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Pereira R, Costa A, Warkentin S, Vilela S, Oliveira A. Sleep duration is associated with appetitive traits in school-age years - results from the Generation XXI birth cohort. Appetite 2024; 199:107384. [PMID: 38688409 DOI: 10.1016/j.appet.2024.107384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/15/2024] [Accepted: 04/27/2024] [Indexed: 05/02/2024]
Abstract
Sleep may influence appetite regulation through physiological and neurocognitive pathways. However, the association between sleep and appetite in childhood has been scarcely reported, particularly using a prospective design. We aimed to test associations between sleep duration at 7 years of age (y) and appetitive traits at both 7 and 10 y. Participants are from the population-based birth cohort Generation XXI (Porto, Portugal), at 7 (n = 2437) and 10 y (n = 1938) follow-ups. Data on sleep was gathered at 7 y and, considering bedtime and get-up time, total mean sleep duration was calculated and further categorized according to the 10th and 90th percentiles. Appetitive traits were assessed at 7 and 10 y using the parent-reported Children's Eating Behaviour Questionnaire. Associations were tested through Generalized Linear Models (co-variates: child's sex; maternal age, education and pre-pregnancy body mass index at 7 y). At 10 y, associations were further adjusted for the respective appetitive trait at 7 y. Children slept a mean of 10.2 h/night, and 13% and 9% slept ≤9.5 and ≥ 11.0 h/night at 7 y, respectively. For each additional hour in sleep duration, children scored 0.078 (99%CI: -0.145; -0.011) lower on Food Responsiveness, 0.065 (99%CI: -0.129; -0.002) lower on Emotional Undereating and 0.096 (99%CI: -0.161; -0.032) lower on Food Fussiness. Lastly, children sleeping ≤9.5 h/night scored higher on Food Responsiveness (β = 0.145 99%CI: 0.020; 0.271); while those sleeping ≥11.0 h/night scored lower on Food Fussiness (β = -0.255 99%CI: -0.370; -0.079). No significant prospective associations were found. In conclusion, in 7 y children, sleep duration was cross-sectionally associated with lower scores on food approach (Food Responsiveness) and avoidant traits (Emotional Undereating and Food Fussiness). However, the magnitude of the associations was small and further studies are warranted.
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Affiliation(s)
- Rita Pereira
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto [Institute of Public Health, University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, [Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal
| | - Alexandra Costa
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto [Institute of Public Health, University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, [Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal
| | - Sarah Warkentin
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto [Institute of Public Health, University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, [Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto [Institute of Public Health, University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, [Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto [Institute of Public Health, University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, [Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto], Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Departamento de Saúde Pública e Ciências Forenses e Educação Médica, Faculdade de Medicina, Universidade Do Porto, [Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto], Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
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Zerón-Rugerio MF, Santamaría-Orleans A, Izquierdo-Pulido M. Late bedtime combined with more screen time before bed increases the risk of obesity and lowers diet quality in Spanish children. Appetite 2024; 196:107293. [PMID: 38447642 DOI: 10.1016/j.appet.2024.107293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 03/08/2024]
Abstract
This cross-sectional study aimed to investigate whether the combination of bedtime and screen time (ST) before bed were associated with obesity and diet quality in toddlers and school-aged children. Parents reported children's bedtimes and ST before bed (0 min, 1-30 min, >30 min). We then defined bed + screen time behavior using bedtime median cut-offs (early [EB] or late [LB]) and ST responses, resulting in four groups: EB-0'ST, EB ≤ 30'ST/LB-0'ST, EB > 30'ST/LB ≤ 30'ST, and LB > 30'ST. For all participants (n = 1133; 5.4 ± 2.7 years, 49.7% girls, 51.9% school-aged) we evaluated body mass index (BMI), diet quality, sleep-related variables, physical activity, and health-related quality of life (HRQoL). Outcome variables were compared across bed + screen time behavior groups, stratified by age group (toddlers and school-aged children) using general linear models for continuous variables, as well as chi-squared tests or logistic regressions for categorical variables. Additionally, we calculated linear p-trends. Analyses were adjusted for sociodemographic variables, BMI, and physical activity (unless the variable was tested). The results showed that toddlers and school-aged children in the LB ≥ 30'ST group were more likely to have overweight/obesity (OR: 3.42 [95%CI:1.41,8.26] and OR: 2.53 [95%CI:1.10,5.03], respectively) than those in the EB-0'ST group. Additionally, toddlers and school-aged children in the EB > 30'ST/LB ≤ 30'ST and LB > 30'ST groups showed significantly lower adherence to the Mediterranean diet compared to the other groups (p < 0.001). Regarding sleep-related outcomes, we observed that the combination of LB and more ST was associated with poorer sleep quality and shorter sleep duration in toddlers and school-aged children (p < 0.001). These findings emphasize the importance of promoting earlier bedtimes and limiting ST before bed as part of obesity prevention strategies for children. Furthermore, such intervention could benefit the quality of children's diet and overall lifestyle.
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Affiliation(s)
- María Fernanda Zerón-Rugerio
- Nutrition and Food Safety Research Institute (INSA-UB), Torribera Campus, University of Barcelona, Spain; Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Spain
| | - Alicia Santamaría-Orleans
- Scientific Communication Department, Laboratorios Ordesa SL, Sant Boi del Llobregat, Barcelona, Spain
| | - Maria Izquierdo-Pulido
- Nutrition and Food Safety Research Institute (INSA-UB), Torribera Campus, University of Barcelona, Spain; Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, Barcelona, Spain.
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Zhang Z, Carlson D, Gilbert-Diamond D, Emond JA. Associations between sleep and appetitive traits in higher-income preschoolers: A six-month study. Appetite 2024; 196:107254. [PMID: 38346496 DOI: 10.1016/j.appet.2024.107254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Short sleep is consistently linked with childhood obesity, possibly via disrupting appetite hormones and increasing food responsiveness. Few studies have objectively examined this association in early childhood. OBJECTIVE To evaluate associations of sleep quantity and quality with child appetitive traits and eating in the absence of hunger (EAH) in a higher-income cohort of 86 preschool-age children (age 4.0 ± 0.8 years; 42% female; 93% non-Hispanic white, Northern New England, US). METHODS Children's sleep duration and quality were assessed via parent report (Children's Sleep Habits Questionnaire, CSHQ) at baseline and 6-month follow-up and via accelerometry at baseline. Parents also completed the Child Eating Behaviors Questionnaire to assess the child's appetitive traits. EAH, an objective measure of overeating, was observed at baseline during an in-person visit. Associations between sleep measures and appetitive traits were examined with linear mixed-effect or linear regression models, as appropriate, adjusting for child age, sex, and household income. RESULTS Shorter sleep duration per parent report was associated with less satiety responsiveness (standardized ß = 0.14, 95% CI: 0.01, 0.26; p = 0.03). Further, satiety responsiveness was inversely related to EAH (Pearson's r = -0.35, p = 0.02). No associations were found between accelerometer-measured sleep parameters and appetitive traits, and no sleep measures were related to EAH. CONCLUSIONS Shorter usual sleep, per the parent report, was cross-sectionally associated with reduced satiety responsiveness in this sample of higher-income preschoolers. Future studies should consider whether socioeconomic status may modify the impact of poor sleep on appetitive traits in early childhood.
