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Haszard JJ, Jackson R, Morrison S, Meredith-Jones KA, Galland BC, Beebe DW, Elder DE, Taylor RW. Losing sleep influences dietary intake in children: a longitudinal compositional analysis of a randomised crossover trial. Int J Behav Nutr Phys Act 2024; 21:61. [PMID: 38835084 PMCID: PMC11149344 DOI: 10.1186/s12966-024-01607-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 05/20/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Although inadequate sleep increases the risk of obesity in children, the mechanisms remain unclear. The aims of this study were to assess how sleep loss influenced dietary intake in children while accounting for corresponding changes in sedentary time and physical activity; and to investigate how changes in time use related to dietary intake. METHODS A randomized crossover trial in 105 healthy children (8-12 years) with normal sleep (~ 8-11 h/night) compared sleep extension (asked to turn lights off one hour earlier than usual for one week) and sleep restriction (turn lights off one hour later) conditions, separated by a washout week. 24-h time-use behaviors (sleep, wake after sleep onset, physical activity, sedentary time) were assessed using waist-worn actigraphy and dietary intake using two multiple-pass diet recalls during each intervention week. Longitudinal compositional analysis was undertaken with mixed effects regression models using isometric log ratios of time use variables as exposures and dietary variables as outcomes, and participant as a random effect. RESULTS Eighty three children (10.2 years, 53% female, 62% healthy weight) had 47.9 (SD 30.1) minutes less sleep during the restriction week but were also awake for 8.5 (21.4) minutes less at night. They spent this extra time awake in the day being more sedentary (+ 31 min) and more active (+ 21 min light physical activity, + 4 min MVPA). After adjusting for all changes in 24-h time use, losing 48 min of sleep was associated with consuming significantly more energy (262 kJ, 95% CI:55,470), all of which was from non-core foods (314 kJ; 43, 638). Increases in sedentary time were related to increased energy intake from non-core foods (177 kJ; 25, 329) whereas increases in MVPA were associated with higher intake from core foods (72 kJ; 7,136). Changes in diet were greater in female participants. CONCLUSION Loss of sleep was associated with increased energy intake, especially of non-core foods, independent of changes in sedentary time and physical activity. Interventions focusing on improving sleep may be beneficial for improving dietary intake and weight status in children. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ANZCTR ACTRN12618001671257, Registered 10th Oct 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true.
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Affiliation(s)
| | - Rosie Jackson
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Kim A Meredith-Jones
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, 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 Centre, Cincinnati, OH, USA
| | - Dawn E Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Rachael W Taylor
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand.
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Galland BC, Haszard JJ, Jackson R, Morrison S, Meredith-Jones K, Elder DE, Beebe D, Taylor RW. Predictors for achieving optimal sleep in healthy children: Exploring sleep patterns in a sleep extension trial. Sleep Health 2024; 10:213-220. [PMID: 37980245 DOI: 10.1016/j.sleh.2023.09.012] [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: 01/10/2023] [Revised: 07/19/2023] [Accepted: 09/24/2023] [Indexed: 11/20/2023]
Abstract
STUDY OBJECTIVES Earlier bedtimes can help some children get more sleep, but we don't know which children, or what features of their usual sleep patterns could predict success with this approach. Using data from a randomized crossover trial of sleep manipulation, we sought to determine this. METHODS Participants were 99 children aged 8-12years (49.5% female) with no sleep disturbances. Sleep was measured by actigraphy at baseline and over a restriction or extension week (1 hour later or earlier bedtime respectively), randomly allocated and separated by a washout week. Data were compared between baseline (week 1) and extension weeks only (week 3 or 5), using linear or logistic regression analyses as appropriate, controlling for randomization order. RESULTS One hour less total sleep time than average at baseline predicted 29.7 minutes (95% CI: 19.4, 40.1) of sleep gained and 3.45 (95% CI: 1.74, 6.81) times higher odds of successfully extending sleep by >30 minutes. Per standardized variable, less total sleep time and a shorter sleep period time were the strongest predictors (significant odds ratios (ORs) of 2.51 and 2.28, respectively). Later sleep offset, more variability in sleep timing and lower sleep efficiency also predicted sleep gains. The sleep period time cut-point that optimized prediction of successful sleep gains was <8 hours 28 minutes with 75% of children's baseline sleep in that range. CONCLUSIONS Children with a baseline sleep period time <8½ hours a night obtained the most sleep from earlier bedtimes maintained over a week, demonstrating experimentally the value of earlier bedtimes to improve sleep. CLINICAL TRIALS REGISTRY Australian New Zealand Clinical Trial Registry, ACTRN12618001671257, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true.
