Weight Gain in Older Adolescent Females: The Internet, Sleep, Coffee, and Alcohol

doi:10.1016/j.jpeds.2008.04.072

The Journal of Pediatrics

Volume 153, Issue 5, November 2008, Pages 635-639.e1

https://doi.org/10.1016/j.jpeds.2008.04.072 Get rights and content

Objectives

To examine whether excessive recreational Internet time, insufficient sleep, regular coffee consumption, or alcoholic beverages promote weight gain.

Study design

A longitudinal cohort of >5000 girls (Growing Up Today Study), from all over the United States and aged 14 to 21 years, returned surveys in 2001 reporting typical past-year recreational Internet time, sleep, coffee (with caffeine), and alcohol consumption. We estimated correlations among these 4 exposures. Each girl also reported her height and weight in 2000 and again in 2001. Multivariate models investigated associations between 1-year change in body mass index and same-year exposures, adjusted for adolescent growth/development, activity, and inactivity.

Results

The exposures were highly (P < .0001) correlated with each other, except for coffee with Internet time (P > .50). More Internet time, more alcohol, and less sleep were all associated (P < .05) with same-year increases in body mass index. Females, aged 18+ years, who slept ≤5 hours/night (P < .01) or who consumed alcohol 2+servings/week (P < .07) gained more body mass index from 2000 to 2001. For females in weight-promoting categories of all exposures, this translates to nearly 4 extra pounds gained over 1 year. We found no evidence that drinking coffee promotes weight gain.

Conclusions

Older girls may benefit from replacing recreational Internet time with sleep and by avoiding alcohol.

Section snippets

Methods

Established in 1996, the Growing Up Today Study includes 16 771 boys and girls from all 50 states who are children of Nurses' Health Study II (NHSII) participants. The study, approved by Human Subjects Committees at Harvard School of Public Health and Brigham and Women's Hospital, is described elsewhere.¹⁴ Mothers provided informed consent, and their children assented by completing baseline questionnaires. The cohort, aged 9 to 14 years in 1996, returned follow-up questionnaires annually

Results

Nearly all participants, daughters of NHSII nurses, are white (95%). At baseline, 12.7% were overweight (85th-95th percentile on BMI charts from the Centers for Disease Control and Prevention), 4.8% were obese (>95th percentile), and 4.7% were very lean (<5th percentile). In 2001, when data were collected on our 4 exposures, 16% of the girls were aged 14 to 15 years, 38% were 16 to 17 years, 34% were 18 to 19 years, and 12% were 20 to 21 years. At that time, 52% of girls were spending 1 to 5

Discussion

Adolescent girls who, between 2000 and 2001, spent more recreational time on the Internet, slept less, or consumed more alcohol, gained more BMI during that year. Although the estimated effects were small, they may accumulate over time and become clinically important as these behaviors are maintained, or more likely magnified, as girls approach adulthood. We found no evidence that coffee consumption promoted weight gain.

Internet time likely promotes weight gain through increased sedentary time,

Funding Information

This study was supported by grant DK46834 from the National Institutes of Health (Bethesda, MD), by a grant from The Breast Cancer Research Foundation (NYC, NY), grant 43-3AEM-0-80074 from the Economic Research Service of the US Department of Agriculture (Washington, DC), grant P30 DK46200 from the Boston Obesity Nutrition Research Center (Boston, MA), and Prevention Research Center Grant U48/CCU115807 from the Centers for Disease Control and Prevention (Atlanta, GA). None of these agencies