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Affiliation(s)
- Zhuoya Zhang
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, NH 03756, USA.
| | - Delaina Carlson
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, NH 03756, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, NH 03756, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, NH 03756, USA; Department of Medicine, Geisel School of Medicine at Dartmouth College, NH, 03756, USA
| | - Jennifer A Emond
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, NH 03756, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, NH, 03756, USA
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The effect of modest changes in sleep on dietary intake and eating behavior in children: secondary outcomes of a randomized crossover trial. Am J Clin Nutr 2023; 117:317-325. [PMID: 36863827 DOI: 10.1016/j.ajcnut.2022.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/01/2022] [Accepted: 10/28/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Insufficient sleep duration increases obesity risk in children, but the mechanisms remain unclear. OBJECTIVES This study seeks to determine how changes in sleep influence energy intake and eating behavior. METHODS Sleep was experimentally manipulated in a randomized, crossover study in 105 children (8-12 y) who met current sleep guidelines (8-11 h/night). Participants went to bed 1 h earlier (sleep extension condition) and 1 h later (sleep restriction condition) than their usual bedtime for 7 consecutive nights, separated by a 1-wk washout. Sleep was measured via waist-worn actigraphy. Dietary intake (2 24-h recalls/wk), eating behaviors (Child Eating Behavior Questionnaire), and the desire to eat different foods (questionnaire) were measured during or at the end of both sleep conditions. The type of food was classified by the level of processing (NOVA) and as core or noncore (typically energy-dense foods) foods. Data were analyzed according to 'intention to treat' and 'per protocol,' an a priori difference in sleep duration between intervention conditions of ≥30 min. RESULTS The intention to treat analysis (n = 100) showed a mean difference (95% CI) in daily energy intake of 233 kJ (-42, 509), with significantly more energy from noncore foods (416 kJ; 6.5, 826) during sleep restriction. Differences were magnified in the per-protocol analysis, with differences in daily energy of 361 kJ (20, 702), noncore foods of 504 kJ (25, 984), and ultraprocessed foods of 523 kJ (93, 952). Differences in eating behaviors were also observed, with greater emotional overeating (0.12; 0.01, 0.24) and undereating (0.15; 0.03, 0.27), but not satiety responsiveness (-0.06; -0.17, 0.04) with sleep restriction. CONCLUSIONS Mild sleep deprivation may play a role in pediatric obesity by increasing caloric intake, particularly from noncore and ultraprocessed foods. Eating in response to emotions rather than perceived hunger may partly explain why children engage in unhealthy dietary behaviors when tired. This trial was registered at Australian New Zealand Clinical Trials Registry; ANZCTR as CTRN12618001671257.
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Ramírez-Contreras C, Santamaría-Orleans A, Izquierdo-Pulido M, Zerón-Rugerio MF. Sleep dimensions are associated with obesity, poor diet quality and eating behaviors in school-aged children. Front Nutr 2022; 9:959503. [PMID: 36211495 PMCID: PMC9539562 DOI: 10.3389/fnut.2022.959503] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The aim of this cross-sectional study was to investigate the association between sleep dimensions (duration, patterns, and disturbances) with body mass index (BMI), diet quality, and eating behaviors in school-aged children. Additionally, we aimed to investigate whether obesogenic eating behaviors (higher food responsiveness, lower satiety responsiveness, and less slowness in eating) and poor diet quality could mediate the potential association between sleep and obesity in school-aged children. Materials and methods For all participants (n = 588 children, age 5–12 years; 51% girls) we evaluated: sleep dimensions, BMI, diet quality, eating behaviors (food responsiveness, satiety responsiveness and slowness in eating). Linear regression models were used to test associations between exposure and outcome variables. Additionally, path analysis was conducted to test whether eating behaviors mediated the relationship between sleep and obesity. Results Shorter sleep duration (β = −0.722, p = 0.009) and greater sleep disturbances (β = 0.031, p = 0.012) were significantly associated with BMI. Additionally, we observed that diet quality was significantly associated with sleep duration (β = 0.430, p = 0.004), the midpoint of sleep (β = −0.927, p < 0.001), and sleep disturbances (β = −0.029, p < 0.001). Among other findings, greater sleep disturbances were associated with food responsiveness (β = 0.017, p < 0.001), satiety responsiveness (β = 0.015, p < 0.001), and slowness in eating (β = 0.012, p < 0.001). Importantly, food responsiveness was found as significant mediator of the relationship between sleep and BMI (R = 0.427, R2 = 0.182, p < 0.001). Conclusions Late sleep patterns, short sleep duration, and greater sleep disturbances are significantly related with what and how school-aged children eat. Importantly, poor diet quality was significantly related to all three sleep dimensions, while eating behaviors had a significant relationship with greater sleep disturbances. These findings may be relevant to the development of behavioral targets to prevent childhood obesity, including sleep hygiene guidelines as a strategy to improve children's eating habits, as well as their BMI.
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Affiliation(s)
- Catalina Ramírez-Contreras
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Barcelona, Spain
| | | | - Maria Izquierdo-Pulido
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Barcelona, Spain
| | - María Fernanda Zerón-Rugerio
- Department of Nutrition, Food Science and Gastronomy, Food Science Torribera Campus, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Barcelona, Spain
- *Correspondence: María Fernanda Zerón-Rugerio
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Hermes FN, Nunes EEM, Melo CMD. Sleep, nutritional status and eating behavior in children: a review study. REVISTA PAULISTA DE PEDIATRIA 2022; 40:e2020479. [PMID: 36102411 PMCID: PMC9462407 DOI: 10.1590/1984-0462/2022/40/2020479in] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/13/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To review the current literature on the relationship between sleep, nutritional status and eating behavior, as well as mechanisms associated with these elements in children. DATA SOURCE The literature research was conducted in the PubMed, LILACS and Scopus databases, using the following terms: "Child"; "Nutritional status"; "Sleep"; "Physical activity OR Physical activities OR Exercise". The articles included were those that met the research objective. Review articles, letters to authors, or guidelines were excluded. DATA SYNTHESIS 402 articles were initially found in the literature search. After careful analyses of the title and abstract, and application of inclusion criteria, only 24 studies were included in the present review. Most studies (n=13) suggest that short sleep duration (<9-10 hours/night) is associated with overweight/obesity in children. Only three studies did not show associations between overweight/obesity and sleep variables. Short sleep duration is also associated with poor food quality, higher intake of soft drinks and stimulant beverages before bedtime, as well as micronutrient deficiency. CONCLUSIONS Sleep duration is related to overweight and obesity development in infants. Changes in dietary pattern are also related to sleep debt, being one of the mechanisms that contribute to excessive weight gain. It is necessary that health professionals understand the importance of sleep quality in the nutritional status maintenance in children.
