Timing and duration of sleep and meals in obese and normal weight women. Association with increase blood pressure.

The aim was to evaluate the efficiency and duration of sleep and meals in normal-weight and obese women and the impact of these factors on metabolic syndrome (MetS) variables. The study was conducted in 70 women, normal-weight women (n=20) and obese women (n=50). Anthropometric variables, plasma glucose, lipids and ghrelin concentrations were determined. Blood pressure measurement was performed before lunch and before dinner for a week on alternate days. Subjects were instructed to keep a sleep and feeding diary. In general, obese women displayed longer and a significantly higher number of awakenings per week than normal-weight women and a higher duration of naps. Sleep efficiency was significantly lower in obese women. The higher intake in energy in the obese women was due to snacking differences. Moreover, higher sleep efficiency was correlated with a decrease in the diastolic blood pressure evening/morning ratio. Interestingly, among normal-weight women, visceral fat increased with the number of awakenings while plasma ghrelin was inversely correlated with meal duration (P=0.027). In conclusion, obese women had lower sleep efficiency, ate more quickly and spent more time eating and sleeping during the daytime hours than normal-weight women. Of note, sleep efficiency was associated with MetS features. Further interventions in obesity could include educating patients in food timing and in healthier sleep-hygiene practices, helping them to modify bad sleep habits.

Toward a chronobiological characterization of obesity and metabolic syndrome in clinical practice.

BACKGROUND & AIMS: To test several circadian rhythm variables in a female population to identify the best tool to assess chronodisruption in obesity and metabolic syndrome (MetS) to define a score to be used for chronodisruption characterization in clinical practice. METHODS: Anthropometric measurements and markers of circadian rhythms, such as sleep and feeding diary, Horne-Ostberg questionnaire, melatonin and cortisol measurements, and wrist temperature measurements, were determined. MetS variables were also analyzed. Study was conducted in 70 women. Data were subjected to factor analysis. Receiver operating characteristic curves were used as predictors of chronodisruption risk, and a score was calculated to classify the subjects of risk. RESULTS: Factor analysis showed that the first-factor grouped variables were related to the skin temperature measurement. Second factor consisted of variables related to salivary cortisol levels and obesity-related measurements. Third factor included variables related to sleep-wake cycle. Fourth factor referred to peripheral temperature variables and included the classification of subjects according to the Horne-Ostberg questionnaire. To obtain a final punctuation we performed the weighted mean of the first four factors. The final range was from 27 to 57, mean value of 42. Punctuation was defined as the "chronodisruption score." Women displaying higher chronodisruption scores had higher MetS risk. CONCLUSION: The study demonstrates that wrist temperature recordings, together with two questions of sleep onset and offset, and one morning salivary cortisol determination could be enough to characterize the chronobiology of obesity and MetS, a new chronodisruption score was developed.

Validation of a questionnaire on emotional eating for use in cases of obesity: the Emotional Eater Questionnaire (EEQ).

INTRODUCTION: Emotions have a powerful effect on our choice of food and eating habits. It has been found that in some people there is relationship between eating, emotions and the increased energy intake. This relationship should be measurable to better understand how food is used to deal with certain mood states and how these emotions affect the effectiveness of weight loss programs. OBJECTIVE: To develop and analyze the psychometric characteristics of a questionnaire on emotional eating for obesity easy to apply in clinical practice. SUBJECTS AND METHODS: A ten-item questionnaire called Emotional-Eater-Questionnaire (EEQ) was developed and administered to a total of 354 subjects (body mass index, 31 ± 5), aged 39 ± 12, who were subjected to a weight-reduction program. The questionnaire was specifically designed for obesity. Analysis of the internal structure, internal consistency, test-retest reliability and convergent validity with Mindful-Eater-Questionnaire (MEQ) were conducted. RESULTS: After principal components analysis, the questionnaire was classified in three different dimensions that explained 60% of the total variance: Disinhibition, Type-of-food and Guilt. Internal consistency showed that Cronbach's alpha was 0.773 for the "Dishinibition" subscale, 0.656 for the "Type of food" subscale and 0.612 for the "Guilt" subscale. The test-retest stability was r = 0.70. The data showed that the percentage of agreement between the EEQ and the MEQ was around 70% with a Kappa index of 0.40; P < 0.0001. CONCLUSION: We have presented a new questionnaire, which classifies individuals as a function of the relation between food intake and emotions. Such information will permit personalized treatments to be designed by drawing up early strategies from the very beginning of treatment programmes.

Differences in daily rhythms of wrist temperature between obese and normal-weight women: associations with metabolic syndrome features.

The circadian rhythm of core body temperature is associated with widespread physiological effects. However, studies with other more practical temperature measures, such as wrist (WT) and proximal temperatures, are still scarce. The aim of this study was to investigate whether obesity is associated with differences in mean WT values or in its daily rhythmicity patterns. Daily patterns of cortisol, melatonin, and different metabolic syndrome (MetS) features were also analyzed in an attempt to clarify the potential association between chronodisruption and MetS. The study was conducted on 20 normal-weight women (age: 38 ± 11 yrs and BMI: 22 ± 2.6 kg/m(2)) and 50 obese women (age: 42 ± 10 yrs and BMI: 33.5 ± 3.2 kg/m(2)) (mean ± SEM). Skin temperature was measured over a 3-day period every 10 min with the "Thermochron iButton." Rhythmic parameters were obtained using an integrated package for time-series analysis, "Circadianware." Obese women displayed significantly lower mean WT (34.1°C ± 0.3°C) with a more flattened 24-h pattern, a lower-quality rhythm, and a higher intraday variability (IV). Particularly interesting were the marked differences between obese and normal-weight women in the secondary WT peak in the postprandial period (second-harmonic power [P2]), considered as a marker of chronodisruption and of metabolic alterations. WT rhythmicity characteristics were related to MetS features, obesity-related proteins, and circadian markers, such as melatonin. In summary, obese women displayed a lower-quality WT daily rhythm with a more flattened pattern (particularly in the postprandial period) and increased IV, which suggests a greater fragmentation of the rest/activity rhythm compared to normal-weight women. These 24-h changes were associated with higher MetS risk.