Duraccio Kara M, Krietsch Kendra N, Chardon Marie L, Van Dyk Tori R, Beebe Dean W
Cincinnati Children's Hospital Center, Behavioral Medicine and Clinical Psychology Department, Cincinnati, OH, USA.
Loma Linda University, Department of Psychology, Loma Linda, CA, USA.
Adolesc Health Med Ther. 2019 Sep 9;10:117-130. doi: 10.2147/AHMT.S219594. eCollection 2019.
Poor sleep is related to increased obesity risk in adolescents, though the mechanisms of this relationship are unclear. This paper presents a conceptual framework of the various pathways that have been proposed to drive this relationship. In this framework, increased food reward, emotional reactivity, decreased inhibitory control, metabolic disturbances, poorer dietary quality, and disrupted meal timings may increase the likelihood of increasing overall energy intake. This paper further notes how poor sleep increases sedentary behavior and screen time, which likely limits overall energy expenditure. The model posits that these mechanisms result in an imbalance of energy intake and expenditure following poor sleep, intensifying the overall risk for obesity. Increases in food reward processes, decreases in insulin sensitivity, disrupted meal timing, and increases in sedentary behavior seem to be the most compelling mechanisms linking poor sleep with increased obesity risk in adolescents. Future directions and clinical implications of this framework are discussed.
睡眠质量差与青少年肥胖风险增加有关，尽管这种关系的机制尚不清楚。本文提出了一个概念框架，阐述了为解释这种关系而提出的各种途径。在此框架中，食物奖赏增加、情绪反应性增强、抑制控制能力下降、代谢紊乱、饮食质量较差以及用餐时间不规律，可能会增加总体能量摄入增加的可能性。本文还进一步指出睡眠质量差如何增加久坐行为和屏幕使用时间，这可能会限制总体能量消耗。该模型认为，这些机制会导致睡眠质量差后能量摄入与消耗失衡，从而加剧肥胖的总体风险。食物奖赏过程增加、胰岛素敏感性降低、用餐时间紊乱以及久坐行为增加，似乎是将睡眠质量差与青少年肥胖风险增加联系起来的最有说服力的机制。本文还讨论了该框架的未来方向和临床意义。
