Longitudinal assessment of daily activity patterns on weight change after involuntary job loss: the ADAPT study protocol

Abstract

BackgroundThe World Health Organization has identified obesity as one of the most visible and neglected public health problems worldwide. Meta-analytic studies suggest that insufficient sleep increases the risk of developing obesity and related serious medical conditions. Unfortunately, the nationwide average sleep duration has steadily declined over the last two decades with 25% of U.S. adults reporting insufficient sleep. Stress is also an important indirect factor in obesity, and chronic stress and laboratory-induced stress negatively impact sleep. Despite what we know from basic sciences about (a) stress and sleep and (b) sleep and obesity, we know very little about how these factors actually manifest in a natural environment. The Assessing Daily Activity Patterns Through Occupational Transitions (ADAPT) study tests whether sleep disruption plays a key role in the development of obesity for individuals exposed to involuntary job loss, a life event that is often stressful and disrupting to an individual’s daily routine.MethodsThis is an 18-month closed, cohort research design examining social rhythms, sleep, dietary intake, energy expenditure, waist circumference, and weight gain over 18 months in individuals who have sustained involuntary job loss. Approximately 332 participants who lost their job within the last 3 months are recruited from flyers within the Arizona Department of Economic Security (AZDES) Unemployment Insurance Administration application packets and other related postings. Multivariate growth curve modeling will be used to investigate the temporal precedence of changes in social rhythms, sleep, and weight gain.DiscussionIt is hypothesized that: (1) unemployed individuals with less consistent social rhythms and worse sleep will have steeper weight gain trajectories over 18 months than unemployed individuals with stable social rhythms and better sleep; (2) disrupted sleep will mediate the relationship between social rhythm disruption and weight gain; and (3) reemployment will be associated with a reversal in the negative trajectories outlined above. Positive findings will provide support for the development of obesity prevention campaigns targeting sleep and social rhythms in an accessible subgroup of vulnerable individuals.

Inconsistent social rhythms are associated with abdominal adiposity after involuntary job loss: An observational study

“…Data for this cross-sectional analysis were collected as part of the ADAPT study, an 18-month closed cohort study previously described. 39 Study participants were recruited through the Arizona Department of Economic Security after requesting application material for unemployment insurance. Individuals were eligible to participate if they were 25-60 years old and experienced involuntary job loss (laid-off or terminated) from full-time employment within the last 90 days.…”

“…Data for this cross‐sectional analysis were collected as part of the ADAPT study, an 18‐month closed cohort study previously described 39 . Study participants were recruited through the Arizona Department of Economic Security after requesting application material for unemployment insurance.…”

“…A total of 446 participants were recruited and screened for exclusion criteria to yield the final baseline sample of n ¼ 191 participants who were eligible for the initial visit. 39 All participants eligible for the parent project were included in this analysis. To ensure changes in social rhythms associated with job loss could be detected, participants must have been employed at their previous, permanent job for a minimum of 6 months, working at least 30 h a week.…”

“…Participants were further screened and excluded for recent participation in treatments likely to influence weight or energy balance-related behaviors, including weight loss surgery and weight loss programs. Similarly, participants were disqualified for particular variables likely to impact sleep, detailed in Haynes et al 39 Other exclusion criteria included taking part in shift work in the last month, meeting the criteria for substance abuse or dependence, or taking narcotics for sleep and pain in the previous 6 weeks. The top reasons for exclusion were employment criteria (e.g., being offered a new job >5 h per week, greater than 90 days since job loss; n ¼ 100) and sleep disorder criteria (e.g., positive objective screen for sleep disordered breathing, current sleep apnea; n ¼ 93).…”

Real-Time Model Predictive Control of Human Bodyweight Based on Energy Intake

“…The modelling framework also has certain limitations. It is known that the weight loss intervention strategies will be affected by external factors [55], such as psychological [56][57][58][59], occupational [60][61][62][63], and metabolic factors [64,65], besides their combined effects [66,67]. These external factors will affect the weight loss intervention, as well as its maintenance in the long term [68,69].…”