Children looking at screens in darkness before bedtime are at risk of poor sleep

Pre-teens who use a mobile phone or watch TV in the dark an hour before bed are at risk of not getting enough sleep compared to those who use these devices in a lit room or do not use them at all before bedtime.
The study by researchers from the University of Lincoln, Imperial College London, Birkbeck, University of London and the Swiss Tropical and Public Health Institute in Basel, Switzerland is the first to analyse the pre-sleep use of media devices with screens alongside the impact of room lighting conditions on sleep in pre-teens.
It found that night-time use of phones, tablets and laptops is consistently associated with poor sleep quality, insufficient sleep, and poor perceived quality of life. Insufficient sleep has also been shown to be associated with impaired immune responses, depression, anxiety and obesity in children and adolescents.
Data was collected from 6,616 adolescents aged between 11 and 12 and more than 70 per cent reported using at least one screen based device within one hour of their bedtime. They were asked to self-report a range of factors including their device use in both lit and darkened rooms, their weekday and weekend bedtimes, how difficult they found it to go to sleep and their wake up times.
The results showed that those who used a phone or watched television in a room with a light on were 31 per cent more likely to get less sleep than those who didn't use a screen. The likelihood increased to 147 per cent if the same activity took place in the dark.
It has been reported that globally, 90 per cent of adolescents are not sleeping the recommended nine to 11 hours per night, which has coincided with an increase in the use of screen-based media devices. In the UK alone, it is estimated that 98 per cent of 12 to 15 year olds watch television and over 90 per cent use mobile phones at home.
Previous studies have shown that sufficient sleep duration and quality are vital in childhood to maintain physical and mental development. Sleep is also crucial for cognitive processes and a lack of sufficient sleep has been directly related to poor academic performance.
Lead author, Dr Michael Mireku, a researcher at the University of Lincoln's School of Psychology said: "While previous research has shown a link between screen use and the quality and length of young people's sleep, ours is the first study to show how room lighting can further influence this.
"Our findings are significant not only for parents but for teachers, health professionals and adolescents themselves. We would recommend that these groups are made aware of the potential issues surrounding screen use during bedtime including insufficient sleep and poor sleep quality."
The full research paper 'Night-time screen-based media device use and adolescents' sleep and health related quality of life' was published in Environment International and can be accessed here https://www.sciencedirect.com/science/article/pii/S0160412018312418

Sleep, mood affect how 'in control' older adults feel

Psychology researchers have found another reason that sleep, mood and stress are important: they affect the extent to which older adults feel they have control over their lives. The findings can inform efforts to improve an individual's sense of control, which has ramifications for physical, mental and emotional health.
"We found that sleep, mood and stress are all important factors in determining a sense of control and in whether older adults feel they can do the things they want to do," says Shevaun Neupert, a professor of psychology at NC State and co-author of a paper on the work. "This finding is important because when older adults begin to lose their sense of autonomy, it can lead to changes in behavior that adversely affect their health and well-being."
For this study, researchers evaluated data on 205 people between the ages of 60 and 94. Study participants provided information on a wide range of psychological variables on eight days across a period of three weeks.
The researchers focused on determining which variables, if any, had an effect on two "control beliefs": perceived competence, or an individual's sense that her or she could do the things they wanted to do; and locus of control, or sense that they were in control of their own lives. The researchers found that several variables have a significant effect on both beliefs.
"We found that sleep efficacy - or the belief that one can get a good night's sleep - was associated with better control beliefs," Neupert says.
"We also found that positive affect was good for an individual's control beliefs, while negative affect was bad," says Shenghao Zhang, a Ph.D. student at NC State and first author of the paper. "In other words, being in a good mood made people feel better about their competence and control, while being in a bad mood made people feel worse about those things.
"Lastly, we found that stressful events on one day had an adverse effect on an individual's subsequent control beliefs," Zhang says. "These results suggest that the adverse effect of stressful events can last for more than a day. It would be interesting to conduct additional work to determine how long the effects of stress resonate in regard to control beliefs."
"We know there are things people can do to improve their mood and to improve their sleep," Neupert says. "And while sleep and mood are things most people think are important, this study highlights a very specific reason that they are important.
"When people think they have little or no control in their lives, they may stop doing some of the everyday things that are important for self-care - because they believe those things don't matter," Neupert says. "By acting to improve mood and sleep, older adults may better retain their sense of control and better maintain their quality of life."
The paper, "Predicting Control Beliefs in Older Adults: A Micro-longitudinal Study," is published in the Journal of Gerontology: Psychological Sciences. Corresponding author of the paper is Jason Allaire, an associate professor of psychology at NC State. The paper was co-authored by Alyssa Gamaldo, a former Ph.D. student at NC State who is now an assistant professor at Penn State University.

