WHAT'S KNOWN ON THIS SUBJECT: Epidemiologic studies have documented that children' s sleep duration is associated with obesity risk. Experimental studies with adults suggest that short sleep may lead to changes in appetite-regulating hormones and food intake, which could lead to weight gain over time. WHAT THIS STUDY ADDS:This controlled experimental study demonstrates that compared to sleeping less, when children increase sleep, they report decreased caloric intake, have lower fasting leptin levels, and weigh less. Such changes, if maintained, could help prevent excess weight gain over time.abstract OBJECTIVE: To examine the effect of experimental changes in children' s sleep duration on self-reported food intake, food reinforcement, appetite-regulating hormones, and measured weight. METHODS:Using a within-subjects, counterbalanced, crossover design, 37 children, 8 to 11 years of age (27% overweight/obese) completed a 3-week study. Children slept their typical amount at home for 1 week and were then randomized to either increase or decrease their time in bed by 1.5 hours per night for 1 week, completing the alternate schedule on the third week. Primary outcomes were dietary intake as assessed by 24-hour dietary recalls, food reinforcement (ie, points earned for a food reward), and fasting leptin and ghrelin. The secondary outcome was child weight.RESULTS: Participants achieved a 2 hour, 21 minute difference in the actigraph defined sleep period time between the increase and decrease sleep conditions (P , .001). Compared with the decrease sleep condition, during the increase condition, children reported consuming an average of 134 kcal/day less (P , .05), and exhibited lower fasting morning leptin values (P , .05). Measured weights were 0.22 kg lower during the increase sleep than the decrease sleep condition (P , .001). There were no differences in food reinforcement or in fasting ghrelin. CONCLUSIONS:Compared with decreased sleep, increased sleep duration in school-age children resulted in lower reported food intake, lower fasting leptin levels, and lower weight. The potential role of sleep duration in pediatric obesity prevention and treatment warrants further study. Pediatrics 2013;132:e1473-e1480 Dr Hart conceptualized and designed the study, obtained funding, oversaw execution of the study, and drafted the initial manuscript; Dr Carskadon helped to design and execute the study and reviewed and revised the manuscript; Dr Considine helped to design the study, analyzed blood samples, and reviewed and revised the manuscript; Dr Fava carried out data analyses and reviewed and revised the manuscript; Ms Lawton coordinated data collection, scored actigraphy data, and reviewed and revised the manuscript; Dr Raynor helped conceptualize and design the study and reviewed and revised the manuscript; Dr Jelalian helped design the study and reviewed and revised the manuscript; Dr Owens helped design the study and reviewed and revised the manuscript; Dr Wing helped conceptualize and design the study and reviewed and revi...

Objective: To evaluate demographic and psychosocial predictors of attrition and weight loss in a behaviorally based adolescent weight control trial. Methods and Procedures: Adolescents (N = 76) aged 13-16 years and 20-80% overweight (M = 60.56%, s.d. = 15.17%) received standard group-based behavioral treatment as part of a randomized trial comparing different activity interventions for overweight adolescents. Anthropometric and psychosocial measures were obtained at baseline and after the 16-week intervention. Results: Higher parent (P < 0.01) and adolescent BMI (P < 0.05) at baseline, as well as ethnic minority status (P < 0.05) were significantly associated with attrition in univariate analyses. Parent BMI remained the only significant predictor of attrition in multivariate analyses. BMI change for completers (N = 62) was highly variable, ranging from -6.09 to +1.62 BMI units. Male gender (P < 0.01) was a significant predictor of reduction in BMI, whereas not being from an ethnic minority group (P < 0.05) and attendance at group sessions (P = 0.05) were associated with ≥5% absolute weight loss in multivariate analyses. Absolute weight loss during the first 4 weeks of the program was strongly associated with weight loss (pr = 0.44, P < 0.001) during the remainder of the intervention. Psychosocial variables were unrelated to attrition or treatment outcome. Discussion: These findings highlight the potential importance of attending to parental BMI in efforts to retain adolescent participants in treatment, as well as the need to develop weight control interventions that are more effective for ethnic minority youth.