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Independent and Combined Association of Lifestyle Behaviours and Physical Fitness with Body Weight Status in Schoolchildren. Nutrients 2022; 14:nu14061208. [PMID: 35334863 PMCID: PMC8953615 DOI: 10.3390/nu14061208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 01/25/2023] Open
Abstract
(1) Background: Lifestyle behaviours and physical fitness play a critical role in the development of childhood obesity. It has been demonstrated in this study that self-reported physical fitness is representative of a healthy lifestyle and thus is associated with a lower incidence of overweight/obesity. The objective of this study was to analyse the independent and combined association of lifestyles (physical activity, screen time, diet and hours of sleep) and self-reported physical fitness with body weight in schoolchildren. (2) Methods: This study performed a descriptive and cross-sectional analysis. The study sample consisted of 864 schoolchildren between 8−9 years old from 26 schools of the province of Cádiz. To measure lifestyles and self-reported physical fitness, questionnaires were administered to both schoolchildren and families. To obtain the body weight status, the children were measured by body mass index (BMI). To verify the influence of lifestyles and self-reported physical fitness on the body weight status of schoolchildren, a combined score of lifestyles and self-reported physical fitness was calculated. (3) Results: Schoolchildren who followed healthier lifestyles and presented good physical fitness had a better body weight status (p < 0.001). Schoolchildren who had less healthful lifestyles and bad physical fitness had a 10.34 times higher risk of being overweight or obese (p = 0.004). (4) Conclusions: It has been shown that there is an independent and combined association between lifestyles and physical fitness on the body weight of the schoolchildren. We have suggested strategies to get children to adopt healthy lifestyles and good physical fitness to maintain a healthy body weight and prevent obesity.
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Hermes FN, Nunes EEM, Melo CMD. Sono, estado nutricional e hábitos alimentares em crianças: um estudo de revisão. REVISTA PAULISTA DE PEDIATRIA 2022. [DOI: 10.1590/1984-0462/2022/40/2020479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
RESUMO Objetivo: Fazer uma revisão da literatura sobre a relação entre sono, estado nutricional e padrão alimentar, bem como mecanismos associados, na população infantil. Fontes de dados: Foram realizadas buscas bibliográficas nas bases PubMed, LILACS e Scopus, usando os seguintes descritores: “Child”; “Nutritional status”; “Sleep”; “Physical activity OR Physical activities OR Exercise”. Os artigos que atenderam ao objetivo da pesquisa foram incluídos. Excluíram-se estudos de revisão, cartas para autores ou diretrizes. Síntese dos dados: Inicialmente, 402 artigos foram encontrados na pesquisa. Após análise dos títulos e abstracts e a aplicação dos critérios de exclusão, 24 estudos foram selecionados para a revisão. A maioria dos estudos (n=13) sugere que sono de curta duração (<9-10 horas/noite) está associado com sobrepeso/obesidade na população infantil. Apenas três artigos não reportaram associações entre variáveis do sono e estado nutricional. Curta duração do sono também foi associada a hábitos alimentares ruins, maior consumo de refrigerantes e bebidas estimulantes antes de deitar, bem como deficiência de micronutrientes. Conclusões: A duração do sono tem relação com sobrepeso e obesidade na população infantil. Alterações no padrão alimentar também têm relação com débito de sono, sendo um dos mecanismos que contribuem para o ganho de peso excessivo. É necessário que os profissionais de saúde tomem conhecimento da importância da qualidade do sono para a manutenção do estado nutricional em crianças.
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Morrison S, Galland BC, Haszard JJ, Jackson R, McIntosh DR, Beebe DW, Elder DE, Ward AL, Meredith-Jones K, Taylor RW. Eating in the absence of hunger in children with mild sleep loss: a randomized crossover trial with learning effects. Am J Clin Nutr 2021; 114:1428-1437. [PMID: 34192297 DOI: 10.1093/ajcn/nqab203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater "eating in the absence of hunger" (EAH) or energy intake beyond the point of satiety, when tired. OBJECTIVE The aim was to determine whether mild sleep loss increases EAH in children. METHODS A crossover study was undertaken in 105 healthy children (8-12 y) with normal sleep (∼8-11 h/night). After randomization, children went to bed 1 h earlier (sleep extension) or 1 h later (sleep restriction) than their usual bedtime, over 2 intervention weeks separated by a 1-wk washout. At the end of each intervention week, children underwent an EAH feeding experiment involving a preloading meal until satiation, followed by an ad libitum buffet (of highly palatable snacks) to measure EAH, with each food item weighed before and after consumption. RESULTS Ninety-three children completed the EAH experiment. There was no evidence of a difference in energy intake from EAH between sleep restriction and extension conditions when analyzed as a crossover design. However, a learning effect was found, with children eating significantly less (-239 kJ; 95% CI: -437, -41 kJ; P = 0.018) during the preload phase and significantly more (181 kJ; 95% CI: 38, 322 kJ; P = 0.013) in the ad libitum phase in the second week. No significant differences were seen using an underpowered parallel analysis for energy intake during the ad libitum phase when sleep deprived (106 kJ; 95% CI: -217, 431 kJ; P = 0.514). CONCLUSIONS Our findings suggest that measuring a difference in eating behavior in relation to sleep proved unsuitable using the EAH experiment in a crossover design in children, due to a learning effect. This trial was registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true) as ACTRN12618001671257 .