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Affiliation(s)
- Barbara C Galland
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand.
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dawn E Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Dean Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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Calcaterra V, Rossi V, Tagi VM, Baldassarre P, Grazi R, Taranto S, Zuccotti G. Food Intake and Sleep Disorders in Children and Adolescents with Obesity. Nutrients 2023; 15:4736. [PMID: 38004130 PMCID: PMC10675320 DOI: 10.3390/nu15224736] [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: 10/14/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Over the last few decades, numerous scientific studies have investigated the possible association between sleep duration and adiposity during childhood, since it has been reported that sleep deprivation causes a related increase in caloric intake. Even though the underlying pathogenetic mechanisms are still under study and not completely known, the effect of dietetic habits and nutrient intake on sleep quality and patterns has been reported. The aim of this study is to explore the intricate interplay between food intake/diet patterns and pediatric sleep disturbances in children and adolescents with obesity, emphasizing the importance of not underestimating this aspect in the prevention and treatment of this complex disease. Recent evidence supports a high correlation between specific diet patterns and foods with sleep disturbances in children at all ages. Diets rich in fiber, fruit, vegetables, and anti-inflammatory nutrients and low in saturated fats seem to promote better sleep quality. Sleep disturbances are, in turn, risk factors for the development of obesity. Therefore, food strategies should be applied to counteract this harmful process. Unraveling the complex links between dietary habits, sleep patterns, and obesity is essential for developing effective strategies to combat this critical public health issue.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Virginia Rossi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Veronica Maria Tagi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Paola Baldassarre
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Roberta Grazi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.R.); (V.M.T.); (P.B.); (R.G.); (S.T.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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Taylor RW, Haszard JJ, Jackson R, Morrison S, Beebe DW, Meredith-Jones KA, Elder DE, Galland BC. Effect of Sleep Changes on Health-Related Quality of Life in Healthy Children: A Secondary Analysis of the DREAM Crossover Trial. JAMA Netw Open 2023; 6:e233005. [PMID: 36920394 PMCID: PMC10018327 DOI: 10.1001/jamanetworkopen.2023.3005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
IMPORTANCE Little is known regarding the effect of poor sleep on health-related quality of life (HRQOL) in healthy children. OBJECTIVE To determine the effect of induced mild sleep deprivation on HRQOL in children without major sleep issues. DESIGN, SETTING, AND PARTICIPANTS This prespecified secondary analysis focused on HRQOL, a secondary outcome of the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized crossover trial of children who underwent alternating weeks of sleep restriction and sleep extension and a 1-week washout in between. The DREAM trial intervention was administered at participants' homes between October 2018 and March 2020. Participants were 100 children aged 8 to 12 years who lived in Dunedin, New Zealand; had no underlying medical conditions; and had parent- or guardian-reported normal sleep (8-11 hours/night). Data were analyzed between July 4 and September 1, 2022. INTERVENTIONS Bedtimes were manipulated to be 1 hour later (sleep restriction) and 1 hour earlier (sleep extension) than usual for 1 week each. Wake times were unchanged. MAIN OUTCOMES AND MEASURES All outcome measures were assessed during both intervention weeks. Sleep timing and duration were assessed using 7-night actigraphy. Children and parents rated the child's sleep disturbances (night) and impairment (day) using the 8-item Pediatric Sleep Disturbance and 8-item Sleep-Related Impairment scales of the Patient-Reported Outcomes Measurement Information System questionnaire. Child-reported HRQOL was assessed using the 27-item KIDSCREEN questionnaire with 5 subscale scores and a total score. Both questionnaires assessed the past 7 days at the end of each intervention week. Data were presented as mean differences and 95% CIs between the sleep restriction and extension weeks and were analyzed using intention to treat and an a priori difference in sleep of at least 30 minutes per night. RESULTS The final sample comprised 100 children (52 girls [52%]; mean [SD] age, 10.3 [1.4] years). During the sleep restriction week, children went to sleep 64 (95% CI, 58-70) minutes later, and sleep offset (wake time) was 18 (95% CI, 13-24) minutes later, meaning that children received 39 (95% CI, 32-46) minutes less of total sleep per night compared with the sleep extension week in which the total sleep time was 71 (95% CI, 64-78) minutes less in the per-protocol sample analysis. Both parents and children reported significantly less sleep disturbance at night but greater sleep impairment during the day with sleep restriction. Significant standardized reductions in physical well-being (standardized mean difference [SMD], -0.28; 95% CI, -0.49 to -0.08), coping in a school environment (SMD, -0.26; 95% CI, -0.42 to -0.09), and total HRQOL score (SMD, -0.21; 95% CI, -0.34 to -0.08) were reported by children during sleep restriction, with an additional reduction in social and peer support (SMD, -0.24; 95% CI, -0.47 to -0.01) in the per-protocol sample analysis. CONCLUSIONS AND RELEVANCE Results of this secondary analysis of the DREAM trial indicated that even 39 minutes less of sleep per night for 1 week significantly reduced several facets of HRQOL in children. This finding shows that ensuring children receive sufficient good-quality sleep is an important child health issue. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12618001671257.
