ResearchPad - nutrition-and-metabolism https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Impact of nutrition education on nutritional knowledge and intentions towards nutritional counselling in Dutch medical students: an intervention study]]> https://www.researchpad.co/article/Na2d002ce-1af2-496d-b040-75f7692e19c9 Management of diet-related chronic diseases may benefit from improved nutrition education of medical students. This study aims to investigate the effects of a nutrition education course on nutritional knowledge and intentions towards nutritional counselling in Dutch medical students.DesignThis is a pre–post intervention study with a comparison group. Participants completed self-reported questionnaires on nutritional knowledge and intentions towards nutritional counselling.ParticipantsIn total, 118 medical students (64.4% undergraduate, 73.2% women) were recruited from two medical schools in the Netherlands (n=66 intervention group, n=52 comparison group).InterventionThe intervention group completed a 25-hour course in nutritional counselling (the Students Experienced in Lifestyle and Food (SELF) course) in addition to the standard medical curriculum. The comparison group followed the standard medical curriculum.Outcome measuresSelf-reported nutritional knowledge and intentions towards nutritional counselling, including attitude, self-efficacy and social support.ResultsNutritional knowledge (B: 2.42, 95% CI 1.81 to 3.02), attitude in men (B: 0.50, 95% CI 0.13 to 0.87) and self-efficacy (B: 0.78, 95% CI 0.62 to 0.95) significantly increased in the intervention group compared with the comparison group. No significant differences were found for social support (B: 0.20, 95% CI −0.02 to 0.43) and attitude in women (B: 0.08, 95% CI −0.24 to 0.31) between the two groups.ConclusionsThe SELF course increased medical students’ nutritional knowledge and stimulated their intentions towards nutritional counselling. Future research is needed to evaluate the long-term impact of nutrition education interventions on physician practice patterns and patient outcomes. ]]> <![CDATA[Association of magnesium intake with type 2 diabetes and total stroke: an updated systematic review and meta-analysis]]> https://www.researchpad.co/article/Ndd920198-5bf0-479c-842c-8af3a530453d

Objective

The detailed associations between type 2 diabetes (T2D) and total stroke and magnesium intake as well as the dose–response trend should be updated in a timely manner.

Design

Systematic review and meta-analyses.

Data sources

PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov were rigorously searched from inception to 15 March 2019.

Eligibility criteria

Prospective cohort studies investigating these two diseases were included.

Data synthesis

Relative risk (RR) and 95% CI in random effects models as well as absolute risk (AR) were pooled to calculate the risk of T2D and stroke. Methodological quality was assessed by the Newcastle-Ottawa Scale.

Results

Forty-one studies involving 53 cohorts were included. The magnitude of the risk was significantly reduced by 22% for T2D (RR 0.78 (95% CI 0.75 to 0.81); p<0.001; AR reduction 0.120%), 11% for total stroke (RR 0.89 (95% CI 0.83 to 0.94); p<0.001; AR reduction 0.281%) and 12% for ischaemic stroke (RR 0.88 (95% CI 0.81 to 0.95); p=0.001; AR reduction 0.246%) when comparing the highest magnesium intake to the lowest. The inverse association still existed when studies on T2D were adjusted for cereal fibre (RR 0.79; p<0.001) and those on total stroke were adjusted for calcium (RR 0.89; p=0.040). Subgroup analyses suggested that the risk for total and ischaemic stroke was significantly decreased in females, participants with ≥25 mg/m2 body mass index and those with ≥12-year follow-up; the reduced risk in Asians was not as notable as that in North American and European populations.

Conclusions

Magnesium intake has significantly inverse associations with T2D and total stroke in a dose-dependent manner. Feasible magnesium-rich dietary patterns may be highly beneficial for specific populations and could be highlighted in the primary T2D and total stroke prevention strategies disseminated to the public.

PROSPERO registration number

CRD42018092690.

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<![CDATA[Determinants of overweight/obesity among reproductive age group women in Ethiopia: multilevel analysis of Ethiopian demographic and health survey]]> https://www.researchpad.co/article/Nb500076a-e80f-4369-b028-5d13b26ed388

Objective

Overweight/obesity among women is associated with an increased risk of gestational diabetes, pre-eclampsia, postpartum haemorrhage, low birth weight, congenital malformation and neonatal deaths. Although the magnitude of overweight and obesity among the reproductive age group women is a common problem in Ethiopia, there are limited studies that determine the associated factors of overweight and obesity at the national level. Therefore, this study aimed to identify the determinant factors of overweight/obesity among reproductive age group women in Ethiopia.

Design

Cross-sectional study design.

Setting

Ethiopia.