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Affiliation(s)
- Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dean W Beebe
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dawn E Elder
- Department of Pediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Aimee L Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand.,Department of Geography, Kent State University, Kent, OH, USA
| | | | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Arnaoutis G, Tambalis KD, Georgoulis M, Psarra G, Panagiotakos DB, Sidossis LS. Students Living in the Islands are Heavier and have Lower Fitness Levels Compared to their Mainland Counterparts; Results from the National Action for Children's Health (EYZHN) Program. Behav Med 2021; 47:236-245. [PMID: 32275194 DOI: 10.1080/08964289.2020.1740969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Few studies have examined variations in obesity by geographic location in youth and its relation with fitness levels. The present study investigated the association between geographic status (islands versus mainland), excess of body weight and fitness levels among 335.810 schoolchildren (male: 51.3%, 6-18 y, during the school year 2014-2015). Students' anthropometric parameters and fitness levels - accessed via the Euro-fit test - were measured by trained physical education teachers and evaluated according to published norms. Prevalence of overweight (23.0 Vs 21.8%) and obese (10.1 Vs 8.0%) was significantly higher for students living in the islands contrary to their mainland counterparts. A significant difference was also observed for centrally obese children (33.5 Vs 28.2%). Except for speed test .408), in all other four fitness tests, the students from the islands presented significantly lower performance (≤25th percentile of published age- and sex-specific normative values) versus their mainland counterparts. Boys and girls living in the islands had 48% and 37% increased odds of low physical fitness (as a total), respectively, compared to their mainland counterparts. Likewise, children living in islands presented increased odds of being overweight or obese by 19% and 15% in boys and girls, respectively, as compared to those living in the mainland. Increased general and abdominal adiposity have a direct negative impact on students' performance in Physical Fitness tests. Our data highlight the problem of excessive body weight that children living in rural areas, face.
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Affiliation(s)
- Giannis Arnaoutis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University
| | - Konstantinos D Tambalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University
| | - Glykeria Psarra
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University
| | | | - Labros S Sidossis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University.,Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University
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Malihi Z, Portch R, Hashemi L, Schlichting D, Wake M, Morton S, Fa'alili-Fidow J, Mensah F, Olds T, Atatoa Carr P, Kingi TK, Grant CC, Denny S. Modifiable Early Childhood Risk Factors for Obesity at Age Four Years. Child Obes 2021; 17:196-208. [PMID: 33595354 DOI: 10.1089/chi.2020.0174] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Childhood obesity is associated with an increased risk of adult obesity and related chronic disease. Our aim was to identify modifiable exposures that are independently associated with obesity in the preschool age group. Methods: A prospective cohort study of 5734 children in New Zealand with anthropometric measurements was completed at age 4.5 years. The modifiable exposures of interest, measured at age 9 months and 2 years, were: food security during infancy; and, at age 2 years, screen time; sleep duration; and takeaway food and soft drink intake. The risk of obesity independently associated with each exposure was determined using Binomial and Poisson regression and described using adjusted risk ratios (RRs) and 95% confidence intervals (CIs), after controlling for confounding variables including gender, ethnicity, birth weight, and mother's age. The probability of obesity given cumulative exposures to the four risk factors and the population attributable fraction (PAF) were estimated. Results: Lower food security during infancy (<mean study sample score; RR = 1.32; 95% CI : 1.06-1.64) and, at age 2 years, more screen time (>1 hour/day; RR = 1.22; 95% CI : 1.01-1.48), shorter sleep duration (≤11.5 hours/day; RR = 1.30; 95% CI : 1.05-1.61), and weekly to daily consumption of takeaway/soft drink (RR = 1.25, 95% CI : 1.00-1.57) were independently associated with an increased risk of obesity at age 4.5 years. The cumulative PAF for childhood obesity was 42.9%, under an ideal scenario where all risk factors were eliminated. Conclusion: Exposure to modifiable factors by age 2 years is associated with obesity at age 4.5 years. Interventions to prevent childhood obesity need to be effective during infancy.
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Affiliation(s)
- Zarintaj Malihi
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Richard Portch
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Ladan Hashemi
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Deborah Schlichting
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Melissa Wake
- Prevention and Innovation Group, Population Health Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Susan Morton
- Growing Up in New Zealand, School of Population Health, University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Jacinta Fa'alili-Fidow
- Growing Up in New Zealand, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Fiona Mensah
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Polly Atatoa Carr
- Department of Paediatrics, Waikato District Health Board and National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Te Kani Kingi
- Research and Innovation, Te Whare Wananga o Awanuiarangi, Whakatane, New Zealand
| | - Cameron C Grant
- Department of Paediatrics, Child, and Youth Health, School of Medicine, University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research-He Ara ki Mua, University of Auckland, Auckland, New Zealand.,General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - Simon Denny
- Mater Young Adult Health Centre, Level 5 Potter Link, South Brisbane, Queensland, Australia
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12
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Oberle MM, Northrop EF, Bramante CT, Rudser KD, Gross AC, Kelly AS. Associations between paediatric fatigue and eating behaviours. Obes Sci Pract 2020; 6:507-515. [PMID: 33082992 PMCID: PMC7556416 DOI: 10.1002/osp4.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In adults, poor sleep quality is associated with increased obesogenic eating behaviours; less is known about this relationship in youth. The objectives of this study were to assess the strength of association between fatigue-related quality of life (QoL) and eating behaviours among youth and to describe the associations in participants with percent body fat (%BF) above and below the 90th percentile for sex and age. METHODS Caregiver-reported measures of fatigue (Pediatric QoL Multidimensional Fatigue Scale) and eating behaviours (Child Eating Behaviour Questionnaire) were obtained from participants aged 8-17 years. %BF was measured by iDXA and grouped by sex- and age-specific percentiles. Multiple linear regression adjusting for age, sex and race/ethnicity was used. RESULTS Of the 352 participants (49% male), 44.6% had %BF >90th percentile. General, sleep/rest and cognitive fatigue QoL was inversely associated with food approach behaviours: food responsiveness, enjoyment of food, emotional overeating and desire to drink. For participants with %BF >90th percentile, higher general fatigue QoL was associated with higher satiety responsiveness (0.13; 95% confidence interval [CI 0.03, 0.24]). For participants with %BF ≤90th percentile, higher general fatigue QoL was associated with less satiety responsiveness (-0.16; 95% CI [-0.31, -0.01]). CONCLUSION Less fatigue symptoms were associated with less behaviours associated with food approach among paediatric participants. For participants with %BF >90th percentile, less symptoms of general fatigues corresponded with more satiety. Though causation has yet to be established, youth with elevated %BF should be screened for fatigue symptoms and offered counselling on sleep hygiene or a sleep medicine referral to help mitigate weight gain.
