Breakfast: to skip or not to skip?

Timing Matters: The Interplay between Early Mealtime, Circadian Rhythms, Gene Expression, Circadian Hormones, and Metabolism-A Narrative Review

Achieving synchronization between the central and peripheral body clocks is essential for ensuring optimal metabolic function. Meal timing is an emerging field of research that investigates the influence of eating patterns on our circadian rhythm, metabolism, and overall health. This narrative review examines the relationship between meal timing, circadian rhythm, clock genes, circadian hormones, and metabolic function. It analyzes the existing literature and experimental data to explore the connection between mealtime, circadian rhythms, and metabolic processes. The available evidence highlights the importance of aligning mealtime with the body's natural rhythms to promote metabolic health and prevent metabolic disorders. Specifically, studies show that consuming meals later in the day is associated with an elevated prevalence of metabolic disorders, while early time-restricted eating, such as having an early breakfast and an earlier dinner, improves levels of glucose in the blood and substrate oxidation. Circadian hormones, including cortisol and melatonin, interact with mealtimes and play vital roles in regulating metabolic processes. Cortisol, aligned with dawn in diurnal mammals, activates energy reserves, stimulates appetite, influences clock gene expression, and synchronizes peripheral clocks. Consuming meals during periods of elevated melatonin levels, specifically during the circadian night, has been correlated with potential implications for glucose tolerance. Understanding the mechanisms of central and peripheral clock synchronization, including genetics, interactions with chronotype, sleep duration, and hormonal changes, provides valuable insights for optimizing dietary strategies and timing. This knowledge contributes to improved overall health and well-being by aligning mealtime with the body's natural circadian rhythm.

Association between lifestyle behaviors and health-related quality of life among primary health care physicians in China: A cross-sectional study

Background

Primary health care (PHC) serves as the gatekeeper of health system and PHC physicians take on significant obligations to provide health care services in the pursuit of Universal Health Coverage (UHC). PHC physicians' health-related quality of life (HRQoL) can have a strong impact on patients, physicians and the health care system. Lifestyle interventions are found to be effective to improve HRQoL. The purpose of this study was to evaluate the association between lifestyle behaviors and HRQoL among PHC physicians, so that lifestyle intervention can be tailored by policy makers for health promotion.

Methods

A survey covering 31 provinces and administrative regions in China was conducted in 2020 using a stratified sampling strategy. Data on sociodemographic characteristics lifestyle behaviors and HRQoL were collected by a self-administered questionnaire. HRQoL was measured through EuroQol-five dimension-five level (EQ-5D-5L) instrument. A Tobit regression model was performed to evaluate the association between sociodemographic characteristics, lifestyle behaviors and HRQoL.

Results

Among 894 PHC physicians who completed the survey, Anxiety/Depression (AD) was the dimension with the most problems reported (18.1%). Regular daily routine (β = 0.025, 95%CI 0.004 to 0.045) and good sleep quality (β = 0.049, 95% CI = 0.029 to 0.069) were protective factors for HRQoL, while smoking (β = −0.027, 95% CI = −0.079 to −0.003) and frequency of eating breakfast (β = −0.041, 95%CI = −0.079 to −0.003) were negatively associated with HRQoL. Physical activity and alcohol drinking were not significantly associated with HRQoL.

Conclusion

These findings suggest that tailored interventions on daily routine, improving sleep quality, and tobacco control among PHC physicians may be effective strategies to improve their HRQoL.

Chrononutrition in the management of diabetes

Circadian rhythms are 24-h cycles regulated by endogeneous molecular oscillators called the circadian clock. The effects of diet on circadian rhythmicity clearly involves a relationship between factors such as meal timings and nutrients, known as chrononutrition. Chrononutrition is influenced by an individual's "chronotype", whereby "evening chronotypes" or also termed "later chronotype" who are biologically driven to consume foods later in the day. Research in this area has suggested that time of day is indicative of having an influence on the postprandial glucose response to a meal, therefore having a major effect on type 2 diabetes. Cross-sectional and experimental studies have shown the benefits of consuming meals early in the day than in the evening on postprandial glycaemia. Modifying the macronutrient composition of night meals, by increasing protein and fat content, has shown to be a simple strategy to improve postprandial glycaemia. Low glycaemic index (GI) foods eaten in the morning improves glycaemic response to a greater effect than when consumed at night. Timing of fat and protein (including amino acids) co-ingested with carbohydrate foods, such as bread and rice, can reduce glycaemic response. The order of food presentation also has considerable potential in reducing postprandial blood glucose (consuming vegetables first, followed by meat and then lastly rice). These practical recommendations could be considered as strategies to improve glycaemic control, rather than focusing on the nutritional value of a meal alone, to optimize dietary patterns of diabetics. It is necessary to further elucidate this fascinating area of research to understand the circadian system and its implications on nutrition that may ultimately reduce the burden of type 2 diabetes.

