轻度睡眠不足儿童在不饥饿时进食：一项具有学习效应的随机交叉试验
Eating in the absence of hunger in children with mild sleep loss: a randomized crossover trial with learning effects.
作者信息
Morrison Silke, Galland Barbara C, Haszard Jillian J, Jackson Rosie, McIntosh Deborah R, Beebe Dean W, Elder Dawn E, Ward Aimee L, Meredith-Jones Kim, Taylor Rachael W
机构信息
Department of Medicine, University of Otago, Dunedin, New Zealand.
Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
出版信息
Am J Clin Nutr. 2021 Oct 4;114(4):1428-1437. doi: 10.1093/ajcn/nqab203.
BACKGROUND
While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater "eating in the absence of hunger" (EAH) or energy intake beyond the point of satiety, when tired.
OBJECTIVE
The aim was to determine whether mild sleep loss increases EAH in children.
METHODS
A crossover study was undertaken in 105 healthy children (8-12 y) with normal sleep (∼8-11 h/night). After randomization, children went to bed 1 h earlier (sleep extension) or 1 h later (sleep restriction) than their usual bedtime, over 2 intervention weeks separated by a 1-wk washout. At the end of each intervention week, children underwent an EAH feeding experiment involving a preloading meal until satiation, followed by an ad libitum buffet (of highly palatable snacks) to measure EAH, with each food item weighed before and after consumption.
RESULTS
Ninety-three children completed the EAH experiment. There was no evidence of a difference in energy intake from EAH between sleep restriction and extension conditions when analyzed as a crossover design. However, a learning effect was found, with children eating significantly less (-239 kJ; 95% CI: -437, -41 kJ; P = 0.018) during the preload phase and significantly more (181 kJ; 95% CI: 38, 322 kJ; P = 0.013) in the ad libitum phase in the second week. No significant differences were seen using an underpowered parallel analysis for energy intake during the ad libitum phase when sleep deprived (106 kJ; 95% CI: -217, 431 kJ; P = 0.514).
CONCLUSIONS
Our findings suggest that measuring a difference in eating behavior in relation to sleep proved unsuitable using the EAH experiment in a crossover design in children, due to a learning effect. This trial was registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true) as ACTRN12618001671257 .
背景
虽然睡眠时间不足已成为肥胖的一个强大独立风险因素，但其机制仍不清楚。一种可能性是在疲倦时出现更多的“无饥饿进食”（EAH）或能量摄入超过饱腹感。
目的
确定轻度睡眠不足是否会增加儿童的EAH。
方法
对105名睡眠正常（约8 - 11小时/晚）的健康儿童（8 - 12岁）进行了一项交叉研究。随机分组后，儿童在两个干预周内比平时就寝时间提前1小时（睡眠延长）或推迟1小时（睡眠限制），中间间隔1周的洗脱期。在每个干预周结束时，儿童进行一次EAH喂养实验，包括一顿预负荷餐直至饱腹感，然后是一顿随意自助餐（提供非常可口的零食）以测量EAH，每种食物在食用前后称重。
结果
93名儿童完成了EAH实验。作为交叉设计进行分析时，没有证据表明睡眠限制和延长条件下从EAH摄入的能量存在差异。然而，发现了一种学习效应，儿童在第二周的预负荷阶段进食明显减少（-239千焦；95%置信区间：-437，-41千焦；P = 0.018），在随意进食阶段进食明显增多（181千焦；95%置信区间：38，322千焦；P = 0.013）。在睡眠剥夺的随意进食阶段，使用效能不足的平行分析能量摄入时未发现显著差异（106千焦；95%置信区间：-217，431千焦；P = 0.514）。
结论
我们的研究结果表明，由于存在学习效应，在儿童交叉设计的EAH实验中，证明测量与睡眠相关的饮食行为差异并不合适。该试验已在澳大利亚新西兰临床试验注册中心（http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true）注册，注册号为ACTRN12618001671257 。
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