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Affiliation(s)
- Megan M. Oberle
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Elise F. Northrop
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
- Division of Biostatistics, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Carolyn T. Bramante
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
- Department of MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Kyle D. Rudser
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
- Division of Biostatistics, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Amy C. Gross
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Aaron S. Kelly
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
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13
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Ward AL, Galland BC, Haszard JJ, Meredith-Jones K, Morrison S, McIntosh DR, Jackson R, Beebe DW, Fangupo L, Richards R, Te Morenga L, Smith C, Elder DE, Taylor RW. The effect of mild sleep deprivation on diet and eating behaviour in children: protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial. BMC Public Health 2019; 19:1347. [PMID: 31640636 PMCID: PMC6805447 DOI: 10.1186/s12889-019-7628-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 09/13/2019] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger. METHODS The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night. DISCUSSION Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018.
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Affiliation(s)
- Aimee L. Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C. Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | | | | | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Behavioral Medicine and Clinical Psychology Cincinnati Children’s Hospital Medical Center, Ohio, USA
| | - Louise Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Lisa Te Morenga
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Claire Smith
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Dawn E. Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
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14
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Jansen EC, Dunietz GL, Tsimpanouli ME, Guyer HM, Shannon C, Hershner SD, O'Brien LM, Baylin A. Sleep, Diet, and Cardiometabolic Health Investigations: a Systematic Review of Analytic Strategies. Curr Nutr Rep 2019; 7:235-258. [PMID: 30187293 DOI: 10.1007/s13668-018-0240-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW Poor sleep is a risk factor for cardiometabolic morbidity. The relationship of sleep and cardiometabolic health could be confounded, mediated, or modified by diet, yet the incorporation of diet in sleep-cardiometabolic health studies is inconsistent. This rapid systematic literature review evaluates the conceptualization of diet as a confounder, mediator, or effect modifier within sleep-cardiometabolic health investigations, and the statistical approaches utilized. RECENT FINDINGS Of 4692 studies identified, 60 were retained (28 adult, 32 pediatric). Most studies included diet patterns, quality, or energy intake as confounders, while a few examined these dietary variables as mediators or effect modifiers. There was some evidence, mostly in pediatric studies, that inclusion of diet altered sleep-cardiometabolic health associations. Diet plays a diverse role within sleep-cardiometabolic health associations. Investigators should carefully consider the conceptualization of diet variables in these relationships and utilize contemporary statistical approaches when applicable.
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Affiliation(s)
- Erica C Jansen
- Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, C728 Med Inn Building, Ann Arbor, MI, 48109, USA.
| | - Galit Levi Dunietz
- Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, C728 Med Inn Building, Ann Arbor, MI, 48109, USA
| | - Maria-Efstratia Tsimpanouli
- Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, C728 Med Inn Building, Ann Arbor, MI, 48109, USA
| | - Heidi M Guyer
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Carol Shannon
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
| | - Shelley D Hershner
- Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, C728 Med Inn Building, Ann Arbor, MI, 48109, USA
| | - Louise M O'Brien
- Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, C728 Med Inn Building, Ann Arbor, MI, 48109, USA.,Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Oral & Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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15
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Sleep and weight-related factors in youth: A systematic review of recent studies. Sleep Med Rev 2019; 46:87-96. [DOI: 10.1016/j.smrv.2019.04.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/11/2019] [Accepted: 04/18/2019] [Indexed: 12/28/2022]
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16
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Cao M, Zhu Y, Sun F, Luo J, Jing J. Short sleep duration is associated with specific food intake increase among school-aged children in China: a national cross-sectional study. BMC Public Health 2019; 19:558. [PMID: 31088522 PMCID: PMC6515588 DOI: 10.1186/s12889-019-6739-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/02/2019] [Indexed: 12/22/2022] Open
Abstract
Background The relationship between sleep duration and food intake is unclear. This study aims to examine the relationship among children aged 6–17 years in China. Methods The sample consisted of 70,519 children aged 6–17 years, which were randomly selected from 7 representative areas from China, from September to November, 2013. In the structured questionnaire, children reported daily sleep hours (less than 7 h, 7–9 h and more than 9 h), weekly food intake amount (including vegetables, fruit, sugar beverages and meat), physical activity and sedentary time. The relationship of sleep duration with vegetable, sugar beverage, fruit and meat intake was evaluated by multi-nominal logistic regression and multi-variable adjusted. Results A total of 62,517 children (51.6% boys) completed the study. Short sleep duration (SSD, < 7 h) was independently associated with increased sugar beverage intake (SBI, Odd Ratio, OR: 1.29, 95% CI: 1.19–1.40) but decreased vegetable (VI, OR: 0.94, 95% CI: 0.90–0.98) & fruit intake (FI, OR: 0.94, 95% CI: 0.88–0.99). Stratified by age and gender, SSD increased SBI for boys of both young (6–12 years) & older (13–17 years) groups and older girls (ORs: 1.25, 1.25, 1.49, 95% CI: 1.08–1.44, 1.04–1.50, 1.22–1.81, respectively), but decreased VI and FI for older girls (ORs: 0.84& 0.81, 95% CI: 0.74–0.96& 0.68–0.96, respectively). Conclusions Among school-aged children in China, short sleep duration was associated with increased risks of more sugar beverage intake among those younger and boys but less vegetable & fruit intake among those older and girls. Longitudinal research is needed to clarify the causation in between.
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Affiliation(s)
- Muqing Cao
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Yanna Zhu
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Fan Sun
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Jingyin Luo
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China
| | - Jin Jing
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou, 510080, China.
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17
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The Combined Impact of Sleep and Diet on Adiposity in Infants, Toddlers, and Young Children: A Systematic Review. J Dev Behav Pediatr 2019; 40:224-236. [PMID: 30741778 DOI: 10.1097/dbp.0000000000000636] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Short sleep duration and poor dietary habits may contribute to increased adiposity; however, the impact of the interaction between these variables on adiposity is less understood. To evaluate research investigating the combined effects of sleep and diet on adiposity in infants, toddlers, and young children. METHODS Systematic searches of electronic databases (PubMed, CINAHL, and Web of Science) from inception through April 2017 were conducted. All studies published in English that had at least 1 sleep (e.g., sleep duration and night awakenings), diet (e.g., 24-hour diet recall and breastfeeding duration), and adiposity (e.g., body mass index z-score and weight-for-length) measure were eligible for inclusion. Abstract and full-text article reviews were conducted by 2 independent reviewers. Data were extracted into a standardized spreadsheet. RESULTS Of the 17 full-text articles reviewed, 14 studies were included. Mediation (n = 2) and moderation (n = 2) were seldom used. Investigation of the combined effects of sleep and diet on adiposity demonstrated a substantial lack of evidence. Synthesis of articles suggests that the relationship between sleep and diet may be interactive and their effects additive in their impact when targeted simultaneously within interventions. CONCLUSION Without consideration of interaction effects among variables of interest, a substantial gap in the literature persists. Both diet and sleep need to be assessed simultaneously and repetitively in future longitudinal research.
