Ep.16 Sugar cravings and poor sleep in teens

American academy of Pediatrics recommends that teenagers sleep at least 8-10 hours every night. 

However,  according to data from CDC, more than 2 out of 3 students in middle schools and high schools do not get the recommended amount of sleep. 

What is the effect of chronic sleep restriction on what these students choose to eat?
Listen to learn more

Here I present research that was done to answer this question.

The manuscript i present is : 
Beebe DW, Simon S, Summer S, Hemmer S, Strotman D, Dolan LM. Dietary intake following experimentally restricted sleep in adolescents. Sleep. 2013 Jun 1;36(6):827-34. doi: 10.5665/sleep.2704. PMID: 23729925; PMCID: PMC3649825.

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Transcript

Speaker 1 0:48

Are you getting frustrated with what to feed a teenager who is always hungry? Everybody knows that teenagers have a huge appetite. It seems like you need to feed them constantly to satisfy their hunger. It's even more difficult where teenagers who struggle with their weight truly want to make changes like cut down on junk food or stop ever eating, and they can't. There's frustration, isolation, stress, and that's why I decided to create a recipe collection of 30 easy and healthy meals for teenagers. They're all high in protein to satisfy your teenager's hunger and they can all be ready in less than 30 minutes. If you want to grab a free copy, go to lifestyleforteenscom for the last recipes.

Speaker 2 1:49

This is the Lifestyle and Weight Loss for Teens podcast. If you are a mom and want to help your child who is struggling to lose weight, you are in the right place. If you are looking for healthy lifestyle tips, Dr Gorgary is here to help you understand the science around safe weight loss in teens and children, because what works for adult weight loss is not always the best for children. This podcast is for educational purposes only. Dr Gorgary does not provide medical, psychological or nutrition therapy advice. You should not use this information to diagnose or treat any health problems without consulting your own medical practitioner and now your host, Dr Jenny Gorgary.

Speaker 1 2:34

Hello, welcome to another episode of the Lifestyle and Weight Loss for Teens podcast. This is Dr Gorgary, and today I'm talking about sleep. I found this study. I was really excited to read it because it was really an excellent study, and it was published in 2012 in the Journal of Sleep, which is a very good journal, and the actual title of this manuscript is Dietary Intake Following Experimentally Restricted Sleep in Under Lessons, and it was done by Dr Dolan and his team, and really this was an excellent study.

Speaker 1 3:17

It was difficult to do, in my opinion, but it's the right way to do a study. It was done by what we called a randomized control trial, so they wanted to examine how the restricting sleep affects eating habits, and I'm going to explain and tell you what exactly they did. So we know from studies from adults that not sleeping enough and even other studies in teenagers, we know that not sleeping enough can affect the way that you eat, and what is more interesting, though, is does that habit and does that choice and does that reaching out for unhealthy habits change when you have the same individual that one week may sleep well and another week may not sleep well? Like is the effect really evident? So this was a three-week protocol study. So first the researchers had some other lessons that for the first week they just it was just the baseline evaluation week where they just had them sleep their usual time and they selected one time that they usually prefer to wake up and then they kind of like kept that same schedule for the following weeks. But what they did is they randomly asked them to have five days, monday through Friday, where they asked them to not sleep enough and they actually asked them to sleep six and a half hours Monday through Friday, versus the next week where they had healthy sleep duration, which was 10 hours Monday through Friday. They allowed for two nights, basically the weekend, for them to recover, and as they transitioned from one week to the other week they had the weekend to recover from whatever study protocol and move to the new study protocol. And some kids did first the short sleep week and some kids did first the healthy sleep duration week. It was kind of like chosen randomly, by chance.

Speaker 1 6:00

The age of the teenagers that were recruited for this study was between 14 and 16 years of age. They were healthy teenagers and they had specifically selected them so that they are not taking any medications that have drugs that could affect their sleep. So they wanted to make sure what effects they were seeing was really because of their sleep, and they also excluded people that they were having very high caffeine used during their routine, because that can also affect the quality of their sleep. They excluded patients and subjects that had very high body mass index more than 30, because I suspect they did that because when your body mass index is that high, your sleep can also be affected just by that by causing obstructive sleep apnea and that can interfere. That is my guess, I'm not sure, but in any case they excluded patients that had. They excluded subjects that had body mass index more than 30. And they would also ask that they did not have any obligations that they could not attend to if they had and they had to stay later than 10 pm or wake up prior to 6 am. So those participants that in the beginning said you know, there is no way that I can sleep before 10 pm were excluded from the study. They excluded also subjects that had a very low IQ or teenagers that had history of neurological problems or neurological injuries, again because you can have sleep cycle alterations in those conditions. So they wanted to try to get a sample of teenager representative population, of the general population of teenagers.

