutritious meal. Information on what the teens ate was not captured in the surveys, although it could play a role. Future research may look whether, for example, soda consumption is a factor in sleeplessness and, in turn, obesity. (A 2013 study by Suglia found young children who drink soda are more likely to have behavioral problems.)

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Teens who sleep less gain more weight in 20s

A study shows that less sleep during the teen years means a person gains more weight by age 21.

Lack of sleep not only puts teens at risk for poor grades, it also puts them at increased risk for obesity, researchers warn.

The study authors analyzed data collected from more than 10,000 Americans when they were aged 16 and 21. Nearly one-fifth of them got less than six hours of sleep a night when they were age 16, and this group was 20 percent more likely to be obese at age 21 than those who got more than eight hours of sleep per night at age 16, the investigators found.

Although lack of exercise and too much time spent watching television were also risk factors for obesity, these behaviors did not account for the link between lack of sleep and obesity, according to the study published online recently in the Journal of Pediatrics.

"Lack of sleep in your teenage years can stack the deck against you for obesity later in life. Once you're an obese adult, it is much harder to lose weight and keep it off. And the longer you are obese, the greater your risk for health problems like heart disease, diabetes, and cancer," study author Shakira Suglia, an assistant professor of epidemiology at the Mailman School of Public Health at Columbia University in New York City, said in a university news release.

"The message for parents is to make sure their teenagers get more than eight hours a night. A good night's sleep does more than help them stay alert in school. It helps them grow into healthy adults," Suglia added.

Teens should get nine to 10 hours of sleep a night, according to the U.S. Centers for Disease Control and Prevention.

It's known that daytime sleepiness and fatigue affect what and how people eat by triggering cravings and altering appetite. For example, sleep-deprived people find it easier to buy calorie-laden fast food rather than preparing a healthy meal.

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ADHD medication use leads to BMI rebound

A study of ADHD stimulant medication shows that its use is associated with BMI rebound later in adolescence.

A new study from researchers at Johns Hopkins Bloomberg School of Public Health found that children treated with stimulants for attention deficit hyperactivity disorder (ADHD) experienced slower body mass index (BMI) growth than their undiagnosed or untreated peers, followed by a rapid rebound of BMI that exceeded that of children with no history of ADHD or stimulant use and that could continue to obesity.

The study, thought to be the most comprehensive analysis of ADHD and stimulant use in children to date, found that the earlier the medication began, and the longer the medication was taken, the slower the BMI growth in earlier childhood but the more rapid the BMI rebound in late adolescence, typically after discontinuation of medication. Researchers concluded that stimulant use, and not a diagnosis of ADHD, was associated with higher BMI and obesity. The study was published in Pediatrics.

"Our findings should motivate greater attention to the possibility that longer-term stimulant use plays a role in the development of obesity in children," said Brian S. Schwartz, MD, MS, Professor of Environmental Health Sciences, Epidemiology, and Medicine at the Bloomberg School of Public Health and lead author of the study. "Given the dramatic rise in ADHD diagnosis and stimulant treatment for it in recent decades, this is an interesting avenue of research regarding the childhood obesity epidemic, because the rises in each of these roughly parallel one another."

Previous research has found substantial evidence that stimulant use to treat ADHD is associated with growth deficits, and some evidence of growth delays. However, the reported associations of ADHD with obesity in both childhood and adulthood was paradoxical and somewhat unexplained. The results of this study suggest it is likely due to the strong influence that stimulants have on BMI growth, with delays in early childhood and a strong rebound in late adolescence. The study also found longitudinal evidence that unmedicated ADHD is associated with higher BMIs, but these effects were small.

ADHD is one of the most common pediatric disorders, with a 9% prevalence among children in the U.S., and ADHD medication is the second most prescribed treatment among children. Over the past 30 years, treatment for ADHD with stimulants has increased rapidly. From 2007 to 2010, 4.2.% of children under age 18 had been prescribed stimulants in the past 30 days, more than five times the amount prescribed to the same-aged children between 1988 and 1984.

The study analyzed the electronic health records of 163,820 children, ages 3 to 18, in the Geisinger Health System, a Pennsylvania-based integrated health services organization. The research geographic area included 37 counties in central and northeastern Pennsylvania. There were an equal number of boys and girls. Nearly 7% -- 11,080, or 6.8% -- had an order for stimulants. (13,789, or 8.4%, received a diagnosis of ADHD. A total of 15,473 were prescribed stimulants, some for other reasons.) There were 201,854 orders for the ADHD medications used in the analysis. The median age at first stimulant use was 8.5 years. Median use was 183 days, with 50% of children taking stimulants for less than 6 months and 50% of children for more than 6 months.

The researchers compared the BMI trajectories of those who had never had a diagnosis or prescription (the "controls") with three groups: 1.) those with a diagnosis but no stimulant prescription; 2.) those with orders for stimulants without an ADHD diagnosis and 3.) those with both an ADHD diagnosis and stimulant orders.

Those in group 3 had slower rates of BMI growth in early childhood, with more rapid rates during adolescence that eventually exceeded those of the controls. Those with a diagnosis of ADHD but no stimulant orders had more rapid BMI growth after age 10 versus the controls, but the effects were small.

"Stimulant use was strongly implicated," said Dr. Schwartz. "The earlier stimulants were started and the longer they were used, the stronger was their influence on the degree of both the delayed BMI growth in early childhood and the rebound BMI growth in late adolescence. This is an important unintended consequence of stimulant use in childhood."

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Study: Losing sleep hurts obese teen's health

A study shows that lack of sleep can hurt the health of obese teens and may increase their risk of heart disease and diabetes.

Obese teens who get too little sleep are at increased risk for heart disease and diabetes, a small study suggests.

Researchers assessed the health, physical activity levels and sleeping habits of 37 obese American youngsters, aged 11 to 17.

Among the study participants, only one-third met the minimum recommendations of being physically active at least one hour per day. Most slept about seven hours a night, typically waking up at least once. Only five got the minimum recommended 8.5 hours of sleep each night.

Too little sleep was associated with an increased risk of heart disease and diabetes, independent of other risk factors, such as lack of physical activity and high levels of body fat, according to the University of Michigan Health System and Baylor University researchers.

The findings, published March 6 in The Journal of Pediatrics, suggest that sleep assessments may be useful in spotting teens at risk for heart disease and diabetes.

Further studies are needed to find out if getting more sleep would help reduce teens' risk for these health problems, lead author Heidi IglayReger, supervisor of the Physical Activity Laboratory at the Michigan Metabolomics and Obesity Center, and colleagues noted in the news release.

Previous research has shown that obesity and lack of sleep are linked with increased risk of heart disease and diabetes in adults and young children, but that association has not been clear in teens, the study authors pointed out.

While the study showed an association between lack of sleep and a raised risk for heart disease and diabetes in teens, it did not prove a cause-and-effect relationship.

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