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18
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Tambalis KD, Panagiotakos DB, Psarra G, Sidossis LS. Breakfast skipping in Greek schoolchildren connected to an unhealthy lifestyle profile. Results from the National Action for Children's Health program. Nutr Diet 2019; 76:328-335. [DOI: 10.1111/1747-0080.12522] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Konstantinos D. Tambalis
- Department of Nutrition and Dietetics, School of Health Science & EducationHarokopio University Athens Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science & EducationHarokopio University Athens Greece
| | - Glykeria Psarra
- Department of Nutrition and Dietetics, School of Health Science & EducationHarokopio University Athens Greece
- Department of Kinesiology and HealthRutgers University New Brunswick New Jersey USA
| | - Labros S. Sidossis
- Department of Nutrition and Dietetics, School of Health Science & EducationHarokopio University Athens Greece
- Department of Kinesiology and HealthRutgers University New Brunswick New Jersey USA
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19
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Portella AK, Paquet C, Bischoff AR, Molle RD, Faber A, Moore S, Arora N, Levitan R, Silveira PP, Dube L. Multi-behavioral obesogenic phenotypes among school-aged boys and girls along the birth weight continuum. PLoS One 2019; 14:e0212290. [PMID: 30789933 PMCID: PMC6383887 DOI: 10.1371/journal.pone.0212290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/30/2019] [Indexed: 11/18/2022] Open
Abstract
Evidence shows that extremes of birth weight (BW) carry a common increased risk for the development of adiposity and related cardiovascular diseases, but little is known about the role of obesogenic behaviors in this process. Moreover, no one has empirically examined whether the relationship between BW, obesogenic behaviors and BMI along the full low-to-high birthweight continuum reflects the U-shape pattern expected from common risk at both BW extremes. Our objective was to characterize physical activity, screen time, and eating behavior and their relationship to BMI as a function of BW among school-aged boys and girls. In this cross-sectional study, 460 children aged 6 to 12 years (50% boys) from Montreal, Canada provided information on sleeping time, screen time, physical activity levels, eating behavior (emotional, external and restrained eating) and anthropometrics (height, weight, BW) through parent reported questionnaires. BMI was normalized using WHO Standards (zBMI), and BW expressed as ratio using Canadian population standards (BW for gestational age and sex). Analyses were conducted using generalized linear models with linear and quadratic terms for BW, stratified by sex and adjusted for age, ethnicity and household income. In boys, physical activity and screen time showed U-shaped associations with BW, while physical activity had an inverted U-shaped in girls. Emotional and restrained eating had positive linear relations with BW in boys and girls. Sleep time and external eating were not associated with BW. A U-shaped relationship between BW and zBMI was found in boys but no association was found in girls. Only sleep (in boys and girls), and emotional eating (girls only) were related to zBMI and mediation of the BW-zBMI relationship was only supported for emotional eating. In conclusion, BW relates to obesogenic behaviors and BMI in both non-linear and linear ways, and these associations differed by sex.
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Affiliation(s)
- Andre Krumel Portella
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
- PostGraduate Program in Pediatrics, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS, Brasil
- * E-mail:
| | - Catherine Paquet
- School of Health Sciences, Centre for Population Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Adrianne Rahde Bischoff
- Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Roberta Dalle Molle
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Aida Faber
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Spencer Moore
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | | | - Robert Levitan
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Patricia Pelufo Silveira
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Sackler Institute for Epigenetics & Psychobiology, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Centre, Montreal, QC, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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20
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Singh R, Singh RK, Singh S. Sleep and children’s development in India. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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21
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Miller AL, Miller SE, LeBourgeois MK, Sturza J, Rosenblum KL, Lumeng JC. Sleep duration and quality are associated with eating behavior in low-income toddlers. Appetite 2019; 135:100-107. [PMID: 30634008 DOI: 10.1016/j.appet.2019.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The present study examined whether different sleep health parameters (duration, timing, and quality) are associated with obesity-related eating behaviors including emotional overeating, food responsiveness, enjoyment of food, satiety responsiveness, and eating in the absence of hunger (EAH), during toddlerhood. DESIGN Among 134 low-income 33-month-old children, parents reported on child sleep parameters, including sleep quality (Children's Sleep Wake Scale; CSWS) and usual bedtimes and wake times on weekdays and weekends (weeknight sleep duration, weekday-to-weekend bedtime delay). Child eating behaviors were assessed using both observed and parent-report measures. Child Emotional Overeating, Food Responsiveness, Enjoyment of Food, and Satiety Responsiveness were measured by parent report using the Child Eating Behavior Questionnaire-Toddler. Observed child EAH was evaluated by measuring kilocalories of palatable foods consumed following a meal. Multivariable linear regression was used to examine the associations between sleep parameters and eating behaviors. RESULTS Poorer child sleep quality was associated with greater Emotional Overeating (standardized β = -0.20 (SE 0.09), p < .05) and greater Food Responsiveness (β = -0.18 (SE 0.09), p < .05). Shorter child nighttime sleep duration was associated with greater EAH kcal consumed (standardized β = -0.22 (SE 0.09), p < .05). Child bedtime delay was not associated with any of the eating behaviors, and no child sleep variables were associated with either Enjoyment of Food or Satiety Responsiveness. CONCLUSIONS Shorter nocturnal sleep duration and poorer sleep quality during toddlerhood were associated with some, but not all, of the obesity-related eating behaviors. Poor sleep health may promote childhood obesity risk through different eating behavior pathways. As children growing up in poverty may experience greater sleep decrements, sleep duration and sleep quality may be important targets for intervention among low-income families with young children.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States; Center for Human Growth and Development, University of Michigan, United States.
| | - Sara E Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States
| | | | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, United States
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, United States; Department of Psychiatry, University of Michigan Medical School, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, United States; Department of Pediatrics, University of Michigan Medical School, United States; Department of Nutritional Sciences, University of Michigan School of Public Health, United States
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22
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Boswell N, Byrne R, Davies PSW. Aetiology of eating behaviours: A possible mechanism to understand obesity development in early childhood. Neurosci Biobehav Rev 2018; 95:438-448. [PMID: 30391377 DOI: 10.1016/j.neubiorev.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/24/2018] [Accepted: 10/28/2018] [Indexed: 11/15/2022]
Abstract
Childhood obesity is an issue of public health concern that is understood to emerge due to disequilibrium in energy homeostasis. This commentary explores literature regarding neuro-biological mechanisms of energy homeostasis and the relationship between subjective measures of children's eating behaviours and objective measures of appetite, in order to better understand the aetiology of childhood obesity. Early life influences, such as in utero exposure, breastfeeding, and general disadvantage, appear to have an important influence on neuro-biological mechanisms of appetite and may contribute to inequitable distributions of obesity within the population. Subject measures of eating behaviours appear to capture various aspects of neuro-biologically driven (objective) appetite systems, however, these systems are complex, interdependent and not yet fully understood. Future research focusing attention on early life influences on appetite and eating behaviours is warranted to increase understanding of differences in rates of obesity within the population, to determine opportunities for targeted obesity prevention initiatives, and to explore the potential to measure change in eating behaviours as a marker of appetite and obesity risk.