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Our data suggest that prolonged Internet use, particularly during leisure time, is associated with less healthful dietary behaviors in Korean adolescents. Am J Clin Nutr 2021;114:1791–1801.
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Despite significant improvements in health and longevity, the gender gap in health persists. Using longitudinal data from 15 waves of the HILDA survey for the period from 2005 to 2019, this paper examines the impacts of risky addictive behaviors given by smoking, drinking and gambling on health outcomes and the gender gap in general and mental health in Australia. To identify the causal effects of cigarette and alcohol consumption, we utilize exogeneous policy changes in the Australian Wine Equalization Tax (WET) and cigarette excise taxes to instrument alcohol and cigarette consumption, respectively. For gambling, we utilize state-level number of gambling machines to instrument the problem gambling severity index. We find that Australian females tend to have better general health but worse mental health outcomes than their male counterparts. More importantly, our instrumental variable estimates reveal the role of risky addictive behaviors in influencing the gender gap in health. Specifically, smoking and gambling widen the gender gap in general health, whereas alcohol consumption plays no role in affecting the gender gap in general health. For mental health, our results show that smoking and gambling reduce the gender gap in mental health, whereas alcohol consumption tends to increase the gender gap in mental health. We find that social support, neighborhood trust, dietary choice and life satisfaction are important channels through which risky addictive behaviors influence general and mental health outcomes. Our results have important policy implications as health quality in general, and gender health equality in particular, are important determinants of standards of living, productivity, and economic development.
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Adolescents often suffer from short and mistimed sleep. To counteract the resulting daytime sleepiness they frequently consume caffeine. However, caffeine intake may exaggerate sleep problems by disturbing sleep and circadian timing. In a 28-hour double-blind randomized crossover study, we investigated to what extent caffeine disturbs slow-wave sleep (SWS) and delays circadian timing in teenagers. Following a 6-day ambulatory phase of caffeine abstinence and fixed sleep-wake cycles, 18 male teenagers (14–17 years old) ingested 80 mg caffeine vs. placebo in the laboratory four hours prior to an electro-encephalographically (EEG) recorded nighttime sleep episode. Data were analyzed using both frequentist and Bayesian statistics. The analyses suggest that subjective sleepiness is reduced after caffeine compared to placebo. However, we did not observe a strong caffeine-induced reduction in subjective sleep quality or SWS, but rather a high inter-individual variability in caffeine-induced SWS changes. Exploratory analyses suggest that particularly those individuals with a higher level of SWS during placebo reduced SWS in response to caffeine. Regarding salivary melatonin onsets, caffeine-induced delays were not evident at group level, and only observed in participants exposed to a higher caffeine dose relative to individual bodyweight (i.e., a dose > 1.3 mg/kg). Together, the results suggest that 80 mg caffeine are sufficient to induce alertness at a subjective level. However, particularly teenagers with a strong need for deep sleep might pay for these subjective benefits by a loss of SWS during the night. Thus, caffeine-induced sleep-disruptions might change along with the maturation of sleep need.
Sleep problemsand complexity of mental health needs in adolescent psychiatric inpatients
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In fact, sleep problems are fairly common in adolescents with anorexia nervosa and bulimia (Delvenne et al., 1992). However, few adolescents from the present sample held a formal eating disorder diagnosis, suggesting that sleep problems may also relate to more subtle eating disturbances such as weight gain (Berkey et al., 2008; Jarrin et al., 2013). Secondly, a positive association was found between sleep problems and adjustment to trauma, echoing previous findings indicating that poor sleep might hinder adjustment to trauma (Bryant et al., 2010; Caldwell and Redeker, 2005; Charuvastra and Cloitre, 2009; Fan et al., 2017; Gerhart et al., 2014; Noll et al., 2006; Tang et al., 2018).
Sleep problems are highly co-morbid with psychiatric disorders and are part of the complex and multiple factors contributing to symptoms and functional disability. The current study aimed to determine how sleep problems in the period preceding psychiatric admission relate to profiles of mental health needs in adolescent inpatients. This retrospective study included 424 adolescents (13–17 years) admitted over a five-year period to an acute crisis stabilization unit in a tertiary care pediatric hospital. Adolescents were divided into two age- and sex-matched groups based on the presence of moderate to severe sleep problems. Profiles of mental health needs were assessed at admission using the Child and Adolescent Needs and Strengths - Mental Health Acute (CANS-MH) and a complexity score was calculated as the total number of actionable CANS-MH items. Results showed a positive association between sleep problems and needs pertaining to eating disturbances, adjustment to trauma, and school attendance. Odds ratios for sleep problems increased progressively as the complexity scores increased, reaching a plateau at six needs beyond which odds ratios remained at their highest level. Adolescents with sleep problems were more likely to undergo medication changes during psychiatric hospitalization and were more likely to be discharged with antipsychotic medication. These findings suggest that sleep difficulties in adolescent inpatients may be associated with distinct and more complex profiles of mental health needs. The evaluation of sleep problems early in the course of psychiatric hospitalization may be an important part of the psychiatric assessment process to inform the global treatment plan.
Environment-wide association study on childhood obesity in the U.S.
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Citation Excerpt :
While there are numerous studies on its role on obesity, study findings have been inconclusive. Our study findings are supported by evidence from a few studies (Lopez-Garcia et al., 2006; Li et al., 2015) while in confliction with others (Dulloo et al., 1989; Astrup et al., 1990; Bracco et al., 1995; Acheson et al., 2004; Striegel-Moore et al., 2006; Berkey et al., 2008). Berkey et al. (2008) found no association between caffeine and weight gain while on the other hand, Lopez-Garcia found a positive association between caffeine and obesity among adults.
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Original articleWeight Gain in Older Adolescent Females: The Internet, Sleep, Coffee, and Alcohol

Objectives

Study design

Results

Conclusions

Section snippets

Methods

Results

Discussion

Funding Information

J Pediatr

J Pediatr

Ann Epidemiol

J Adolescent Health

Physiol Behav

Am J Clin Nutr

Am J Clin Nutr

Am J Clin Nutr

Prevalence of overweight and obesity in the United States, 1999-2004

JAMA

Social and economic consequences of overweight in adolescence and young adulthood

N Engl J Med

Long-term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935

N Engl J Med

Environmental contributions to the obesity epidemic

Science

Evidence for a role of developmental genes in the origin of obesity and body fat distribution

Proc Natl Acad Sci USA

Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth

Int J Obes

Use of information and communication technology and prevalence of overweight and obesity among adolescents

Int J Obes (Lond)

Original article
Weight Gain in Older Adolescent Females: The Internet, Sleep, Coffee, and Alcohol