Participants

Non-pregnant women aged 15–49 years.

Primary outcome

Overweight/obesity.

Methods

The present study used the Ethiopia Demographic Health Survey (EDHS) data for 2016. A total of 10 938 non-pregnant reproductive age group women were included in the analysis. Both bivariable and multivariable multilevel logistic regression were performed to determine the determinants of overweight and obesity among women in Ethiopia. The OR with a 95% CI was estimated for potential determinants included in the final model.

Results

Those women with secondary education (adjusted OR (AOR)=1.48, 1.01, 2.18), higher education (AOR=1.78, 1.13, 2.81), richer (AOR=1.85, 1.15, 2.98) and richest wealth index (AOR=3.23, 1.98, 5.29), urban residence (AOR=4.46, 2.89, 6.87), married (AOR=1.79, 1.21, 2.64), widowed (AOR=2.42, 1.41, 4.15), divorced (AOR=1.84, 1.13, 3.00), aged 25–34 years (AOR=2.04, 1.43, 2.89), 35–44 years (AOR=2.79, 1.99, 3.93) and 45–49 years (AOR=2.62, 1.54, 4.45) had higher odds of developing overweight and obesity.

Conclusion

Women with higher education level, high wealth status, older age, formerly married and those urban dwellers had higher odds of overweight and obesity. Therefore, regular physical activity, reducing consumption of fat/energy-dense food as well as modifying the mode of transportation is recommended.

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<![CDATA[Time to recovery from severe acute malnutrition and its predictors: a multicentre retrospective follow-up study in Amhara region, north-west Ethiopia]]> https://www.researchpad.co/article/Ne9af7df6-8394-436b-81ce-ddeab4f55e96

Objectives

This study aimed to determine the time to recovery from severe acute malnutrition (SAM) and its predictors in selected public health institutions in Amhara Regional State, Ethiopia.

Design

An institution-based retrospective follow-up study was conducted using data extracted from 1690 patient cards from September 2012 to November 2016.

Setting

Selected government health institutions in the Amhara region, Ethiopia.

Participants

Children treated in therapeutic feeding units for SAM were included.

Outcome measures

Time to recovery from SAM.

Results

One thousand and fifty children have recovered from SAM, 62.13% (95% CI 59.8% to 64.5%). The median time to recovery was 16 days (IQR=11–28). Female gender (adjusted HR (AHR)=0.81, 95% CI 0.67 to 0.98), oedematous malnutrition (AHR=0.74 95% CI 0.59 to 0.93), pneumonia (AHR=0.66, 95% CI 0.53 to 0.83), tuberculosis (AHR=0.53, 95% CI 0.36 to 0.77), HIV/AIDS (AHR=0.47, 95% CI 0.28 to 0.79), anaemia (AHR=0.73, 95% CI 0.60 to 0.89) and receiving vitamin A (AHR=1.43, 95% CI 1.12 to 1.82) were notably associated with time to recovery.

Conclusions

The time to recovery in this study was acceptable but the proportion of recovery was far below the minimum standard. Special emphasis should be given to the prevention and treatment of comorbidities besides the therapeutic feeding. Supplementing vitamin A would also help to improve the recovery rate.

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<![CDATA[‘Am I really hungry?’ A qualitative exploration of patients’ experience, adherence and behaviour change during hunger training: a pilot study]]> https://www.researchpad.co/article/Na2c29a17-070d-430b-b143-4f85143afe74

Objectives

Hunger training (HT) is an intervention designed to teach people to eat according to their hunger by connecting physical symptoms of appetite with glucose levels. HT is most effective for weight loss, and improving eating behaviours when adherence is high. However, adherence is a challenge that should be explored prior to wider dissemination. The aim of this study was to explore participants’ experience and self-reported adherence and behaviour change related to HT.

Design

A qualitative study, nested within a randomised controlled pilot study of two different methods of monitoring glucose during HT. Semistructured interviews were audio-recorded, transcribed verbatim and analysed thematically using a phenomenological approach.

Setting

Single-centre study with participants recruited from the local area.

Participants

40 participants began the pilot study and 38 participants (52.6% women) remained at 1 month and completed interviews.

Results

Most participants felt they were able to match their hunger to their glucose levels by the end of the intervention. The main adherence barriers were the social pressure to eat, lack of time and lack of flexibility in participants’ meal schedules. Common adherence enablers were having a set routine, social support and accountability. Participants described increased awareness of hungry versus non-hungry eating and better cognition of feelings of hunger and satiety as a result of the intervention, which in turn led to changes of food choice, portion size and adjusted meal timing and frequency.