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Affiliation(s)
- Nikki Boswell
- The University of Queensland, Brisbane QLD, Australia.
| | - Rebecca Byrne
- Queensland University of Technology, Brisbane QLD, Australia.
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Tambalis KD, Panagiotakos DB, Moraiti I, Psarra G, Sidossis LS. Poor dietary habits in Greek schoolchildren are strongly associated with screen time: results from the EYZHN (National Action for Children's Health) Program. Eur J Clin Nutr 2018; 72:572-580. [PMID: 29500462 DOI: 10.1038/s41430-018-0119-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/31/2017] [Accepted: 01/05/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND/OBJECTIVES To investigate adherence to the Mediterranean diet (MD) and the relationship between MD and lifestyle factors in a representative sample of Greek school children. SUBJECTS/METHODS The data derived from 232,401 (51% boys) children aged 8 to 17 years old who participated in a health survey (2015). Physical fitness (PF) and anthropometric estimations were obtained by trained investigators. Physical activity (PA) status, sedentary activities and sleeping hours were assessed through self-completed questionnaires. Mediterranean diet was evaluated via KIDMED test. RESULTS Forty percent of participants presented an optimal adherence to MD (≥8), while one to ten incorporated a low adherence to MD (≤3), in both genders. Participants with optimal adherence to MD presented a more favourable status in anthropometric and lifestyle characteristics. Adjusting for several potential confounders, increased screen time (<2 h/d) augmented odds of low adherence by 135% (95% CI: 2.216-2.491) and 150% (95% CI: 2.346-2.687), in boys and girls, respectively. For each 1-year enlarge in the age of children the odds of low adherence to MD enlarged by almost 11% (95%CI: 1.101-1.138) in both genders, while, boys had almost 6% increased probabilities to the low adherence (95%CI: 1.039, 1.102) than girls. Furthermore, insufficient sleeping hours (>2 h/d) and inadequate PA status were connected to higher odds of low adherence to MD. CONCLUSIONS Support a modest adherence to the MD and an enhancement considered necessary to adjust dietary intake to current guidelines. However, screen time presented a strong association with low adherence to MD.
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Affiliation(s)
- Konstantinos D Tambalis
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece. 70 Eleftheriou Venizelou Avenue, Athens, 17671, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece. 70 Eleftheriou Venizelou Avenue, Athens, 17671, Greece
| | - Ioanna Moraiti
- Hellenic Ministry of Culture and Athletics, Secretariat General of Sports, Athens, Greece
| | - Glykeria Psarra
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece. 70 Eleftheriou Venizelou Avenue, Athens, 17671, Greece
| | - Labros S Sidossis
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece. 70 Eleftheriou Venizelou Avenue, Athens, 17671, Greece. .,Department of Exercise Sciences, Rutgers University, New Brunswick, NJ, 08901, USA.
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Eating behavior traits associated with demographic variables and implications for obesity outcomes in early childhood. Appetite 2017; 120:482-490. [PMID: 29024677 DOI: 10.1016/j.appet.2017.10.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/19/2017] [Accepted: 10/04/2017] [Indexed: 11/21/2022]
Abstract
Despite ongoing investigation of children's eating behaviors to better understand the etiology of childhood obesity, few studies have aimed to determine differences in eating behavior based on psycho-social variables reflective of 'stressful' life circumstance. Cross-sectional data collected from parents of 977 Australian children (2.0-5.0 years) in an online survey was used to determine associations between parent-reported Children's Eating Behavior Questionnaire [CEBQ] sub-scales, child BMI z-scores and psycho-social variables. When examined individually, all CEBQ sub-scales, except Slowness in Eating, were associated with BMI z-score (Food Responsiveness B = 0.226, p = 0.003, Enjoyment of Food B = 0.169, p = 0.035, Food Fussiness B = -0.139, p = 0.024, Satiety Responsiveness B = -0.318, p = 0.001). On examining CEBQ sub-scales along with psycho-social demographic variables, only Food Responsiveness and Satiety Responsiveness were retained, along with being a boy, child age, and parent BMI. Food Responsiveness was positively associated with parental stress and child age and negatively with parent BMI, while Enjoyment of Food was positively associated with child sleep duration, single parent status, and negatively with breastfeeding less than 6 months and parental depression. Satiety Responsiveness was positively associated with parent BMI and child age, and negatively with child sleep duration, while Food Fussiness was positively associated with child age and breastfeeding less than 6 months, and negatively with sleep duration, parental depression and single parent status. Attention to eating behaviors and associated psycho-social variables may provide opportunity for targeted obesity prevention initiatives.
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Rangan A, Zheng M, Olsen NJ, Rohde JF, Heitmann BL. Shorter sleep duration is associated with higher energy intake and an increase in BMI z-score in young children predisposed to overweight. Int J Obes (Lond) 2017; 42:59-64. [PMID: 28883538 DOI: 10.1038/ijo.2017.216] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 08/14/2017] [Accepted: 08/20/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inadequate sleep has been shown to be a contributor to obesity in both children and adults. Less evidence is available for toddlers and among those with higher obesity risk. The objective of this study was to examine the relationship between sleep patterns and body weight development in a group of young obesity-predisposed children, and to assess whether intakes of energy or macronutrients mediate this relationship. METHODS Participants included 368 Danish children aged 2-6 years from the Healthy Start Study, a 1.3 year randomised controlled intervention trial. Sleep habits were measured using a 7-day sleep diary. Multivariate linear regression with adjustment for confounders was used to assess the association of sleep duration and sleep variability with 1.3 year changes (Δ) in body mass index (BMI) z-score from baseline to follow-up. RESULTS The average nighttime sleep duration was 10.7 h (range 8.8-12.5 h). After controlling for potential confounders, a significant inverse association between nighttime sleep duration and ΔBMI z-score (β=-0.090, P=0.046) was observed. This relationship was mediated by energy intake, with all macronutrients contributing to this mediation effect. No associations were found for sleep variability and ΔBMI z-score but baseline intake of added sugars and sugary beverages were positively associated with sleep variability. CONCLUSION Shorter sleep duration, mediated by energy intake in early in life, seems a risk factor for weight gain among young obesity-predisposed children.
