Keryn E. Pasch

Adolescent sleep, risk behaviors, and depressive symptoms: are they linked?

OBJECTIVE To explore how weekday and weekend sleep patterns are related to adolescent substance use, depressive symptoms, and school truancy. METHODS Selfreport surveys of 242 youth (93.4% white, mean age 16.4 years). RESULTS Longer weekday sleep duration was inversely associated with depressive symptoms, past month alcohol use, and drunkenness. Later weekend bedtime and wake-times, compared to those of weekdays, were associated with increased substance use and truancy. CONCLUSIONS Weekday sleep duration appears to be protective for substance use, depression and school truancy for teenagers. However, inconsistent sleep patterns between weekdays and weekends were associated with a range of markers for adolescent risk.

Associations between energy drink consumption and alcohol use behaviors among college students

BACKGROUND To explore associations between energy drink consumption and alcohol use among college students. METHODS Participants included 585 students (m age=18.7; 47.0% White, 21% Hispanic, 25% Asian, 7% other race/ethnicity; 56.0% female). Energy drink behaviors included past month and past week consumption. Alcohol use behaviors included past month and past two week consumption, as well as heavy drinking and quantity of alcohol consumed. Consumption of energy drinks mixed with alcohol was also measured. Linear and logistic regression analyses between energy drink consumption and alcohol use were run controlling for gender, age, and race/ethnicity. RESULTS For each one unit increase in past month (i.e., additional day used) energy drink use, the likelihood of past month alcohol use increased by 80%, heavy drinking by 80% and past month energy drinks mixed with alcohol use by 90%. Similar results were found for past week energy drink use. A positive relationship between energy drink use and quantity of alcohol consumed during a single episode of drinking was also found (p<0.001). Significant gender interactions between energy drink consumption and alcohol use as well as quantity of alcohol consumed were found, with relationships stronger among males than females. There were no significant interactions by race/ethnicity. CONCLUSIONS Energy drinks are readily available to students and pose potential health risks. Students who report greater energy drink consumption also consume more alcohol, are more likely to mix energy drinks and alcohol, and experience heavy episodes of drinking, which is problematic given the potential negative consequences of these drinks.

Tracing the Roots of Early Sexual Debut Among Adolescents in Psychiatric Care

OBJECTIVE To identify the most important social and personal characteristics related to early sexual debut among troubled teenagers. METHOD One hundred ninety-eight youths aged 12-19 years were recruited from outpatient mental health clinics and completed self-reports and interviews about their age of sexual debut; family, peer, and partner relationships (e.g., parental hostile control, negative peer influence, need for intimacy); and personal characteristics (e.g., achievement motivation, externalizing problems). Broad-band (externalizing, internalizing) and narrow-band (depression/anxiety, delinquency) psychopathology was assessed with the Youth Self-Report and Child Behavior Checklist. RESULTS Optimal Data Analysis was used to generate a classification tree model to identify variables associated with whether or not youths initiated oral, vaginal, and/or anal sexual activity before or after age 14. Three social context variables (parental hostile control, negative and positive peer influence) and one personal characteristic (externalizing problems) correctly classified 87.4% of teenagers as initiating sexual activity at < or =14 or >14 years of age. CONCLUSIONS Parental behavior and peer influence were the most important variables associated with the timing of sexual debut. Results support a social-personal framework for understanding sexual risk-taking among adolescents in psychiatric care, and the data offer relatively strong evidence that specific factors could be used to identify troubled teens at risk for early sexual debut.

Away-from-Home Family Dinner Sources and Associations with Weight Status, Body Composition, and Related Biomarkers of Chronic Disease among Adolescents and Their Parents

