Effects of Anxiety, Depression, and Stress on Sleep Disorder and Night Eating Syndrome in Adolescents: Results of an Internet Survey

PurposeThe current study examined how sleep quality is related to night eating syndrome (NES) via the indirect effects of anxiety, depression, and stress to determine the mechanism of its development. MethodsThis cross-sectional web-based study included 171 adolescents aged 12-18 years (55.0% girls). Participants completed the self-report Night Eating Questionnaire (NEQ), Scales for Outcomes in Parkinson’s disease (SCOPA) Sleep Scale, and Depression, Anxiety and Stress Scale–21 items (DASS-21). ResultsThe results showed that anxiety, depression, and stress directly influenced the NEQ. AMOS path analysis was used to examine whether these also had an indirect influence on the NEQ. Moreover, for the anxiety, depression, and stress subscales, only the anxiety subscale influenced nighttime eating problems due to increased sleep problems, which in turn increased the difficulty of morning sleepiness and falling asleep at night. ConclusionConsequently, depression and stress directly increased nighttime eating problems. Anxiety exacerbates eating problems, both directly and indirectly, through sleep. Behavioral and psychological interventions to reduce anxiety, depression, and stress may be helpful strategies for the treatment of night eating syndrome.Level of evidence: Level IV

Abstract 13175: Social Jet Lag in Eating Patterns as a Marker of Meal Timing Variability is Associated With Elevated Cardiometabolic Risk in the AHA Go Red for Women Strategically Focused Research Network

Introduction: Social jet lag, typically defined as the difference in sleep timing on work vs. free days, is related to elevated cardiovascular disease (CVD) risk, via circadian disruption. Irregular meal timing may also lead to circadian disruption, but the role of social jet lag in eating patterns in CVD risk has not been examined. Hypothesis: Social jet lag in eating patterns, a measure of meal timing variability, will be associated with elevated cardiometabolic risk in women. Methods: Women from the AHA Go Red for Women SFRN at Columbia (n=116, mean age: 33 y, 45% Hispanic) completed a 1-wk food record using the web-based NIH Automated Self-Administered 24-h Dietary Assessment Tool. Social jet lag in eating patterns was evaluated using the difference between weekday vs. weekend: 1) nightly fasting duration (NFD), 2) time of first meal, and 3) time of last meal. Standard deviation (SD) of % kcal consumed after 5PM and 8PM was used to capture variability in nighttime eating. Cardiovascular health (CVH) was assessed with the AHA Life Simple 7 (LS7) score. Linear regression models adjusted for age, socioeconomic status, and sleep were used to examine associations with CVH, BMI, waist circumference (WC), systolic blood pressure (SBP), diastolic BP (DBP), and fasting glucose. Results: The average time of first meal and NFD on weekdays vs. weekends was 8:54AM vs. 10:11AM and 12.5 h vs. 13.7 h, respectively; average time of last meal was similar (8:27PM). Each 1-h increase in the difference between first meal time on weekdays vs. weekends was associated with higher BMI (β=0.81, p=0.018), WC (β=0.67, p=0.029), DBP (β=1.34, p=0.049), and SBP (β=1.45, p=0.062). Each 1-h increase in the difference between weekday vs. weekend NFD was associated with higher BMI (β=0.55, p=0.045), fasting glucose (β=2.46, p=0.028), and SBP (β=1.17, p=0.058) and lower LS7 score (β=-0.24, p=0.014). Greater variability in nighttime eating (higher %kcal after 5PM and 8PM SD) was associated with higher WC (β=0.014, p=0.020 and β=0.030, p=0.040). Conclusions: Greater meal timing variability was related to poorer CVH and higher BMI, WC, BP, and fasting glucose. Results suggest that stabilizing meal timing patterns should be considered for lowering CVD risk and warrant confirmation in a larger sample.

Habitual Nightly Fasting Duration, Eating Timing, and Eating Frequency are Associated with Cardiometabolic Risk in Women