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Affiliation(s)
- A Rangan
- Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - M Zheng
- Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - N J Olsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark
| | - J F Rohde
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - B L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Boden Institute of Obesity, Nutrition, Exercise & Eating disorders, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Institute of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark
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Gong QH, Li H, Zhang XH, Zhang T, Cui J, Xu GZ. Associations between sleep duration and physical activity and dietary behaviors in Chinese adolescents: results from the Youth Behavioral Risk Factor Surveys of 2015. Sleep Med 2017; 37:168-173. [PMID: 28899530 DOI: 10.1016/j.sleep.2017.06.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/16/2017] [Accepted: 06/18/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To assess the association between sleep duration and physical activity and dietary behaviors among adolescents in a representative sample. METHODS The analysis was performed using data from the 2015 Ningbo Youth Risk Behavior Survey. Associations between physical activity and dietary behaviors and sleep duration were examined on weighted data using logistic regression. RESULTS Of the 10726 students, roughly 40% reported sleep duration <8 h. Longer sleep duration was associated with higher likelihood of milk intake, fruit consumption, vegetable consumption, water consumption, moderate physical activity, and muscle-strengthening physical activity, and with a lower likelihood of cigarette use, alcohol use, sweets intake, Western fast food intake, and breakfast skipping. CONCLUSION Insufficient sleep may be common among Chinese adolescents. Sleep duration was associated with dietary behaviors, physical activity, and other health-related behaviors. These findings suggest that sleep duration could be a potential target for many health-risk behaviors in young adolescents.
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Affiliation(s)
- Qing Hai Gong
- Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang Province, China
| | - Hui Li
- Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang Province, China
| | - Xiao Hong Zhang
- Medical School of Ningbo University, Ningbo, Zhejiang Province, China
| | - Tao Zhang
- Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang Province, China
| | - Jun Cui
- Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang Province, China
| | - Guo Zhang Xu
- Ningbo Center for Disease Control and Prevention, Ningbo, Zhejiang Province, China.
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Ferranti R, Marventano S, Castellano S, Giogianni G, Nolfo F, Rametta S, Matalone M, Mistretta A. Sleep quality and duration is related with diet and obesity in young adolescent living in Sicily, Southern Italy. ACTA ACUST UNITED AC 2016; 9:117-22. [PMID: 27656277 PMCID: PMC5021953 DOI: 10.1016/j.slsci.2016.04.003] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/08/2016] [Accepted: 04/11/2016] [Indexed: 12/28/2022]
Abstract
The aim of this study was to evaluate the association between sleeping habits, Mediterranean diet pattern, and weight status in an adolescent population. The sample consisted of 1586 individuals aged 11–14 years attending 15 secondary schools of Sicily, Southern Italy. School were randomly selected and the data collected during two school years. Anthropometric data was collected and body composition was assessed by bioelectrical impedance analysis. Demographic information, sleep duration, pediatric daytime sleepiness questionnaire (PDSS), physical activity and dietary habits (including adherence to the Mediterranean Diet using the KIDMED score) were further collected. The mean age was 12±0.7 and about 24% were overweight and obese. An inverse correlation between total sleep time and body mass index (β=−0.829, P=0.021), fat mass (β=−0.526, P=0.025), and waist circumference (β=−0.426, P=0.045) was found. Similar results were found for weekdays sleep time, while an inverse relationship was found with PDSS score. Adherence to Mediterranean Diet was higher in under/normal weight adolescent with a significant linear association between the KIDMED score and the PDSS, weekdays sleep time and total sleep time. Sleep duration was also associated positively with fruits and vegetable intake and negatively with sweet and snack consumption and eating outside habits. Short sleep duration and poor sleep were associated with an increase in BMI and fat mass as well as to unhealthy eating behaviors. These findings suggest that sleep patterns could be a potential target for obesity prevention programs in young adolescence.
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Affiliation(s)
| | - Stefano Marventano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Sabrina Castellano
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - Gabriele Giogianni
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Francesca Nolfo
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | - Stefania Rametta
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
| | | | - Antonio Mistretta
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Preventive Medicine, University of Catania, Catania, Italy
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Cao M, Zhu Y, He B, Yang W, Chen Y, Ma J, Jing J. Association between sleep duration and obesity is age- and gender-dependent in Chinese urban children aged 6-18 years: a cross-sectional study. BMC Public Health 2015; 15:1029. [PMID: 26446623 PMCID: PMC4596376 DOI: 10.1186/s12889-015-2359-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/28/2015] [Indexed: 12/11/2022] Open
Abstract
Background Information on the relationship between sleep duration and obesity among children in urban Guangzhou, China is limited. This study aims to examine the relationship between sleep duration and obesity in children aged 6–18 years. Methods The sample consisted of 11,830 children aged 6–18 years. The children were randomly selected from 13 schools in three urban districts of Guangzhou. The study was conducted from September to November 2013. The height and weight of the children were measured. Adiposity status was estimated using body mass index and according to the cut point in China criteria. In the structured questionnaire, children reported daily sleep hours (less than 7 h, 7–9 h and more than 9 h), weekly food intake amount (including vegetables, fruit, sugar beverages and meat), physical activity and sedentary time. A caretaker would answer the questionnaire on behalf of a child aged below nine. Results A total of 8,760 children (49.0 % boys) completed the study. The prevalence of obesity was 8.4 % (9.8 % in boys and 5.7 % in girls). Adjusted for age, diet and physical activity/sedentary behaviour, the odds ratio (OR) for obesity comparing sleeping <7 h (short sleep duration, SSD) with ≥9 h (long sleep duration, LSD) was 0.70 (95 % CI: 0.69–0.72) among boys and 1.73 (95 % CI: 1.71–1.74) among girls. Stratified by age, OR for boys aged 6–12 years comparing SSD with LSD was 0.60 (95 % CI: 0.55–0.66); by contrast, OR was 1.33 (95 % CI: 1.30–1.37) for boys aged 13–18 years. Conclusion Short sleep duration is associated with increased chances of obesity among girls and 13- to 18-year-old boys, but the chances of obesity are decreased among 6- to 12-year-old boys. Age and gender should be regarded as specific characteristics for the effects of short sleep on obesity.
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Affiliation(s)
- Muqing Cao
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
| | - Yanna Zhu
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
| | - Baoting He
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
| | - Wenhan Yang
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
| | - Yajun Chen
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Sciences Center, Beijing, People's Republic of China.
| | - Jin Jing
- Department of Maternal and Child Health, Faculty of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
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