Information regarding associations between types of away-from-home family meal sources and obesity and other chronic diseases could help guide dietetics practitioners. The present study describes the purchase frequency of away-from-home food sources for family dinner (fast food, other restaurant purchases, home delivery, and takeout foods) and associations with weight status and percent body fat among adolescents (n=723) and parents (n=723) and related biomarkers of chronic disease among adolescents (n=367). A cross-sectional study design was used with baseline parent surveys and anthropometry/fasting blood samples from two community-based obesity studies (2006-2008) in Minnesota. Logistic regression and general linear modeling assessed associations between frequency of family dinner sources (weekly vs none in past week) and outcomes (parent and adolescent overweight/obesity and percent body fat; adolescent metabolic risk cluster z score, cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein, triglycerides, fasting glucose, insulin, and systolic blood pressure. Models accounted for clustering and adjusted for study allocation, baseline meal frequency, and demographic characteristics. The odds of overweight/obesity were considerably greater when families reported at least one away-from-home dinner purchase in the past week (odds ratio=1.2 to 2.6). Mean percent body fat, metabolic risk cluster z scores, and insulin levels were significantly greater with weekly purchases of family dinner from fast-food restaurants (P<0.05). Mean percent body fat, metabolic risk cluster z scores, and high-density lipoprotein levels were significantly higher for families who purchased weekly family dinner from takeout sources (P<0.05). Although frequent family dinners may be beneficial for adolescents, the source of dinners is likely as important in maintaining a healthy weight. Interventions should focus on encouragement of healthful family meals.

The relationship between sleep and weight in a sample of adolescents.

Research to date in young children and adults shows a strong, inverse relationship between sleep duration and risk for overweight and obesity. Fewer studies examining this relationship have been conducted in adolescents. The purpose of the article is to describe the relationship between sleep and weight in a population of adolescents, controlling for demographics, energy intake, energy expenditure, and depression. This is a cross‐sectional study of 723 adolescents participating in population‐based studies of the etiologic factors related to obesity. We examined the relationship between three weight‐related dependent variables obtained through a clinical assessment and three sleep variables obtained through self‐report. Average caloric intake from dietary recalls, average activity counts based on accelerometers, and depression were included as covariates and the analysis was stratified by gender and grade level. Our results show that the relationship between sleep duration and BMI is evident in middle‐school boys (β = −0.32, s.e. = 0.06: P < 0.001) and girls (β = −0.18, s.e. = 0.08: P = 0.02) but largely absent in high‐school students. Differences in sleep patterns have little association with weight in males, but in high‐school girls, waking up late on weekends as compared to weekdays is associated with lower body fat (β = −0.80, s.e. = 0.40: P = 0.05) and a healthy weight status (β = −0.28, s.e. = 0.14: P = 0.05). This study adds to the evidence that, particularly for middle‐school boys and girls, inadequate sleep is a risk factor for early adolescent obesity. Future research needs to examine the relationship longitudinally and to study potential mediators of the relationship.

The Differential Prevalence of Obesity and Related Behaviors in Two- vs. Four-Year Colleges

The objective of this study was to determine whether obesity prevalence and weight‐related behaviors (e.g., diet, physical activity) differ among students enrolled in 2‐year community/technical colleges and those attending 4‐year colleges/universities. This information could inform the development of intervention strategies. Through an existing surveillance system of Minnesota postsecondary education institutions, survey data were collected from 16,539 students from 27 campuses (14 two‐year college campuses, 13 four‐year college/university campuses; 2007–2008), including self‐reported physical activity, media use, dietary patterns, weight control behaviors, height, and weight. Unadjusted analyses indicated that students enrolled in 2‐year colleges, particularly females, had a higher prevalence of overweight/obesity, lower levels of physical activity, more television viewing, higher intakes of soda, fast food, and diet pills compared to students attending 4‐year colleges (P < 0.05). Females attending 4‐year colleges were more likely to engage in certain unhealthy weight control behaviors (taking diet pills, binge eating, self‐induced vomiting) compared to females attending 2‐year institutions. Among male students there were fewer differences between 2‐year and 4‐year colleges. Controlling for sociodemographic factors (e.g., race/ethnicity, age), most disparities in prevalence estimates remained, though many were attenuated. Overall, few young adults engage in weight‐related behaviors consistent with national recommendations. Two‐year college students may represent a particularly at‐risk group. Disparities between 2‐ and 4‐year college students exist beyond the sociodemographic differences in these populations. Effective weight‐related interventions are needed for young adults, particularly females attending 2‐year colleges and all males attending postsecondary institutions.