Does the 'buddy system' approach to weight loss work?

One of the more common self-improvement goals, particularly in the winter months before "beach body" season, is to lose weight. How people attempt to achieve their goals may vary by individual, but one of the more popular approaches is enrollment in a commercial weight loss program that uses a 'buddy system' approach to weight loss.
This is where the program's design is aimed to shape and optimize a sense of community among participants to generate a positive impact on the participants' individual weight loss efforts.
So, does it work?
According to some new research, it does, but possibly not in the ways most people assume.
The study to be published in the January edition of the INFORMS journal Marketing Science is titled "Inspiration from the 'Biggest Loser': Social Interactions in a Weight Loss Program," and is authored by Kosuke Uetake of Yale University, and Nathan Yang of McGill University in Montreal.
The study focused on how individuals lose weight when they participate in commercial weight loss programs. The researchers' analysis included a review of data from a large U.S.-based weight loss program with nearly 2 million participants. The program does not explicitly restrict certain food groups. Instead it adopts a calorie budgeting system that gives participants freedom to eat any type of food so long as they do not exceed their daily calorie budget.
"The use of peer effects, otherwise known as the 'buddy system,' can have an impact on weight loss," said Uatake. "But those peer dynamics can have either encouraging or discouraging effects, so it is important to know what works and what does not."
The researchers found that the showcasing of average weight loss among a peer group can have a negative effect on an individual participant's actual weight loss. More specifically, when an individual compares himself or herself to their peer group, it can be discouraging.
On the other hand, when the results of top performers in the weight loss program are showcased, it can have an encouraging effect on other participants' individual weight loss. Individuals tend to be more inspired by those who have achieved the most significant results.

"Meeting leaders can use the weight loss successes of top performers to provide inspiration to the group, and perhaps avoid using the overall group's success as the benchmark," said Yang. "In addition, weight loss program leaders can design the composition of groups so that meeting participants benefit from the encouraging effects of top performers, while minimizing the discouraging effects of average performers."

Healthy diet

Key facts

• A healthy diet helps to protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including such as diabetes, heart disease, stroke and cancer.
• Unhealthy diet and lack of physical activity are leading global risks to health.
• Healthy dietary practices start early in life – breastfeeding fosters healthy growth and improves cognitive development, and may have longer term health benefits such as reducing the risk of becoming overweight or obese and developing NCDs later in life.
• Energy intake (calories) should be in balance with energy expenditure. To avoid unhealthy weight gain, total fat should not exceed 30% of total energy intake (1, 2, 3). Intake of saturated fats should be less than 10% of total energy intake, and intake of trans-fats less than 1% of total energy intake, with a shift in fat consumption away from saturated fats and trans-fats to unsaturated fats (3), and towards the goal of eliminating industrially-produced trans-fats (4, 5, 6).
• Limiting intake of free sugars to less than 10% of total energy intake (2, 7) is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits (7).
• Keeping salt intake to less than 5 g per day (equivalent to sodium intake of less than 2 g per day) helps to prevent hypertension, and reduces the risk of heart disease and stroke in the adult population (8).
• WHO Member States have agreed to reduce the global population’s intake of salt by 30% by 2025; they have also agreed to halt the rise in diabetes and obesity in adults and adolescents as well as in childhood overweight by 2025 (9, 10).

