Adölesanlarda Sağlıklı Beslenme ve Uyku Hijyeni Eğitimlerinin Vücut Ağırlığı ve İlgili Parametrelere Etkisi
Özet
Eğlenoğlu HD. The Effect of Healthy Nutrition and Sleep Hygiene Education on Body Weight and
Related Parameters in Adolescents, Hacettepe University Graduate School of Health Sciences
Nutrition and Dietetics Program Doctoral Thesis, 2023. Childhood obesity is a public health problem
that is growing every day and paves the way for a range of chronic diseases in adulthood. Sleep
deprivation is known to increase the risk of obesity, and sleep patterns are disrupted during
adolescence as well as dietary patterns. This randomised controlled clinical trial investigated the
effects of nutrition and sleep hygiene education on nutritional status, diet quality, anthropometrical
measurements, body weight associated biochemical indicators, sleep habits and sleep quality in preobese and obese adolescents. In the study, 60 pre-obese and obese participants, 38 girls and 22
boys, aged 12-18 years attending an outpatient clinic were followed up with a healthy nutrition
education programme for 12 weeks, and at week 6 the participants were randomised into two
groups, and the intervention group (n=30) was given sleep hygiene education for the rest 6 weeks in
addition to the nutrition education. Participants were interviewed face-to-face at baseline, 6 weeks
and 12 weeks, and online at weeks 2, 4, 8 and 10. The face-to-face interviews included a physical
examination, blood sampling, anthropometric measurements, a 3-day dietary recall and food
frequency questionnaire, and diet quality score which was assessed using the Healthy Eating Index2010. Serum leptin and ghrelin levels were analysed by ELISA. Moreover, participants' sleep quality
was assessed using the Pittsburgh Sleep Quality Index, sleep hygiene using the Sleep Hygiene Index,
chronotype using the Children's Chronotype Scale, night time eating habits using the Night Eating
Questionnaire, and sleep habits and social jetlag status using sleep diaries. The online interviews
included the assessment of the adherence of healthy nutrition programme and nutritional status in
both groups, as well as the adherence to the sleep hygiene education after week 6 in the intervention
group. The study showed that dietary intakes of energy, carbohydrate and fat, and the percentage of
energy from fat and saturated fat decreased in both groups and genders, while percentage of energy
from protein and intakes of total fibre, insoluble fibre, vitamin B6, potassium, magnesium and
phosphorus increased by the nutrition education programme (p<0.05 for each). The total HEI-2010
scores of the participants increased from 45.8 (34.8-57.6) to 74.5 (63.4-86.7) in the intervention
group and from 44.1 (32.6-57.4) to 69.6 (48.3-77.0) in the control group during the study, and this
increase was found to be higher in the intervention group after sleep hygiene education (p<0.001 for
each). Body weight, body mass index, waist circumference, waist-to-height ratio and body fat mass
decreased in both groups and genders by the nutrition education, and the changes in these
parameters were higher in the intervention group than in the control group between week 6 and
week 12 (p<0.05 for each). In the both groups, fasting plasma insulin, serum triglycerides and GGT,
HOMA-IR, visceral adiposity index and blood pressure levels decreased whereas serum ghrelin levels
increased by the nutrition education (p<0.05 for each). Morningness/eveningness scores decreased
in both groups, with a greater decrease between week 6 and week 12 in the intervention group
(p<0.001 for each). By the nutrition education, mean sleep duration scores increased in both groups,
while total sleep quality, night eating questionnaire and sleep hygiene scores decreased, and these
changes were more pronounced in the intervention group between week 6 and week 12 (p<0.001 for
each). There was a greater decrease in bedtime and social jetlag duration in the intervention group
compared to the control group, and a greater increase in weekday morning wake-up time, weekday
total sleep time, and weekday time spent in bed (p<0.001 for each). Sleep hygiene education had a
positive effect on sleep habits, sleep hygiene, sleep quality, diet quality and anthropometric
measurements. In line with these results, it is predicted that planning sleep hygiene education in
addition to the nutrition education will have important benefits in the prevention and treatment of
obesity and its possible complications in adolescents.