Speaker 1 8:00

So, as I said, after they did this first initial week, then they had one week where they actually sleep deprived or they were sleeping 10 hours, and they asked them to wear specific watches that I don't know if you have noticed. You have an Apple watch or Fitbit or any kind of the smart watches that can actually tell you whether you're sleeping or not sleeping. So they use a research watch that can give them that information so they can know whether they slept or they did not sleep. And so after this certain week, whether it was the short sleep or the long week they asked them to fill out, with the help of researcher, a questionnaire on what they ate in the last 24 hours. Now, different food categories in that diet food diary included whether they had sweet and beverages like soda, or unsweetened beverages like water or sports drinks. Whether they had fruits and vegetables, like banana, apple vegetable salad, where they had meat, eggs, chips, crackers and fresh fries, which are all processed food. Whether they had fast food for main meal, like hamburger's, pizza and sandwiches. How much grains and starches they consumed, like bread, rice, pasta and cereal. And also how much sweet and desserts like candy, ice cream, milkshakes and things like that. So this way of collecting the data about how much and what they ate is actually a validated method. On how they use it, they use specific method to make sure that they could collect as much accurate information about that as possible.

Speaker 1 9:54

So that was, in a summary, the way this study was designed, and now let's find out what the results of this study were. Ready. Here we go. So, even though they started this study with a total number of 64 participants, they had to exclude a few participants because they were not following the instructions, like they were not waking up when the researchers were telling them to. And some other people did not follow their sleep protocol or they ate too much more than 4,000 calories, which was too much, and they didn't want this to hyperinflate the data. So they excluded these participants as well. So the final sample was 41 adolescents, of which 59% were females and the rest were boys, 54% were Caucasian and 37% were African American.

Speaker 1 11:00

The average age of teenagers in this study was 15.3 years, and they reported that, on average, they slept 9.3 hours on non-school nights and 7.1 hours on school nights. 59% of them reported that they were sleeping less than 7 hours and 20% of them reported that they were actually sleeping less than 6 hours on typical school nights. And even though they, as I mentioned, the researchers excluded teenagers that had body mass index more than 30, they had 66% of teenagers that they were normal body mass index, 17% had body mass index in the 85th to 95th percentile or in the overweight category, and 17% of the population was above the 95th percentile, which was in the obesity category. So these were just the basic characteristics of the subjects that participated in this study. So when they compared the total amount of calories consumed in the week that they had sleep restriction versus the week that they were sleeping 10 hours, they found that the average calories was 1,953 on the sleep restricted week plus minus for 788 calories, versus 1,796 calories plus minus 724 during the week that they slept 10 hours. So this was almost significant. It didn't really quite reach statistical significance, but you can tell that is approximately 200 calories difference on the same person after a week where they don't sleep well compared to a week that they sleep well.

Speaker 1 13:20

What was statistically significant was that the type of foods that they ate had higher glycemic index and glycemic load. And what do we mean by that? We mean that they ate particular foods that, after they ate it, their blood sugar increases typically more, compared to something that does not increase as much. So, in general, food that are high in processed carbohydrates tend to cause higher rises in blood glucose and higher levels on insulin levels, causing all these metabolic disturbances that go along with consistently having elevated insulin and sugar. And so, basically, what this study showed was that the teenagers, when they don't sleep well for a week, they tend to reach for food that has higher glycemic index and, in particular, there was a significant change in the amount of sweet and desserts that they eat on the weeks that they sleep versus the weeks that they don't sleep well. So the average amount of sweet and desserts was 1.9 versus 0.8 on the two different weeks. So that was a significant difference.

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Speaker 1 15:00

Now, as the researchers also mentioned in this study and I absolutely agree with this personally although the number of the total calories that they consumed during the week that they did not sleep well was approximately 9% higher, if you add this over a year, that is significant. It comes up to a total number of 28,000 calories. Basically, what that means is that, if you continue to eat every day 10% more calories than what you actually need, especially if the calories come from sweets and desserts, then over a year, you're likely to gain 5 or 10 extra pounds. So, my dearest friends, if you're listening to this and if you're not getting enough sleep especially if you're a teenager and, trust me, I know what your schedule looks like I would like you to consider sleeping a little bit more. Even if it is 15 minutes, half an hour, whatever you can add to your daily schedule, anything counts. I hope you enjoy this episode and I'll see you again next week. Take care you all. Bye, my friends.

Speaker 2 16:23

If you enjoyed listening to this podcast. I invite you to come check out the LIFT program. It's Dr Gorgary's 12-week coaching program for teens and their moms, where we take all this information, we apply it to your daily life and we work together so your teenager learns how to create a healthy lifestyle so they can feel happier, more confident, less stressed and love their body again. Visit the website at lifestyleforteenscom and click on the work with me and free resources to learn more about this program and get free help to start this journey right away. Thanks for tuning in and we'll catch you in the next episode of Lifestyle and Weight Loss for Teens.