Overview

Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of noncommunicable diseases (NCDs) and conditions. However, increased production of processed foods, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars and salt/sodium, and many people do not eat enough fruit, vegetables and other dietary fibre such as whole grains.
The exact make-up of a diversified, balanced and healthy diet will vary depending on individual characteristics (e.g. age, gender, lifestyle and degree of physical activity), cultural context, locally available foods and dietary customs. However, the basic principles of what constitutes a healthy diet remain the same.

For adults

A healthy diet includes the following:

• Fruit, vegetables, legumes (e.g. lentils and beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat and brown rice).
• At least 400 g (i.e. five portions) of fruit and vegetables per day (2), excluding potatoes, sweet potatoes, cassava and other starchy roots.
• Less than 10% of total energy intake from free sugars (2, 6), which is equivalent to 50 g (or about 12 level teaspoons) for a person of healthy body weight consuming about 2000 calories per day, but ideally is less than 5% of total energy intake for additional health benefits (6). Free sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
• Less than 30% of total energy intake from fats (1, 2, 3). Unsaturated fats (found in fish, avocado and nuts, and in sunflower, soybean, canola and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) and trans-fats of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and pre-packaged snacks and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and cooking oils and spreads) and ruminant trans-fats (found in meat and dairy foods from ruminant animals, such as cows, sheep, goats and camels). It is suggested that the intake of saturated fats be reduced to less than 10% of total energy intake and trans-fats to less than 1% of total energy intake (5). In particular, industrially-produced trans-fats are not part of a healthy diet and should be avoided (4, 6).
• Less than 5  g of salt (equivalent to about one teaspoon) per day (8).  Salt should be iodized.

For infants and young children

In the first 2 years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing NCDs later in life.
Advice on a healthy diet for infants and children is similar to that for adults, but the following elements are also important:

• Infants should be breastfed exclusively during the first 6 months of life.
• Infants should be breastfed continuously until 2 years of age and beyond.
• From 6 months of age, breast milk should be complemented with a variety of adequate, safe and nutrient-dense foods. Salt and sugars should not be added to complementary foods.

Practical advice on maintaining a healthy diet

Fruit and vegetables

Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs (2) and helps to ensure an adequate daily intake of dietary fibre.
Fruit and vegetable intake can be improved by:

• always including vegetables in meals;
• eating fresh fruit and raw vegetables as snacks;
• eating fresh fruit and vegetables that are in season; and
• eating a variety of fruit and vegetables.

Fats

Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population (1, 2, 3). Also, the risk of developing NCDs is lowered by:

• reducing saturated fats to less than 10% of total energy intake;
• reducing trans-fats to less than 1% of total energy intake; and
• replacing both saturated fats and trans-fats with unsaturated fats (2, 3) – in particular, with polyunsaturated fats.

Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:

• steaming or boiling instead of frying when cooking;
• replacing butter, lard and ghee with oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower and sunflower oils;
• eating reduced-fat dairy foods and lean meats, or trimming visible fat from meat; and
• limiting the consumption of baked and fried foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies, biscuits and wafers) that contain industrially-produced trans-fats.

Salt, sodium and potassium

Most people consume too much sodium through salt (corresponding to consuming an average of 9–12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke (8, 11).
Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year (12).
People are often unaware of the amount of salt they consume. In many countries, most salt  comes from processed foods (e.g. ready meals; processed meats such as bacon, ham and salami; cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the point of consumption (e.g. table salt).
Salt intake can be reduced by:

• limiting the amount of salt and high-sodium condiments (e.g. soy sauce, fish sauce and bouillon) when cooking and preparing foods;
• not having salt or high-sodium sauces on the table;
• limiting the consumption of salty snacks; and
• choosing products with lower sodium content.

Some food manufacturers are reformulating recipes to reduce the sodium content of their products, and people should be encouraged to check nutrition labels to see how much sodium is in a product before purchasing or consuming it.
Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.