Association of meal skipping with subjective health complaints in children and adolescents: the CASPIAN-V study

PURPOSE

Few studies have assessed the relationship between meal skipping with subjective health complaints in children and adolescents. The aim of our study was to determine the association between meal skipping and subjective health complaints in this population.

METHODS

A total of 14,400 students aged 7-18 years were selected using multistage stratified cluster sampling method from 30 provinces of Iran. Data were collected as a part of the fifth national school-based surveillance program (CASPIAN-V) in Iran. Information about students' lifestyle, health behaviours, health status and health complaints were gathered through a validated questionnaire.

RESULTS

The mean (standard deviation) age of participants was 12.3 (3.2) years old. Breakfast skipping was associated with increased odds of stomachache (OR 1.77, 95% CI 1.56, 2.00), backache (OR 1.68, 95% CI 1.46, 1.92), difficulty in getting to sleep (OR 1.66, 95% CI 1.48, 1.86), feeling nervous (OR 1.59, 95% CI 1.43, 1.76) and irritability (OR 1.29, 95% CI 1.02, 1.25). There were 27, 63, 58 and 107% increase in odds of headache, stomachache, backache and difficulty in getting to sleep by lunch skipping, respectively. While dinner skipping was related to 39, 59 and 52% increase in odds of headache, feeling low and difficulty in getting to sleep, respectively, it was associated with decreased odds of stomachache (OR 0.33, 95% CI 0.25, 0.44).

CONCLUSIONS

Our study suggests that meal skipping is associated with some somatic and psychological health complaints among children; therefore, regular meal consumption, at least three times a day, is highly recommended in this population.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

The association between the timing of energy intake and the risk of overweight and obesity among Saudi female university student

OBJECTIVES

To investigate the relationship between the timing of energy intake and obesity. Methods: A cross-sectional study was conducted between September 2018 and December 2018. A total of 450 Saudi female students from the University of Tabuk, Tabuk, Saudi Arabia were recruited. A 4-day dietary record was used to estimate the total energy intake per day and per meal. Height and weight were measured to calculate body mass index. Results: The study showed a significant negative association between obesity and energy intake at breakfast (r = -0.70, p less than 0.05) and mid-morning (r = -0.53, p less than 0.05) as well as a significant positive association between obesity and energy intake at dinner (r = 0.85, p less than 0.05). Additionally, there was no significant difference between the obese and normal weight groups in the total energy intake per day or the total percentage of energy from fat, carbohydrate, and protein per day. However, the total energy intake for each meal and the percentage of energy from fat, carbohydrate, and protein per meal were significantly different between the groups. Conclusion: The greater intake of energy at dinner was positively associated with obesity, while greater energy intake at breakfast were negatively associated with overweight and obesity.

Heritability of the timing of food intake

BACKGROUND & AIMS

While environmental factors are presumed to be primary drivers of food timing, preliminary evidence suggests that genetics may be an additional determinant. The aim was to explore the relative contribution of genetics and environmental factors to variation in the timing of food intake in a Spanish twin population. Because chronotype, bedtime and wake time are related to food timing, covariance with food timing was further assessed.

METHODS

In this observational study, 53 pairs of adult (mean (SD) = 52 (6.03) years) female twins (28 monozygotic; 25 dizygotic) were recruited from the Murcia Twin Register. Zygosity was determined by DNA-testing. Timing of the three main meals of the day was assessed via 7-day dietary records, and the midpoint of food intake was computed by calculating the midpoint between breakfast and dinner times. Chronotype, bedtime and wake time were self-reported. Heritability of food timing and related traits were estimated by comparing monozygotic and dizygotic twin correlations and fitting genetic structural equation models to measured variables.

RESULTS

We observed genetic influences for food timing, with highest heritability for the midpoint of food intake (64%) in an overweight/obese population (BMI = 26.01 ± 3.77). Genetic factors contributed to a higher degree to the timing of breakfast (56%) than the timing of lunch (38%) or dinner (n.s.). Similarly, heritability estimates were larger in related behavioral traits earlier on in the day (i.e. wake time, (55%)), than those later on in the day (i.e. bedtime, (38%)). Bivariate analyses revealed a significant genetic overlap between food timing and bedtime and chronotype (rG between 0.78 and 0.91).