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Affiliation(s)
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Dean W. Beebe
- Department of Neuropsychology, Cincinnati Children’s Hospital Medical Centre, Cincinnati, Ohio
| | | | - Dawn E. Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Barbara C. Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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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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Zarpellon RS, Vilela DRM, Louzada FM, Radominski DRB, Crippa DACDS. Association of food intake with sleep disorders in children and adolescents with obesity. Sleep Med X 2022; 4:100053. [PMID: 36072436 PMCID: PMC9442327 DOI: 10.1016/j.sleepx.2022.100053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/28/2022] [Accepted: 08/10/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction the great increase in childhood obesity rates is well documented in the scientific literature. However, the influence of diet on sleep quality in children and adolescents still needs further research in order to be better understood. The objective of this study was to evaluate the association between diet and sleep characteristics and in children and adolescents with obesity. Methods observational analytical cross-sectional study with prospective data collection. Forty-three children and adolescents aged between 6 and 13 years diagnosed with obesity and treated at a public tertiary care institution participated in the study. The 6-day Food Intake Registry was used to evaluate the intake of energy and macronutrients. To investigate the risk of sleep disturbances and to know the routine and characteristics of sleeping habits, the Sleep Disturbance Scale for Children (SDSC) questionnaire was used. Results and discussion: Food intake showed association with Sleep Breathing Disorders (SBD) and Sleep Wake Transition Disorders (SWTD). The sum of all SDSC factors demonstrated the presence of pathological sleep in most patients (n = 25). Positive association between food intake and SBD through the analysis of the SDSC. Positive association between food intake and SWTD through the analysis of the SDSC. Positive association between food intake and the risk for sleep disorders.
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Affiliation(s)
- Raquel S.M. Zarpellon
- Postgraduate Program in Child and Adolescent Health, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil
- Corresponding author.
| | - Dra Regina M. Vilela
- Federal University of Paraná (UFPR), Health Sciences Sector, Department of Nutrition, Curitiba, Paraná, Brazil
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Ruan H, Zhang Y, Tang Q, Zhao X, Zhao X, Xiang Y, Geng W, Feng Y, Cai W. Sleep duration of lactating mothers and its relationship with feeding pattern, milk macronutrients and related serum factors: A combined longitudinal cohort and cross-sectional study. Front Nutr 2022; 9:973291. [PMID: 36110402 PMCID: PMC9468784 DOI: 10.3389/fnut.2022.973291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Insufficient sleep is common in postpartum mothers. The main objectives of this study are to explore the sleep duration among Chinese lactating mothers and preliminarily investigate the relationship between sleep duration and feeding pattern. The secondary objectives are to investigate the relationships between sleep duration and milk macronutrients and between maternal-related indicators, including melatonin (MT), growth hormone (GH), ghrelin (GHRL), glucagon-like peptide-1 (GLP-1), prolactin (PRL), and cholecystokinin (CCK). Methods The present study comprises a longitudinal and a cross-sectional cohort from December 2019 to December 2021. Postpartum lactating women living in Shanghai were recruited through online and offline recruitment. The subjects were included in the longitudinal cohort or cross-sectional study based on their lactation period at the time of recruitment. The longitudinal cohort included a total of 115 mothers. Human milk and feeding pattern were measured and collected at 2–4 months and 5–7 months postpartum. At four predetermined follow-up time points, data on sleep duration was collected (at the time of recruitment, 2–4 months postpartum, 5–7 months postpartum, and 12–17 months postpartum). The cross-sectional study included 35 lactating mothers (2–12 months postpartum) who reported their sleep duration and provided blood samples. Mid-infrared spectroscopy (MIRS) method was used to analyze the macronutrients of breast milk, while MT, GH, GHRL, GLP-1, PRL, and CCK in maternal blood were determined by ELISA. Results The maternal sleep duration before pregnancy was 8.14 ± 1.18 h/d (n = 115), 7.27 ± 1.31 h/d (n = 113) for 2–4 months postpartum, 7.02 ± 1.05 h/d (n = 105) for 5–7 months postpartum, and 7.45 ± 1.05 h/d (n = 115) for 12–17 months postpartum. The incidence of insufficient sleep (<7 h/d) before pregnancy (12.17%) was significantly less than at any follow-up time after delivery (vs. 2–4 months postpartum, χ2 = 10.101, p = 0.001; vs. 5–7 months postpartum, χ2 = 15.281, p < 0.0001; vs. 12–17 months postpartum, χ2 = 6.426, p = 0.011). The percentage of insufficient