Conclusions

Findings show that HT is acceptable from a patient perspective, and results can be used to inform the translation of HT programme to healthcare settings.

Trial registration number

ACTRN12618001257257.

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<![CDATA[Association of the frequency of spicy food intake and the risk of abdominal obesity in rural Chinese adults: a cross-sectional study]]> https://www.researchpad.co/article/N7d6173e9-e446-41b7-a80f-052a1e984079

Objectives

Recent data relating to the association between spicy food intake frequency and abdominal obesity are limited, especially in low-income areas. Therefore, the study explored the relationship between spicy food intake frequency and abdominal obesity, and assessed the role of energy intake as a mediator of these associations in a rural Chinese adult population.

Design

Cross-sectional study.

Setting

Rural Chinese adult population.

Participants

Subjects from Henan Rural Cohort Study (n=28 773).

Primary outcome measures

The effects of spicy food intake frequency on abdominal obesity were analysed by restricted cubic spline and logistic regression, and the mediation effect was analysed using the bootstrap method.

Results

The adjusted percentages of abdominal obesity were 47.32%, 51.93%, 50.66% and 50.29% in the spicy food intake subgroups of never, 1–2 day/week, 3–5 day/week and 6–7 day/week, respectively. An inverse U-shaped association was found between spicy food intake frequency and abdominal obesity (p<0.01). Compared with subjects who never consumed spicy food, the adjusted ORs (95% CIs) in the 1–2 day/week, 3–5 day/week and 6–7 day/week subgroups were 1.186 (1.093, 1.287), 1.127 (1.038, 1.224) and 1.104 (1.044, 1.169), respectively. Furthermore, the increased odd of abdominal obesity related to more frequent spicy food intake was mediated by higher fat energy intake; the direct and indirect effects were 1.107 (1.053, 1.164) and 1.007 (1.003, 1.012), respectively.

Conclusions

The data indicated that spicy food intake increased the risk of abdominal obesity, and fat energy intake may be a mediator of this association in rural Chinese populations. Clarifying the mechanisms will facilitate the development of novel preventive and therapeutic approaches for abdominal obesity.

Trial registration number

ChiCTR-OOC-15006699

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<![CDATA[Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire]]> https://www.researchpad.co/article/N4b74ecb2-6e80-4a2a-b7bd-cc6e9a8367dd

Objectives

To examine knowledge and beliefs about the biological roles of dietary inorganic nitrate in UK-based nutrition professionals, and to explore potential differences by participants’ education level.

Setting

An online questionnaire was administered to UK-based nutrition professionals, exploring knowledge and/or beliefs across five areas: (1) health and performance effects of nitrate; (2) current and recommended intake values for nitrate; (3) dietary sources of nitrate; (4) methods of evaluating nitrate intake and (5) nitrate metabolism.

Participants

One hundred and twenty-five nutrition professionals.

Primary outcome

Knowledge and beliefs about inorganic nitrate.

Results

Most nutrition professionals taking part in the survey had previously heard of inorganic nitrate (71%) and perceived it to be primarily beneficial (51%). The majority believed that nitrate consumption can improve sports performance (59%) and reduce blood pressure (54%), but were unsure about effects on cognitive function (71%), kidney function (80%) and cancer risk (70%). Knowledge of dietary sources of nitrate and factors affecting its content in food were generally good (41%–79% of participants providing correct answers). However, most participants were unsure of the average population intake (65%) and the acceptable daily intake (64%) of nitrate. Most participants (65%) recognised at least one compound (ie, nitric oxide or nitrosamines) that is derived from dietary nitrate in the body. Knowledge of nitrate, quantified by a 23-point index created by summing correct responses, was greater in individuals with a PhD (p=0.01; median (IQR)=13 (9–17)) and tended to be better in respondents with a masters degree (p=0.054; 13 (8–15)) compared with undergraduate-level qualifications (10 (2–14)).

Conclusions

UK-based nutrition professionals demonstrated mixed knowledge about the physiology of dietary nitrate, which was better in participants with higher education. More efficient dissemination of current knowledge about inorganic nitrate and its effects on health to nutrition professionals will support them to make more informed recommendations about consumption of this compound.

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<![CDATA[Role for structured telephone clinics in paediatric gastroenterology: reflections, lessons and patient feedback]]> https://www.researchpad.co/article/5c8ad954d5eed0c4849a0d99

Background

Telephone clinics have been established within our department to try and improve communication with families, limit waiting times and help face-to-face clinics run more efficiently. As part of the ongoing care needs for our patients and families it was felt important to determine if telephone clinics were meeting the needs of the young person and family as well as those of the health professional.

Objective

To assess the effects of a structured consultant delivered telephone clinic.