CONCLUSIONS

Genetic influences appear to account for a significant proportion of the variability in food timing, particularly breakfast. Thus, interventions related to food timing may be more effective when targeting afternoon/evening traits, such as lunch or dinner times. Furthermore, our data suggest shared genetic architecture underlying food timing and phenotypically related traits.

CLINICAL TRIAL

NCT03059576. https://clinicaltrials.gov/ct2/show/NCT03059576.

Nutrition behaviors and sociodemographic factors associated with overweight in the multi-ethnic adolescents of New Caledonia

Objectives: New Caledonia is a multi-ethnic French territory in the Pacific, characterized by communities with widely varying nutritional habits. Little is currently known about adolescent food behaviors and habits and their association with overweight. This study therefore determined the sociodemographic factors and food behaviors associated with overweight and underweight in this population, as well as the factors associated with skipping breakfast. Methods: A cross-sectional survey was conducted among New Caledonian adolescents using a self-administered questionnaire; anthropometric measurements were also taken. Weight status was determined using international cutoffs, and the factors associated with overweight and underweight were identified with multiple logistic regression analysis. The factors associated with breakfast skipping were also determined. Results: Skipping breakfast, being Melanesian, living in a rural area and having low economic status were positively associated with overweight in these adolescents. Skipping breakfast was relatively infrequent, reported by 18% and 13% of the males and females, respectively. Logistic regression models found that the main factors associated with breakfast consumption habits were gender, weight status and ethnicity. Conclusions: Several factors are associated with overweight status in New Caledonian adolescents. Breakfast education should be improved for adolescents living in rural areas and from low socioeconomic status.

Unhealthy eating habits around sleep and sleep duration: To eat or fast?

Traditionally, breakfast skipping (BS), and recently late-night dinner eating (LNDE), have attracted attention in public health because they can predispose to cardiometabolic conditions such as obesity and type 2 diabetes. Intriguingly, it has become evident that short duration of sleep elicits similar health risks. As LNDE, BS, and short sleep can be closely related and can aggravate each other, these three should not be considered separately. In this context, LNDE (or its equivalents, snacking or heavy alcohol consumption after dinner) and BS may be representative unhealthy eating habits around sleep (UEHAS). While it is important to take energy in the early morning for physical and intellectual activities, attaining a fasting state is essential for metabolic homeostasis. Our previous UEHAS studies have shown that BS without LNDE, i.e., BS alone, is not associated with obesity and diabetes, suggesting the possibility that BS or taking a very low energy breakfast, which could yield fasting for a while, may prevent obesity and diabetes in people with inevitable LNDE. Further studies considering UEHAS and short sleep simultaneously are needed to elucidate the effects of these unhealthy lifestyles on cardiometabolic diseases.

Eat or Skip Breakfast? The Important Role of Breakfast Quality for Health-Related Quality of Life, Stress and Depression in Spanish Adolescents

This study examined the associations between eating or skipping breakfast and the quality of breakfast eaten on health-related quality of life (HRQOL), perceived stress and depression in 527 Spanish adolescents. Results showed differences in stress and two domains of HRQOL; Moods and Emotions and Parent Relations and Home Life between adolescent breakfast skippers and eaters, those having breakfast showing higher levels of stress and poor HRQOL. When breakfast quality was analyzed in breakfast eaters, adolescents who ate a good quality breakfast showed better HRQOL and lower levels of stress and depression than those who ate a poor or very poor quality breakfast. Further, breakfast skippers showed better HRQOL and lower levels of stress and depression than breakfast eaters who ate a poor or very poor quality breakfast. These findings indicate the importance of eating a good quality breakfast, rather than just having or not having breakfast. The conclusions of the present study are especially relevant for clinicians and nutritional educators, given the significant impact of breakfast quality on health-related quality of life, stress and depression observed in the adolescents studied.

Breakfast Skipping and overweight/obesity among European adolescents, a cross-sectional analysis of the HELENA dataset: a DEDIPAC study

