睡眠对 18 个月行为体重管理干预期间减肥及饮食和身体活动建议依从性的影响。
Effect of sleep on weight loss and adherence to diet and physical activity recommendations during an 18-month behavioral weight loss intervention.
机构信息
Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
出版信息
Int J Obes (Lond). 2022 Aug;46(8):1510-1517. doi: 10.1038/s41366-022-01141-z. Epub 2022 May 16.
BACKGROUND/OBJECTIVES: To examine the association between indices of sleep quantity and quality with dietary adherence, physical activity adherence, and weight loss during a behavioral weight loss intervention.
METHODS
Adults (n = 156) with overweight and obesity (40 ± 9 years, 84% female, BMI: 34.4 ± 4.2 kg/m) participated in an 18-month behavioral weight loss intervention which prescribed a reduced calorie diet (1200-1800 kcal/d) and increased physical activity (300 min/wk). Body weight, indices of sleep (SenseWear armband; SWA), energy intake (EI, 3-day food records), and moderate-to-vigorous physical activity (SWA) were measured at baseline, 6, 12, and 18 months. Linear mixed effects models examined the association between sleep and weight change over time. Additional models were adjusted for covariates including age, BMI, sex, race, ethnicity, study completion, randomization, EI, and physical activity. Secondary analyses examined the association between sleep and adherence to diet and physical activity recommendations.
RESULTS
Mean weight loss was 7.7 ± 5.4, 8.4 ± 7.9, and 7.1 ± 9.0 kg at 6, 12, and 18 months, respectively. Lower sleep efficiency, higher wake after sleep onset (WASO), more awakenings, and higher sleep onset latency (SOL) were significantly associated with attenuated weight loss (p < 0.05). Lower sleep efficiency, more awakenings, and higher SOL remained significantly associated with blunted weight loss after adjustment for covariates (p < 0.05). Later waketime, longer time in bed, longer sleep duration, higher WASO, more awakenings, and higher SOL were associated with lower odds of achieving ≥300 min/wk of moderate-to-vigorous physical activity, adjusted for covariates (FDR p < 0.05).
CONCLUSIONS
Future studies should evaluate whether incorporating strategies to improve sleep health within a behavioral weight loss intervention leads to improved adherence to diet and physical activity recommendations and enhanced weight loss.
CLINICAL TRIALS IDENTIFIER
NCT01985568.
背景/目的：探讨睡眠数量和质量指数与饮食依从性、身体活动依从性和减肥的关系。
方法
超重和肥胖成年人（n=156，年龄 40±9 岁，84%为女性，BMI：34.4±4.2kg/m2）参与了为期 18 个月的行为减肥干预，包括低热量饮食（1200-1800 千卡/天）和增加身体活动（300 分钟/周）。在基线、6、12 和 18 个月时测量体重、睡眠指数（SenseWear 臂带；SWA）、能量摄入（3 天食物记录）和中高强度体力活动（SWA）。线性混合效应模型检验了睡眠与体重随时间的变化关系。在调整年龄、BMI、性别、种族、民族、研究完成情况、随机分组、能量摄入和体力活动等因素后，进行了额外的模型分析。二次分析检查了睡眠与饮食和体力活动推荐的依从性之间的关系。
结果
6、12 和 18 个月时，平均体重分别减轻了 7.7±5.4、8.4±7.9 和 7.1±9.0kg。较低的睡眠效率、较高的睡眠后醒来时间（WASO）、更多的觉醒和较高的睡眠潜伏期（SOL）与减肥效果减弱显著相关（p<0.05）。调整了混杂因素后，较低的睡眠效率、更多的觉醒和较高的 SOL 与减肥效果减弱仍显著相关（p<0.05）。较晚的起床时间、较长的卧床时间、较长的睡眠时间、较高的 WASO、更多的觉醒和较高的 SOL 与达到≥300 分钟/周的中高强度体力活动的可能性较低相关，调整了混杂因素（FDR p<0.05）。
结论
未来的研究应评估在行为减肥干预中纳入改善睡眠健康的策略是否会提高饮食和身体活动的依从性，并增强减肥效果。
临床试验标识符
NCT01985568。
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