Method

Data were collected regarding patients who had a consultant telephone appointment between July 2016 and March 2017. Data collected include demographics and appointment reason. An evaluation questionnaire was sent to all parent/carer(s).

Results

25 clinics comprising 194 contacts, including 34 duplicate contacts. 120 questionnaires sent. 7/160 (4.3%) were new patients. The main contact reason was biopsy results after endoscopy (93/180; 52%). Failure to attend rate was significantly lower at 18/194 (9.2%) compared with failure to attend rate of 52/240 (21.6%) for a traditional clinic (p<0.001). 40/120 (33%) returned completed questionnaires, 25/40 (68.4%) reported the reason for appointment was test results. Travel time and school attendance were identified as main advantages. Mean parental rating score for the service was 8/10 with 21/40 (54%) scoring the service as 10/10.

Conclusion

The initial results of this audit are promising. Structured telephone appointments have a key role in delivering patient care in paediatric gastroenterology and have benefits to health professional, parent/carer and patients. These clinics have now been widely adopted by all members of our department.

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<![CDATA[The Molecular Basis for Oat Intolerance in Patients with Celiac Disease]]> https://www.researchpad.co/article/5989da4fab0ee8fa60b8d922

Abstract

Background

Celiac disease is a small intestinal inflammatory disorder characterized by malabsorption, nutrient deficiency, and a range of clinical manifestations. It is caused by an inappropriate immune response to dietary gluten and is treated with a gluten-free diet. Recent feeding studies have indicated oats to be safe for celiac disease patients, and oats are now often included in the celiac disease diet. This study aimed to investigate whether oat intolerance exists in celiac disease and to characterize the cells and processes underlying this intolerance.

Methods and Findings

We selected for study nine adults with celiac disease who had a history of oats exposure. Four of the patients had clinical symptoms on an oats-containing diet, and three of these four patients had intestinal inflammation typical of celiac disease at the time of oats exposure. We established oats-avenin-specific and -reactive intestinal T-cell lines from these three patients, as well as from two other patients who appeared to tolerate oats. The avenin-reactive T-cell lines recognized avenin peptides in the context of HLA-DQ2. These peptides have sequences rich in proline and glutamine residues closely resembling wheat gluten epitopes. Deamidation (glutamine→glutamic acid conversion) by tissue transglutaminase was involved in the avenin epitope formation.

Conclusions

We conclude that some celiac disease patients have avenin-reactive mucosal T-cells that can cause mucosal inflammation. Oat intolerance may be a reason for villous atrophy and inflammation in patients with celiac disease who are eating oats but otherwise are adhering to a strict gluten-free diet. Clinical follow-up of celiac disease patients eating oats is advisable.

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<![CDATA[Children Born to HIV-Infected Mothers in C&#244;te d'Ivoire: Methodological Clarifications Needed]]> https://www.researchpad.co/article/5989da79ab0ee8fa60b97bd9 ]]> <![CDATA[Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance]]> https://www.researchpad.co/article/5b45a010463d7e50b4360cad

Objective

Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight.

Setting

Four multiethnic birth cohorts based in Canada (the NutriGen Alliance).

Participants

3997 full-term mother–infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores—plant-based, Western and health-conscious—and birth weight data.

Results

No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (β=−67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (β=−65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (β=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption.

Conclusions

Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight.

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<![CDATA[Does Industry Sponsorship Undermine the Integrity of Nutrition Research?]]> https://www.researchpad.co/article/5989daa1ab0ee8fa60ba5e3e

Drug companies have tried to influence the scientific record so as to make their products look healthier. Are food companies doing the same?

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<![CDATA[Meat Consumption and Cancer Risk]]> https://www.researchpad.co/article/5989da14ab0ee8fa60b7abe0

The authors review the key studies on the association between meat intake and cancer risk, including a new prospective cohort study by Amanda Cross and colleagues published inPLoS Medicine.

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<![CDATA[Food Insecurity—A Risk Factor for HIV Infection]]> https://www.researchpad.co/article/5989da82ab0ee8fa60b9ae92

Nigel Rollins discusses a new study showing that food insufficiency is a risk factor for increased sexual risk-taking in women in Botswana and Swaziland.

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<![CDATA[Type 2 Diabetes: Hypoinsulinism, Hyperinsulinism, or Both?]]> https://www.researchpad.co/article/5989da49ab0ee8fa60b8c6a7

The author discusses a new study reporting the birth weight of patients carrying a mutation in either of two closely related genes associated with maturity-onset diabetes of the young, testing the hypothesis that the primary defect caused by these genes results in decreased insulin secretion.

