Lack of sleep may raise health risks

Lack of quality sleep for adults may negatively impact heart health. Evidence now suggests that sleep problems during adolescence may increase health risks as well.

The research appeared Monday in the Canadian Medical Association Journal.

"When most people think about cardiovascular risk factors and risk behaviors, they don't necessarily think of sleep," said Dr. Brian McCrindle, senior author and cardiologist at SickKids in Toronto, Ontario. "This study ... shows a clear association between sleep disturbance (in adolescents) and a greater likelihood of having high cholesterol, high blood pressure and being overweight or obese."

"These findings are important, given that sleep disturbance is highly prevalent in adolescence and that cardiovascular disease risk factors track from childhood into adulthood," noted Dr. Indra Narang, the lead study author and director of sleep medicine at SickKids.

The researchers examined data from the 2009/2010 school year for adolescents in the Niagara region of Ontario.

More than 4,000 ninth-grade students completed questionnaires asking about their sleep duration, quality, disturbances, snoring, daytime sleepiness and the use of any sleep medications during a period of one month.  Their average age was 14.6.

The students also answered questions about their physical activity, time spent in front of a computer or television and nutrition.

Researchers studied participants' height, weight, waist circumference, cholesterol levels and blood pressure. They adjusted for those with family history of cardiovascular disease, so they could be confident of the association found.

Participants slept, on average, 7.9 hours during the week and 9.4 hours on weekends. The Centers for Disease Control and Prevention recommends adolescents get 8.5 to 9.5 hours of sleep a night.

Almost one in five reported their weeknight sleep as "fairly bad" or "bad." One in 10 said the same was true for their weekend sleep. In addition, almost 6% of respondents said they had used medications to help them sleep.

"What happens with these kids is they have very poor sleep habits and sleep hygiene, so they're sleepy and tired and have poor energy during the day, so they hop themselves up on caffeinated beverages and then that just perpetuates their problem and a lot of them wound up taking some kind of sleep medication," McCrindle said. "So they get in a cycle."

Narang said 6% was "quite a lot" of adolescents taking over-the-counter and prescription medication to help them sleep.

"It really shows that some adolescents are experiencing very disturbed sleep that they're then needing sleep medication," she said.

Common sleep disturbances reported by the adolescents included waking up during the night or early in the morning, not being able to fall asleep within a half-hour, feeling too hot or too cold, having to use the restroom and bad dreams.

Those who reported sleep disturbances more often consumed soft drinks, fried food, sweets and caffeine, the research showed. They also reported less physical activity and increased screen time. In addition, the adolescents with shorter sleep routines reported less physical activity and more screen time.

In the short term, poor sleep impairs daytime function.

"It can affect (your) learning, it can affect (your) memory," Narang added.

Parents concerned about their child's sleep can intervene in several ways.

McCrindle suggests trying to minimize media use in the bedroom.

"Do (the adolescents) really need to have a TV, a computer, all their video games in the bedroom?" he asked.

Instead, ensure kids have down time before bedtime.

Narang feels consumption of high-energy caffeine drinks may largely be to blame.

But the big picture, she says?

"Everybody involved in the health care of a child - a nurse, a physician, a teacher - needs to promote well sleep, and that would involve a certain number of hours a sleep and routine of sleep," Narang said.

The routine would keep them on the same sleep schedule all week long, she added.

Fewer, larger meals - Key to weight loss?

You've probably heard that eating multiple small meals throughout the day is a good way to stave off hunger and keep your metabolism revved up while trying to lose weight. But a new study could change your diet strategy.

healthy-meals

Eating two large meals early and skipping dinner may lead to more weight loss than eating six smaller meals throughout the day, research presented at the American Diabetes Association Scientific Sessions conference this week in Chicago suggests.


The study

Researchers from the Czech Republic followed 54 patients with Type 2 diabetes for 24 weeks. The study participants were split into two groups at random. Both groups followed a diet that reduced their energy intake by 500 calories per day and contained 50 to 55% carbohydrates, 20 to 25% protein and less than 30% fat.

For the first 12 weeks, one group ate three main meals - breakfast, lunch and dinner - and three small snacks in between meals. The other group ate a large breakfast between 6 and 10 a.m. and a large lunch between noon and 4 p.m. The two groups then switched for the second 12 weeks.

Researchers asked the patients not to alter their exercise habits during the study.

The results

Although both groups lost weight and decreased the amount of fat in their livers, the group that was eating only two larger meals lost more during each 12-week session. Eating fewer, bigger meals also led to lower fasting blood sugar levels, meaning that the body's insulin production was working more efficiently.

The timing and frequency of the groups' meals did not seem to have an effect on the function of beta cells that produce insulin or on the glucose metabolic clearance rate - i.e. how fast their bodies were able to process and get rid of sugar.

Our expert's take

"This is interesting," says CNN diet and fitness expert Melina Jampolis. "But the first thing I think of is that it's not really liveable, telling people to skip dinner every day."

Jampolis is also concerned that the two groups did not end up eating the same total number of calories. "Eating six times a day, it's very hard to control calories," she says. The researchers admit that while they did their best to ensure both groups consumed the same amount, the group that ate two larger meals may have eaten less.

While the study was small, Jampolis agrees that there's research to support eating a lighter meal later in the day. Most of us consume the majority of our day's calories late at night when we're the least active, she says. And when we're not active, our insulin sensitivity drops. A recent study showed that walking for just 15 minutes after dinner can help lower your risk for diabetes. Fasting between lunch and breakfast may have a similar effect, she says.

The takeaway

Don't skip dinner altogether. Focus instead on eating a hearty breakfast and lunch, and keep your last meal of the day low in calories.

Truths About Training

I was never a runner. In fact, I kind of despised running—especially since my high school soccer coach used it as punishment. As an adult, however, I’ve come to love it so much I’ve completed five marathons.

But after Hurricane Sandy put the kibosh on last year’s New York City Marathon, I fell off track. Though I stayed active, for four months I never ran. Now I’m training again to run the marathon this November, and dealing with body aches and slooow runs.

Yet I know I won’t quit, because I’ve found that the sucky days are the ones that make you better. Thinking of running a race, too? Here are a few other things I’ve learned along the way.

Training is a bit scary
I can’t lie. The training is grueling. Four. Long. Months. But at some point—for me, it’s after the first month—you hit your stride. And before you know it, you’re a week out from the big day.

Commitment is key
You can’t BS your way through training. Believe me, I tried once. I figured if I did my long runs I’d be OK. The problem: Training is like a ladder. Each rung prepares your body for the next, so skipping just one step weakens your foundation, making those 15- and 20-milers—and ultimately the big 26.2—tougher. My advice: Stick to a schedule. I run after work, though life can get in the way. Sometimes I’ve had to get up at dawn (wearing running clothes to bed helps!).

Find what fuels you
Sure, I love my shrinking waistline and toned thighs. But the real reason I run is it’s a total stress buster. When my granny died two years ago, the first thing I did was lace up my sneakers. There was something about falling into the rhythm of the run that soothed me and helped me wrap my mind around my grief. I ran my 2011 marathon in her honor.

You’ll surprise yourself
Some days, self-doubt tells me I won’t succeed. It’s then I have to remind myself: No one ran those miles for me. I pushed my body and found my way to the finish line. So much of running is mental (I can forge ahead!). You are showing yourself that you can do what less than 1 percent of the population can do. How’s that for an ego boost?