maternal sleep was highest at 5–7 months postpartum (34.29%). No significant difference was found between the incidence of insufficient sleep at 5–7 months postpartum, 2–4 months postpartum (29.20%, χ2 = 0.650, p = 0.420), and 12–17 months postpartum (25.22%, χ2 = 2.168, p = 0.141). At 2–4 months postpartum, the frequency of formula feeding per day is related to reduced maternal sleep duration (Standardization coefficient β = −0.265, p = 0.005, Adjusted R2 = 0.061). At 2–4 months and 5–7 months postpartum, the relationship between macronutrients in breast milk and the mother's sleep duration was insignificant (all p > 0.05). Other than the positive correlation found between maternal GHRL and sleep duration (r = 0.3661, p = 0.0305), no significant relationship was observed between sleep duration and other indexes (all p > 0.05). Conclusions Postpartum mothers generally sleep less, but there is no correlation between insufficient sleep and the macronutrient content of breast milk. Formula feeding may be related to the mother's sleep loss, while breastfeeding (especially direct breastfeeding) may be related to increased maternal sleep duration. The findings suggest that sleep duration is related to maternal serum GHRL. More high-quality studies are needed to clarify the mechanism of these findings and provide a solid theoretical basis and support references for breastfeeding.
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Affiliation(s)
- Huijuan Ruan
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yajie Zhang
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
- Shanghai Institute of Pediatric Research, Shanghai, China
| | - Qingya Tang
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuan Zhao
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuelin Zhao
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xiang
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Geng
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Feng
- Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Cai
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China
- Shanghai Institute of Pediatric Research, Shanghai, China
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Wei Cai
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Bastian A, Parks C, Yaroch A, McKay FH, Stern K, van der Pligt P, McNaughton SA, Lindberg R. Factors Associated with Food Insecurity among Pregnant Women and Caregivers of Children Aged 0-6 Years: A Scoping Review. Nutrients 2022; 14:nu14122407. [PMID: 35745136 PMCID: PMC9227310 DOI: 10.3390/nu14122407] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023] Open
Abstract
With a global focus on improving maternal and child nutrition through the 2030 Sustainable Development Goals, it is important to understand food insecurity in pregnant women and families with young children, as food insecurity at these life stages can have ongoing negative health consequences. However, factors that influence food insecurity among this population group are not well understood. This scoping review investigates the factors that influence food insecurity among pregnant women and households with young children aged 0–6 years living in high-income countries. A scoping literature review was conducted using four electronic databases. The search combined terms relevant to: food security, determinants, pregnancy and family and high-income countries. Only full text and English language articles were included. The search identified 657 titles and abstracts; 29 articles were included in the review. A majority (70%) of the studies were conducted in the United States and were mostly either cross-sectional or secondary data analysis of existing population data. Factors associated with food insecurity were identified and grouped into 13 constructs. These included social, economic and health risk factors, food access and utilization factors and health and dietary outcomes. This scoping review identifies the factors associated with food insecurity among pregnant women and families with young children that could be used to better measure and understand food insecurity, which could assist in developing program and policy responses. This review also highlights the lack of literature from high-income countries outside the US.
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Affiliation(s)
- Amber Bastian
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia; (A.B.); (P.v.d.P.); (S.A.M.)
| | - Courtney Parks
- Gretchen Swanston Centre for Nutrition, 8401 W Dodge Rd, Omaha, NE 68114, USA; (C.P.); (A.Y.); (K.S.)
| | - Amy Yaroch
- Gretchen Swanston Centre for Nutrition, 8401 W Dodge Rd, Omaha, NE 68114, USA; (C.P.); (A.Y.); (K.S.)
| | - Fiona H. McKay
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia;
| | - Katie Stern
- Gretchen Swanston Centre for Nutrition, 8401 W Dodge Rd, Omaha, NE 68114, USA; (C.P.); (A.Y.); (K.S.)
| | - Paige van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia; (A.B.); (P.v.d.P.); (S.A.M.)
| | - Sarah A. McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia; (A.B.); (P.v.d.P.); (S.A.M.)
| | - Rebecca Lindberg
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 2000, Geelong, VIC 3220, Australia; (A.B.); (P.v.d.P.); (S.A.M.)