Sugars

In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake (2, 7).  A reduction to less than 5% of total energy intake would provide additional health benefits (7).
Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases (13).
Sugars intake can be reduced by:

• limiting the consumption of foods and drinks containing high amounts of sugars, such as sugary snacks, candies and sugar-sweetened beverages (i.e. all types of beverages containing free sugars – these include carbonated or non‐carbonated soft drinks, fruit or vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee and flavoured milk drinks); and
• eating fresh fruit and raw vegetables as snacks instead of sugary snacks.

Faster weight loss no better than slow weight loss for health benefits

Losing weight slowly or quickly won't tip the scale in your favour when it comes to overall health, according to new research. Health researchers at York University found that people who lose weight quickly versus those who lose it slowly don't get any additional health benefits and it's the amount of weight lost overall that can have an impact.
In the study led by Jennifer Kuk, associate professor in York University's Faculty of Health, researchers looked at the data of over 11,000 patients at a publicly-funded clinical weight management program and found that those who lost weight quickly had similar improvements in metabolic health with those who lost weight slowly. Moreover, the rate of weight loss matters less for overall health benefits than the amount of weight you lose.
Normally, individuals are recommended to lose weight at one to two pounds per week, as faster weight loss is related with a slightly higher risk for gallstones. However, there are reasons to believe that faster weight loss may have better effects for cardiovascular disease and diabetes risk factors.
The study is the first study of its kind to look specifically at risk factors for cardiovascular health and diabetes.
"With the same pound for pound weight loss, there is no difference in terms of health benefits if you lose weight fast or slow," says Kuk. "However, given the risk for gallstones with faster weight loss, trying to lose weight at the recommended one to two pounds per week is the safer option."
The study looked at 11,283 patients who attended the Wharton Medical Clinic Weight Management Program between July 2008 and July 2017. Researchers found that patients who lost weight more quickly tended to have a bigger reduction in obesity and better health improvements than patients who lost weight slowly. However, these improvements in health associated with faster weight loss were abolished after adjusting for absolute weight loss.
"The results show that we really need to look at interventions that focus on long-term weight management that can achieve sustained weight loss at the recommended one to two pounds per week," says Kuk.
The study is published today in the Journal of Obesity.

Vegan diets are best for gut hormones and satiety

A study published in the journal Nutrients finds that a vegan diet helps to promote beneficial gut hormones that are responsible for regulating blood sugar, satiety, and weight.

Researchers compared a vegan meal with a meal containing meat and cheese on hormone levels in a group of 60 men: 20 with obesity, 20 with type 2 diabetes, and 20 who were healthy. The meals contained the same amount of calories and ratio of macronutrients.

Across all three groups, the vegan meal increased beneficial gastrointestinal hormones, compared with the non-vegan meal. These hormones are involved in the regulation of glucose metabolism, insulin secretion, energy homeostasis, satiety, and weight management.

"These beneficial gut hormones can help keep weight down, enhance insulin secretion, regulate blood sugar, and keep us feeling full longer," says study author Hana Kahleova, M.D., Ph.D., director of clinical research at the Physicians Committee for Responsible Medicine. "The fact that simple meal choices can increase the secretion of these healthy hormones has important implications for those with type 2 diabetes or weight problems."

In the United States, more than 2 in 3 adults are overweight or obese, while more than 114 million adults have either diabetes or prediabetes. Previous studies have shown that plant-based diets are beneficial for weight loss and that those following a plant-based diet have approximately half the risk of developing diabetes, compared with non-vegetarians.


"This study adds to the mounting evidence that plant-based diets can help manage and prevent type 2 diabetes and obesity," says Dr. Kahleova.

Study participants across all three groups also self-reported that the vegan meal increased satiety, or feelings of after-meal satisfaction. The researchers note that vegan meals are often rich in fiber--a nutrient found in plant foods that adds bulk to the diet without adding extra calories.

