by Keith-Thomas Ayoob, EdD, RD, FADA
Sleep can be a Catch-22: Most people who are sleep-deprived feel lousy; and people who feel lousy often struggle to sleep. Two new studies suggest food can perpetuate this unhealthy cycle in teens, particularly in teenage girls.
One of the studies, which were presented at the meeting of the Associated Professional Sleep Societies in Minneapolis, found that teen girls who felt pressured to be skinny had more difficulty sleeping than their body-comfortable counterparts.
The other found that sleepy teens were more likely to crave carbohydrates. Together the research suggests teens may have unrealistic expectations of how their bodies should look and what they should eat to fuel them.
"I think ours is one of the first studies to look at body image and sleep," said Katherine Marczyk, a doctoral student at the University of North Texas in Denton, and lead author of the body image study in teen girls. Out of 789 middle school girls in Texas studied, Caucasians were most likely to be affected by pressure from friends and the media and were also most likely to have disrupted sleep.
"If you're not satisfied with how you look, I think you might feel anxious about how you think you look to other people," Marczyk said. "And when you're trying to fall asleep, you might be ruminating about that."
A busy mind can wreak havoc on sleep. And as sleep goes down, carb cravings go up, according to the study by Dr. Mahmood Siddique, director of Sleep and Wellness Medical Associates and associate professor of medicine at Robert Wood Johnson Medical School in New Jersey. Among 262 high school seniors in New Jersey studied, those who reported being sleepy at school were 50 percent more likely to crave carbs, Siddique reported.
While carbs may offer a temporary energy boost, they may not be the smartest choice in the long run.
"Carbs are great, but you need to have them with some protein," said Dr. Keith Ayoob, director of the Rose R. Kennedy Center Nutrition Clinic and associate professor of pediatrics at the Albert Einstein College of Medicine in New York. Protein, he said, blunts the sugar high that comes with carbs as well as the subsequent fall in blood glucose levels -- the sugar lull, so to speak.
"Protein is especially important in the mornings," said Ayoob, who sometimes gives his patients a "two-week challenge," in which he guarantees they'll feel less tired if they eat more protein at breakfast and lunch. "It can be as simple as eating a bit of last night's dinner in addition to that bowl of cereal, or a hard-boiled egg."
And when teens make excuses, parents should help them make the right choices, Ayoob said.
"If they say they don't have time, they have to make time," he said. "They need protein at the right time -- not at night, but in the morning and at lunch." And having lean protein with every meal is not going to cause huge weight gain. It will, however "provide a huge benefit," he said.
Sleep problems as well as disordered eating can signal certain mood disorders, such as anxiety or depression. Siddique found that carb cravings were most intense among depressed teens, he reported.
"Parents should look out for their kids skipping meals," Ayoob said, adding that afternoon fatigue can signal meal skipping.
Also be on the lookout for changes in schoolwork, appetite and sleep patterns in teens, Ayoob said.
"If they can't seem to go to sleep at night for extended period of time, you want to make sure that a doctor is involved," he said. "And if you suspect an eating disorder, that's a sign they need help.”