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<![CDATA[Muscle Mitochondrial ATP Synthesis and Glucose Transport/Phosphorylation in Type 2 Diabetes]]> https://www.researchpad.co/article/5989db13ab0ee8fa60bcc8ce

Background

Muscular insulin resistance is frequently characterized by blunted increases in glucose-6-phosphate (G-6-P) reflecting impaired glucose transport/phosphorylation. These abnormalities likely relate to excessive intramyocellular lipids and mitochondrial dysfunction. We hypothesized that alterations in insulin action and mitochondrial function should be present even in nonobese patients with well-controlled type 2 diabetes mellitus (T2DM).

Methods and Findings

We measured G-6-P, ATP synthetic flux (i.e., synthesis) and lipid contents of skeletal muscle with 31P/1H magnetic resonance spectroscopy in ten patients with T2DM and in two control groups: ten sex-, age-, and body mass-matched elderly people; and 11 younger healthy individuals. Although insulin sensitivity was lower in patients with T2DM, muscle lipid contents were comparable and hyperinsulinemia increased G-6-P by 50% (95% confidence interval [CI] 39%–99%) in all groups. Patients with diabetes had 27% lower fasting ATP synthetic flux compared to younger controls (p = 0.031). Insulin stimulation increased ATP synthetic flux only in controls (younger: 26%, 95% CI 13%–42%; older: 11%, 95% CI 2%–25%), but failed to increase even during hyperglycemic hyperinsulinemia in patients with T2DM. Fasting free fatty acids and waist-to-hip ratios explained 44% of basal ATP synthetic flux. Insulin sensitivity explained 30% of insulin-stimulated ATP synthetic flux.

Conclusions

Patients with well-controlled T2DM feature slightly lower flux through muscle ATP synthesis, which occurs independently of glucose transport /phosphorylation and lipid deposition but is determined by lipid availability and insulin sensitivity. Furthermore, the reduction in insulin-stimulated glucose disposal despite normal glucose transport/phosphorylation suggests further abnormalities mainly in glycogen synthesis in these patients.

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<![CDATA[HIV and Cardiovascular Disease: Contribution of HIV-Infected Macrophages to Development of Atherosclerosis]]> https://www.researchpad.co/article/5989dab0ab0ee8fa60bab169 ]]> <![CDATA[From Theory to Practice: Translating Research into Health Outcomes]]> https://www.researchpad.co/article/5989d9e2ab0ee8fa60b69ff7

Commenting on recent research articles which look at the potential health benefits of behaviour change, the PLoS Medicine Editors say that publication of the findings of such research is only one part of the behaviour-change process.

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<![CDATA[Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index]]> https://www.researchpad.co/article/5989daceab0ee8fa60bb56d0

Background

Sleep duration may be an important regulator of body weight and metabolism. An association between short habitual sleep time and increased body mass index (BMI) has been reported in large population samples. The potential role of metabolic hormones in this association is unknown.

Methods and Findings

Study participants were 1,024 volunteers from the Wisconsin Sleep Cohort Study, a population-based longitudinal study of sleep disorders. Participants underwent nocturnal polysomnography and reported on their sleep habits through questionnaires and sleep diaries. Following polysomnography, morning, fasted blood samples were evaluated for serum leptin and ghrelin (two key opposing hormones in appetite regulation), adiponectin, insulin, glucose, and lipid profile. Relationships among these measures, BMI, and sleep duration (habitual and immediately prior to blood sampling) were examined using multiple variable regressions with control for confounding factors.

A U-shaped curvilinear association between sleep duration and BMI was observed. In persons sleeping less than 8 h (74.4% of the sample), increased BMI was proportional to decreased sleep. Short sleep was associated with low leptin (p for slope = 0.01), with a predicted 15.5% lower leptin for habitual sleep of 5 h versus 8 h, and high ghrelin (p for slope = 0.008), with a predicted 14.9% higher ghrelin for nocturnal (polysomnographic) sleep of 5 h versus 8 h, independent of BMI.

Conclusion

Participants with short sleep had reduced leptin and elevated ghrelin. These differences in leptin and ghrelin are likely to increase appetite, possibly explaining the increased BMI observed with short sleep duration. In Western societies, where chronic sleep restriction is common and food is widely available, changes in appetite regulatory hormones with sleep curtailment may contribute to obesity.

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<![CDATA[TV and Inactivity Are Separate Contributors to Metabolic Risk Factors in Children]]> https://www.researchpad.co/article/5989da2dab0ee8fa60b83245

Interventions against childhood obesity will need to target both excess TV viewing and physical inactivity "separately, yet together," say Prentice and Jebb.

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