Background: The aim was to examine demographic and dietary factors associated with breakfast skipping, and the relationship of breakfast skipping with overweight/obesity among adolescents across Europe. Methods: Cross-sectional data from the Healthy Lifestyle in Europe by Nutrition in Adolescence study (n=3528) conducted in ten European cities: Athens (Greece), Dortmund (Germany), Ghent (Belgium), Herkalion (Greece), Lille (France), Pecs (Hungary), Rome (Italy), Vienna (Austria), Stockholm (Sweden) and Zaragoza (Spain) were used.  Analysis was carried out using a sub-sample of adolescents (n=1894) aged 12.5-17.49 years with data on breakfast skipping and two days of 24-Hour Diet Recall data. As 24-Hour Recall data was not available from Pecs (Hungary) this city was excluded. Using responses from the Food Choices and Preferences Questionnaire adolescents were classified as breakfast skippers or non-breakfast skippers. All analyses were stratified by sex. Differences in the intake of macronutrients, both overall and when breakfast was excluded, and key foods were compared between skippers and non-skippers using Wilcoxen Rank Sum test. Multivariate logistic regression was used to examine the relationship between breakfast skipping and overweight/obesity. Results: Overall, 44% of females were skippers compared to 36% of males. Among both male and female estimated mean fibre intake and median fruit intake were significantly lower among skippers compared to non-skippers. Male skippers were significantly more likely than non-skippers to be overweight/obese [AOR = 2.34, 95% CI, 1.40-3.90] but this was not observed among females [AOR = 0.89, 95% CI 0.59-1.34]. Conclusions: Different patterns of daily macronutrient intake were observed among adolescents who skip and do not skip breakfast.  In males, breakfast skipping was associated with increased odds of being overweight/obese. Gender may play a key part in breakfast skipping behaviours. These results present an opportunity to identify and target adolescents who may be at risk of a poorer nutritional profile or overweight/obesity.

The sedentary (r)evolution: Have we lost our metabolic flexibility?

During the course of evolution, up until the agricultural revolution, environmental fluctuations forced the human species to develop a flexible metabolism in order to adapt its energy needs to various climate, seasonal and vegetation conditions. Metabolic flexibility safeguarded human survival independent of food availability. In modern times, humans switched their primal lifestyle towards a constant availability of energy-dense, yet often nutrient-deficient, foods, persistent psycho-emotional stressors and a lack of exercise. As a result, humans progressively gain metabolic disorders, such as the metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease, certain types of cancer, cardiovascular disease and Alzheimer´s disease, wherever the sedentary lifestyle spreads in the world. For more than 2.5 million years, our capability to store fat for times of food shortage was an outstanding survival advantage. Nowadays, the same survival strategy in a completely altered surrounding is responsible for a constant accumulation of body fat. In this article, we argue that the metabolic disease epidemic is largely based on a deficit in metabolic flexibility. We hypothesize that the modern energetic inflexibility, typically displayed by symptoms of neuroglycopenia, can be reversed by re-cultivating suppressed metabolic programs, which became obsolete in an affluent environment, particularly the ability to easily switch to ketone body and fat oxidation. In a simplified model, the basic metabolic programs of humans' primal hunter-gatherer lifestyle are opposed to the current sedentary lifestyle. Those metabolic programs, which are chronically neglected in modern surroundings, are identified and conclusions for the prevention of chronic metabolic diseases are drawn.

The sedentary (r)evolution: Have we lost our metabolic flexibility?

During the course of evolution, up until the agricultural revolution, environmental fluctuations forced the human species to develop a flexible metabolism in order to adapt its energy needs to various climate, seasonal and vegetation conditions. Metabolic flexibility safeguarded human survival independent of food availability. In modern times, humans switched their primal lifestyle towards a constant availability of energy-dense, yet often nutrient-deficient, foods, persistent psycho-emotional stressors and a lack of exercise. As a result, humans progressively gain metabolic disorders, such as the metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease, certain types of cancer, cardiovascular disease and Alzheimer´s disease, wherever the sedentary lifestyle spreads in the world. For more than 2.5 million years, our capability to store fat for times of food shortage was an outstanding survival advantage. Nowadays, the same survival strategy in a completely altered surrounding is responsible for a constant accumulation of body fat. In this article, we argue that the metabolic disease epidemic is largely based on a deficit in metabolic flexibility. We hypothesize that the modern energetic inflexibility, typically displayed by symptoms of neuroglycopenia, can be reversed by re-cultivating suppressed metabolic programs, which became obsolete in an affluent environment, particularly the ability to easily switch to ketone body and fat oxidation. In a simplified model, the basic metabolic programs of humans’ primal hunter-gatherer lifestyle are opposed to the current sedentary lifestyle. Those metabolic programs, which are chronically neglected in modern surroundings, are identified and conclusions for the prevention of chronic metabolic diseases are drawn.

Energy and Nutrient Timing for Weight Control: Does Timing of Ingestion Matter?

Over the past 40 years, meal skipping and snacking in US adults have increased, and currently most eating occasions occur later in the day than previously. Whether these changes have played a causal role in the obesity epidemic is poorly understood. Observational studies are largely inconclusive due to methodological limitations. Experimental evidence does not support a causal role for eating frequency or breakfast skipping in weight control. Emerging evidence suggests that eating irregularity and eating later in the day may be detrimental for weight control, but more studies are needed. This article summarizes studies and highlights areas needing attention.