A recent report from the World Health Organization found that high-fiber diets reduce the risk for heart disease, diabetes, certain types of cancer, and even premature death.

94 percent of meals served in restaurants contain more than the recommended number of calories

Restaurants frequently serve oversized meals, not only in the United States but also in many other countries, according to a study conducted by an international team of researchers and supported by FAPESP - São Paulo Research Foundation.

Published in the British Medical Journal, the study weighed and measured the energy content of meals served by restaurants in Brazil, China, Finland, Ghana and India.

The results showed that 94% of the most popular main dishes served in sit-down restaurants and 72% of those purchased over the counter from fast food outlets contained more than 600 kilocalories (kcal), the benchmark recently recommended by the United Kingdom's National Health Service (NHS) to help reduce the global obesity epidemic.

The researchers found a significant correlation between meal weight and energy content. They concluded that some popular meals were both far larger and more caloric than necessary.
Examples include Brazil's traditional rice, beans, chicken, cassava and salad with a bread roll (841 g and 1,656 kcal); Ghana's classic fufu, goat and soup (1,105 g and 1,151 kcal); and India's popular mutton biryani (1,012 g and 1,463 kcal).

"Obesity is a world health problem caused by several factors, such as sedentary living, processed food and sugar intake, and overeating. Many people may confuse food craving with hunger. This study shows that any strategy to combat obesity should also consider these excesses," said Vivian Suen, a professor in the Department of Clinical Medicine at the University of São Paulo's Ribeirão Preto Medical School (FMRP-USP), who is a coauthor of the article.
The World Health Organization (WHO) considers obesity a global epidemic and a major risk factor for heart disease, stroke and diabetes, among other diseases. It estimates that 1.9 billion adults are overweight and 600 million are obese worldwide.
According to the study, the selected restaurant and fast food meals supplied between 70% and 120% of the daily energy required by a sedentary woman - approximately 2,000 kcal - except in China, where the energy content of the most popular meals was significantly lower.
"The study did not take into account the mode of preparation or the nutritional composition of the meals analyzed. The fact is that many people who patronize these restaurants are overeating," Suen said.
The researchers measured the energy content of a representative sample of 223 popular meals purchased from 111 randomly selected sit-down restaurants and fast food outlets located in the following five cities: Ribeirão Preto (Brazil), Beijing (China), Kuopio (Finland), Accra (Ghana) and Bangalore (India).
They compared these findings with data from restaurants in Boston (USA) extracted from previous studies by Tufts University. The restaurants and fast food outlets were located within an area of 25 square kilometers around each participating research center.
"The findings refute two widely held ideas. We're not just eating the wrong foods but also overeating, and in terms of calories, a meal considered healthy may often increase the organism's energy balance and hence add more weight than a fast food meal," Suen said.
The results showed that the energy content of a fast food meals was lower on average (809 kcal) than that of a sit-down restaurant meal (1,317 kcal). However, the study was far from being a defense of fast food outlets.
"It can be taken as a warning that while we're focusing on fast food and campaigns to encourage healthy eating, all of which is positive and necessary, we're overlooking important factors such as the sheer amount of food we eat, which can also have a major impact on global obesity," Suen said.
Compensation
Oversized portions also have an effect on the so-called compensation mechanism, Suen explained.
"When nonobese people have a large midday meal, they normally feel less hungry in the evening and eat less for dinner, for example," she said. "However, obese people appear not to have this perception, as has been found in several studies by the research group at Tufts University. Therefore, this regulation in terms of eating less in the next meal doesn't happen in obese individuals."
Another problem with obesity is the organism's resistance to weight loss.
"There are countless diets - low carb, high protein, low fat, and so on - but which is best for weight loss? No one truly knows. What matters in the long term is total energy content in terms of calories.
Food quality is also important, of course. Eating low-quality carbohydrates such as saturated fat or large amounts of sugar contributes to diseases associated with excessive intake of these products. Weight gain is associated with excessive calorie intake," Suen said.