Nightly fasting duration (NFD) and eating timing and frequency may influence cardiometabolic health via their impact on circadian rhythms, which are entrained by food intake, but observational studies are limited. This 1-year prospective study of 116 US women (33 ± 12y, 45% Hispanic) investigated associations of habitual NFD and eating timing and frequency with cardiovascular health (CVH; American Heart Association Life’s Simple 7 score) and cardiometabolic risk factors. NFD, eating timing and frequency, and nighttime eating levels were evaluated from 1-week electronic food records completed at baseline and 1 y. In multivariable-adjusted linear regression models, longer NFD was associated with poorer CVH (β = −0.22, p = 0.016 and β = −0.22, p = 0.050) and higher diastolic blood pressure (DBP) (β = 1.08, p < 0.01 and β = 1.74, p < 0.01) in cross-sectional and prospective analyses, respectively. Later timing of the first eating occasion at baseline was associated with poorer CVH (β = −0.20, p = 0.013) and higher DBP (β = 1.18, p < 0.01) and fasting glucose (β = 1.43, p = 0.045) at 1 y. After adjustment for baseline outcomes, longer NFD and later eating times were also associated with higher waist circumference (β = 0.35, p = 0.021 and β = 0.27, p < 0.01, respectively). Eating frequency was inversely related to DBP in cross-sectional (β = −1.94, p = 0.033) and prospective analyses (β = −3.37, p < 0.01). In cross-sectional analyses of baseline data and prospective analyses, a higher percentage of daily calories consumed at the largest evening meal was associated with higher DBP (β = 1.69, p = 0.046 and β = 2.32, p = 0.029, respectively). Findings suggest that frequent and earlier eating may lower cardiometabolic risk, while longer NFD may have adverse effects. Results warrant confirmation in larger multi-ethnic cohort studies with longer follow-up periods.

1043 The Relationship Between Nighttime Eating And Body Mass Index

Introduction Late night eating has been associated with higher odds of being overweight or obese. This study aims to evaluate the relationship between late night eating and body mass index in a nationally representative sample. Methods Actigraphy was used to estimate the average bedtime, waketime, duration and midpoint of sleep in the National Health and Nutrition Examination Survey 2003-04 and 2005-06 cohorts. Given the circular nature of clock time, the average was calculated to be the point that minimized the sum of squares of differences between time points. Dietary data was collected through two detailed interviews of the participants. Nighttime calories were defined as the average amount of calories consumed between the average bedtime and the average midpoint of time-in-bed, based on the data recorded during the dietary interviews. Results Higher average nighttime caloric consumption (in units of 100 kcal) was associated with higher BMI [B(95% CI): 0.062 (0.003, 0.121)]; this remained significant after adjustment for age, gender, and race [B(95% CI): 0.084 (0.026, 0.142)]. Higher nighttime caloric consumption (as a percentage of total average daily calories consumption) was associated with higher BMI [B(95% CI): 1.522 (0.312, 2.733)]. This remained significant after adjustment for age, gender, and race [B(95% CI): 1.718 (0.505, 2.931)]. Conclusion Higher nighttime caloric consumption, both in average amount (in units of 100 kcal) and as a percentage of average daily calories consumption, was associated with higher BMI. Additional study is needed to further elucidate the relationship between nighttime eating habits and body mass index. Support NHLBI T32HL110952

Nighttime Eating Is Associated with Poor Diet Quality in Adult Females (P21-055-19)

Objectives Night Eating Syndrome (NES) is a disordered eating pattern characterized by nighttime hyperphagia. Previous research suggests that nighttime eating, especially in individuals with NES, is associated with obesity and higher intake of energy, sodium, saturated fat, and processed foods. The purpose of this study was to examine the effect of nighttime eating on diet quality and weight status in adult females. Methods An online survey was administered to 516 women (age 18–65) from July 2018 thru January 2019. The survey included the validated Night Eating Questionnaire and the National Cancer Institute Diet History Questionnaire (DHQ) II. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. The Diet*Calc program analyzed the DHQ II output to generate estimates of nutrient and food group intake. NCI SAS macros were used to calculate the HEI 2015 component and total scores. IBM SPSS Statistics (version 25) was used to run descriptive statistics and inferential statistics (chi-square tests, independent samples t-tests). Results Of the 516 women, 36 were classified as night eaters and 480 were classified as non-night eaters. The majority of participants were employed (70.3%) and highly educated (95.1% reported some college or higher). Night eaters worked night shifts more often than non-night eaters (P ≤ 0.001). Mean HEI scores were lower in night eaters (58.6 ± 11.1) than in non-night eaters (64.9 ± 9.8) (P ≤ 0.001). There was no difference between the two groups (night eaters, non-night eaters) for BMI; the mean BMI for all participants was 24.1.7 ± 5.5 kg/m2. However, a higher proportion of night eaters than expected were underweight and obese (P ≤ 0.001). There was also an association between nighttime eating and history of eating disorder diagnosis (P ≤ 0.001). Conclusions These findings are consistent with previous research suggesting that nighttime eating is associated with reduced diet quality, unhealthy weight status, and disordered eating. Further research should be directed at understanding hormonal responses to nighttime eating and its affect on weight status and dietary choices. Funding Sources None.