Differential prevalence of alcohol use among 2-year and 4-year college students

PURPOSE To determine whether alcohol use behaviors and alcohol-related consequences differed among students attending two-year versus four-year colleges. METHODS Participants (N=13,700) from 7 two-year and 11 four-year colleges completed the 2010 College Student Health Survey. Alcohol use behaviors included past year alcohol use, past month alcohol use, and binge drinking over the past two weeks. Alcohol-related factors included average calculated blood alcohol level and average number of alcohol-related consequences. Cross-sectional mixed-effects regression analyses were conducted to determine if the prevalence of alcohol-related behaviors and consequences differed among two-year and four-year students. RESULTS Students attending four-year colleges, particularly males, were more likely to report past year alcohol use, past month alcohol use, and binge drinking, as well as a higher average blood alcohol content and a greater number of alcohol-related consequences than their two-year counterparts (p<0.05). Among female students there were fewer differences between two-year and four-year college students. Many differences remained after adjusting for socio-demographic factors (e.g., age, race/ethnicity), however, with the addition of living situation as a covariate, several of the differences among males were no longer significant. CONCLUSIONS Significant differences in alcohol-related behaviors and consequences exist among students attending two-year versus four-year colleges. While the prevalence of alcohol-related behaviors and consequences was lower among two-year college students, they are not a population to be over-looked. The prevalence of alcohol use remains high among both two-year and four-year college students, making it important for researchers to design appropriate interventions for all students regardless of the type of institution being attended.

Longitudinal associations between family dinner and adolescent perceptions of parent-child communication among racially diverse urban youth.

We examined changes in adolescent self-reported parent-child communication using growth curve models conditional on family meal frequency over a 3.5-year period among a population of racially diverse, low-income adolescents from an urban environment (n = 4,750). Results indicated that although both family dinner frequency and adolescent perceptions of parent-child communication scores were characterized by negative linear growth over time (both p < .001), family dinner frequency was positively associated with adolescent perceptions of parent-child communication scores over time (p < .001). Study findings suggest that families with teenagers may enhance parent-child communication and ultimately promote healthy adolescent development by making family dinner a priority. In addition, the communication benefits of family dinner at the beginning of sixth grade may be protective through eighth grade.

E-Cigarette Marketing Exposure Is Associated With E-Cigarette Use Among US Youth

PURPOSE E-cigarettes are currently the most commonly used tobacco product among US youth. However, unlike conventional cigarettes, e-cigarettes are not subject to marketing restrictions. This study investigates the association between exposure to e-cigarette marketing and susceptibility and use of e-cigarettes in youth. METHODS Data were obtained from the 2014 National Youth Tobacco Survey. Participants were 22,007 US middle and high school students. Multivariate logistic regression models assessed the relationship between e-cigarette marketing (internet, print, retail, and TV/movies) and current and ever use as well as susceptibility to use e-cigarettes among never e-cigarette users. RESULTS Exposure to each type of e-cigarette marketing was significantly associated with increased likelihood of ever and current use of e-cigarettes among middle and high school students. Exposure was also associated with susceptibility to use of e-cigarettes among current nonusers. In multivariate models, as the number of channels of e-cigarette marketing exposure increased, the likelihood of use and susceptibility also increased. CONCLUSIONS Findings highlight the significant associations between e-cigarette marketing and e-cigarette use among youth and the need for longitudinal research on these relationships.

Examining the longitudinal relationship between change in sleep and obesity risk in adolescents.

Evidence is building regarding the association between inadequate amounts of sleep and the risk of obesity, especially in younger children. Less is known about the relationship between change in sleep and change in weight during adolescence. The objective of this study was to examine the longitudinal relationship between change in sleep duration and change in body mass index (BMI) and percent body fat (PBF) in a cohort of adolescents. The cohort included 723 adolescents (mean age = 14.7 years at baseline) from Minnesota. Total sleep duration was assessed via self-report. BMI and PBF were objectively assessed. Covariates used in the multivariate analyses included energy intake as assessed through 24-hour recalls, activity levels as assessed by accelerometers, screen time/sedentary behavior, depression, and sociodemographic characteristics. For both males and females, average BMI and PBF increased slightly over the 2 years and average sleep duration decreased by about 30 minutes. The authors saw no statistically significant longitudinal relationships between change in total sleep and change in BMI or PBF over time in either girls or boys. The only longitudinal relationship that approached statistical significance was a positive association between sleep and PBF in females (p = .068). This research contributes to the literature as the only study to date to examine how change in sleep duration during adolescence may be related to a concomitant change in BMI and body fat. The findings of this study do not support the hypothesis that a decline in sleep duration during adolescence increases obesity risk.