A longitudinal study of sleep, weight status, and weight-related behaviors: Childhood Obesity Study in China Mega-cities

Childhood sleep: physical, cognitive, and behavioral consequences and implications

BACKGROUND

Sleep problems in children have been increasingly recognized as a major public health issue. Previous research has extensively studied and presented many risk factors and potential mechanisms for children's sleep problems. In this paper, we aimed to identify and summarize the consequences and implications of child sleep problems.

DATA SOURCES

A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info published in the past two decades. Both relevant data-based articles and systematic reviews are included.

RESULTS

Many adverse consequences are associated with child sleep deficiency and other sleep problems, including physical outcomes (e.g., obesity), neurocognitive outcomes (e.g., memory and attention, intelligence, academic performance), and emotional and behavioral outcomes (e.g., internalizing/externalizing behaviors, behavioral disorders). Current prevention and intervention approaches to address childhood sleep problems include nutrition, exercise, cognitive-behavioral therapy for insomnia, aromatherapy, acupressure, and mindfulness. These interventions may be particularly important in the context of coronavirus disease 2019. Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments.

CONCLUSIONS

Given the increasing prevalence of child sleep problems, which have been shown to affect children's physical and neurobehavioral wellbeing, understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention, thus improving sleep-related child development and health.

Association between short sleep duration and intake of sugar and sugar-sweetened beverages: A systematic review and meta-analysis of observational studies

BACKGROUND

Findings of previous investigations that evaluated the relationship between sleep duration and sugar or sugar-sweetened beverages (SSBs) intake have been inconsistent. We aimed to summarize extant research that assessed the relation between short sleep duration and sugar and SSB intake.

METHODS

A comprehensive search of PubMed, ISI Web of Sciences, Scopus, Science Direct, Embase, and Google Scholar was conducted. All observational studies that reported sleep duration as the exposure and intake of sugar or sugary drinks as the outcome were included. The quality of included studies was evaluated using the Newcastle-Ottawa Scale. The body of evidence was assessed using the GRADE approach. Random and fixed effects models were used to estimate pooled OR and 95% confidence intervals.

RESULTS

Twenty-two studies in children and twelve in adults were included in the systematic review. Only 10 studies in children and 3 investigations in adults provided odds ratios (95% confidence intervals) for this association and could be included in the meta-analysis. All studies had a cross-sectional design and found a negative association between sleep duration and sugar in children, but not in adults. SSB intake was lower in those with sufficient sleep in all populations. Compared with those with sufficient sleep, children with short sleep duration had 16% (significant) higher odds of consuming sugar (OR: 1.16; 95% CI: 1.10, 1.21), 21% higher odds of soda intake (OR: 1.21; 95% CI: 1.16, 1.26), and 92% higher odds of consuming energy drink intake (OR: 1.92; 95% CI: 1.66, 2.22). However, sleep duration was not significantly associated with soft drink intake in children (OR: 1.17; 95% CI: 0.93, 1.48). In adults, the odds of drinking soda in those with short sleep duration was 1.2 times more than in those with sufficient sleep (OR: 1.20; 95% CI: 1.12, 1.28). Also, low vs. optimal sleep duration in adults was associated with a 58% increased intake of energy drinks (OR: 1.58; 95% CI: 1.31, 1.90). Of note, these findings in the adult population resulted from only 2 included investigations, due to the limited number of studies.

CONCLUSION

The evidence reviewed supports a significant association between shorter sleep duration and higher SSBs intake in both children and adults, while such association with higher total sugar intake was significant in children but not in adults. Further research with more accurate measurements, sex-specific, and prospective designs should be carried out to clarify the causality and underlying mechanisms.

A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities

This study examined the longitudinal associations between parental feeding practices and child weight status, and their potential modification effects by child sex, age, and maternal and paternal educations among children. Data were collected from 2015 to 2017 of 2139 children aged 6−17 years and their parents in five Chinese mega-cities. Parental feeding practices were assessed using 11-items from Child Feeding Questionnaire. Waist-to-height ratio (WHtR), body mass index (BMI), and general and central obesity were measured and analyzed using a mixed-effects model. Three parental feeding patterns were identified by factor analysis including “concern”, “pressure to eat”, and “control”. Concern was associated with higher BMI z-score, WHtR (βs ranged from 0.01 to 0.16), and general obesity (ORs ranged from 1.29 to 6.41) among children aged ≤12 years and >12 years, regardless of child sex and parental educations. Pressure to eat was associated with lower BMI z-score (β = −0.08, p < 0.001), WHtR (β = −0.004, p < 0.01), and general (OR = 0.53, 95%CI = 0.42, 0.66) and central obesity (OR = 0.72, 95%CI = 0.58, 0.90) among children aged ≤12 years. Further analyses showed that significant associations were found for children with maternal or paternal education of college and above. Control was associated with increased risk of general and central obesity among children with maternal education of college and above, regardless of age. Our study indicates that higher concern and lower pressure to eat were associated with increased risk of obesity among children. Control was associated with increased risk of obesity among children with maternal education of college and above. Future childhood obesity preventions may optimize parental feeding practices.