- Correspondence: ; Tel.: +61-3-9246-8947
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Measuring short-term eating behaviour and desire to eat: Validation of the child eating behaviour questionnaire and a computerized 'desire to eat' computerized questionnaire. Appetite 2021; 167:105661. [PMID: 34437924 DOI: 10.1016/j.appet.2021.105661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/18/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022]
Abstract
The Child Eating Behaviour Questionnaire (CEBQ) is designed to measure 'usual' eating behaviour, with no time period attached, thus may not be suitable for assessing the effectiveness of short-term experimental studies. The aim of this study was to validate i) the CEBQ adapted to measure 'past week' rather than 'usual' eating behaviour, and ii) a computerized questionnaire assessing desire to eat core and non-core foods, against an objective measure of eating behaviour and food intake (eating in the absence of hunger (EAH) experiment). Children (n = 103) aged 8-12 years completed the desire to eat questionnaire followed by the EAH experiment while primary caregivers completed the adapted CEBQ. Results from the CEBQ showed that children with greater 'satiety responsiveness' (1-point higher) consumed less energy (-342 kJ; 95% CI -574, -110) whereas those with greater 'enjoyment of food' scale consumed more energy (380 kJ; 95% CI 124, 636) during the ad-libitum phase of the EAH experiment. Higher scores for slowness in eating (-705 kJ; 95% CI -1157, -254), emotional undereating (-590 kJ; 95% CI -1074, -106) and food fussiness (-629 kJ; 95% CI -1103, -155) were associated with lower total energy intake. Children who expressed greater desire to eat non-core foods consumed more energy in total (275 kJ; 95% CI 87, 463). Overall, this adapted CEBQ appears valid for measuring several short-term eating behaviours in children. The desire to eat questionnaire may be useful for identifying short-term susceptibility to overeating, however further investigation into how ratings of desire relate to the intake of highly palatable, energy dense foods is warranted.
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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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Ward AL, Jospe M, Morrison S, Reynolds AN, Kuroko S, Fangupo LJ, Smith C, Galland BC, Taylor RW. Bidirectional associations between sleep quality or quantity, and dietary intakes or eating behaviors in children 6-12 years old: a systematic review with evidence mapping. Nutr Rev 2021; 79:1079-1099. [PMID: 33440009 DOI: 10.1093/nutrit/nuaa125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Although dietary advice has long been a cornerstone of a healthy lifestyle, how sleep quality and quantity may interact with dietary intake or eating behaviors remains unclear. OBJECTIVE To consider a bidirectional relationship between sleep and diet in children aged 6-12 years via a systematic review following PRISMA guidelines. DATA SOURCES Relevant trials and observational studies were identified by searching the PubMed, Medline, Embase, and CENTRAL databases up to June 1, 2019, without language or date restrictions and supplemented with hand searching. Recognized procedures and reporting standards were applied. DATA EXTRACTION Data on participant characteristics, study parameters, diet measures, sleep measures, and findings of study quality assessment criteria were collected. DATA ANALYSIS Forty-five articles involving 308 332 participants on a diverse range of topics were included. Meta-analyses were planned but were impossible to perform due to high study heterogeneity. Most studies (82%) were cross-sectional, which prevented examining directionality of the observed associations. Risk of bias was assessed for trial, cohort studies, and cross-sectional studies, using the Cochrane Risk of Bias Tool or Newcastle Ottawa Scale. RESULTS Of 16 studies in which the effect of sleep on dietary intake was investigated, 81% (n = 13) reported a significant association. All studies (n = 8) of sugar-sweetened or caffeinated beverages reported a negative association with sleep, and in 6 of 7 studies in which eating behaviors were investigated, associations with sleep were reported. The use of objective measures of sleep and diet were scarce, with most trials and studies relying on subjective measures of sleep (68%) or diet (93%). CONCLUSION Because most studies investigating the relationship between sleep and diet in this age group are cross-sectional, temporality could not be determined. Additional randomized controlled trials and long-term cohort studies in middle childhood, particularly those using objective rather than questionnaire measures of sleep, are required to better understand interactions between diet and sleep. SYSTEMATIC REVIEW REGISTRATION Prospectively registered with PROSPERO International Prospective Register of Systematic Reviews (CRD42018091647).
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Affiliation(s)
- Aimee L Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand and Department of Geography, Kent State University, Kent, Ohio, USA
| | - Michelle Jospe
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Sarahmarie Kuroko
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Louise J Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Claire Smith
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand
| | - Barbara C Galland
- Department of Women's & Children's Health, University of Otago, Dunedin, New Zealand
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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