Unified theory of Alzheimer's disease (UTAD): implications for prevention and curative therapy

The aim of this review is to propose a Unified Theory of Alzheimer's disease (UTAD) that integrates all key behavioural, genetic and environmental risk factors in a causal chain of etiological and pathogenetic events. It is based on three concepts that emanate from human's evolutionary history: (1) The grandmother-hypothesis (GMH), which explains human longevity due to an evolutionary advantage in reproduction by trans-generational transfer of acquired knowledge. Consequently it is argued that mental health at old-age must be the default pathway of humans' genetic program and not development of AD. (2) Therefore, mechanism like neuronal rejuvenation (NRJ) and adult hippocampal neurogenesis (AHN) that still function efficiently even at old age provide the required lifelong ability to memorize personal experiences important for survival. Cumulative evidence from a multitude of experimental and epidemiological studies indicate that behavioural and environmental risk factors, which impair productive AHN, result in reduced episodic memory performance and in reduced psychological resilience. This leads to avoidance of novelty, dysregulation of the hypothalamic-pituitary-adrenal (HPA)-axis and cortisol hypersecretion, which drives key pathogenic mechanisms of AD like the accumulation and oligomerization of synaptotoxic amyloid beta, chronic neuroinflammation and neuronal insulin resistance. (3) By applying to AHN the law of the minimum (LOM), which defines the basic requirements of biological growth processes, the UTAD explains why and how different lifestyle deficiencies initiate the AD process by impairing AHN and causing dysregulation of the HPA-axis, and how environmental and genetic risk factors such as toxins or ApoE4, respectively, turn into disease accelerators under these unnatural conditions. Consequently, the UTAD provides a rational strategy for the prevention of mental decline and a system-biological approach for the causal treatment of AD, which might even be curative if the systemic intervention is initiated early enough in the disease process. Hence an individualized system-biological treatment of patients with early AD is proposed as a test for the validity of UTAD and outlined in this review.

Within-person comparison of eating behaviors, time of eating, and dietary intake on days with and without breakfast: NHANES 2005-2010

BACKGROUND

Breakfast omission is known to be associated with lower 24-h energy intake. However, little is known about downstream eating behaviors subsequent to skipping breakfast in free-living individuals.

OBJECTIVE

We replicated the traditional crossover design of nutrition studies in a naturalistic setting to compare within-person differences in self-reported eating behaviors, energy intake, and other dietary characteristics of individuals on a day that included breakfast with a day that omitted breakfast.

DESIGN

We used cross-sectional dietary data for 2132 adult respondents who reported breakfast in only one of 2 dietary recalls in the NHANES 2005-2010. Dietary outcomes examined included meal- and snack-eating behaviors, clock time of eating episodes, and intakes of energy, macronutrients, and food groups. Regression methods accounted for replicate diet measurements, covariates, and survey-design characteristics.

RESULTS

The breakfast meal provided a mean of 508 kcal in men and 374 kcal in women, but differences in 24-h energy intakes between the breakfast and no-breakfast day were 247 and 187 kcal, respectively. Energy intakes at the lunch meal were higher on the no-breakfast day (202 kcal in men and 121 kcal in women), and the reported time of lunch was ∼35 min earlier. The energy contribution of dinner or its reported time did not differ. A higher number of energy-adjusted servings of fruit and whole grains were reported on the breakfast day, but the energy and macronutrient density of reported foods were not different.

CONCLUSIONS

In free-living American adults, the eating time for lunch was earlier, and the lunch meal provided more energy on the no-breakfast day than on the breakfast day. Although the quality of dietary selections reflected in the energy and macronutrient density of a day's intake did not differ between the breakfast and the no-breakfast day, breakfast skippers may need encouragement to consume fruit and whole grains at other eating episodes.

Obesity, the deadly quartet and the contribution of the neglected daily organ rest - a new dimension of un-health and its prevention

The "deadly quartet": excessive weight, hypertension, impaired glucose homeostasis, and atherogenic dyslipidemia constitute a greater threat to health than the added effects of smoking and alcohol abuse. It is strongly associated with unrestricted consumption of processed, refined foods. Recent observations from experience in South East Asia shows that the interval between lifestyle changes and associated change in disease pattern is shorter than earlier believed. Recent experience from obesity studies in Africa demonstrates not only dramatic changes in health but also large social consequences from being overweight. Obesity is not only a result of overeating - dozens of other factors are known to contribute. Our palaeolithic forefathers and those living a similar lifestyle today are reported to rarely have diseases and to live a long life. One such group is the Hunzas, living in Northern Pakistan, are reported to live on a daily 1,800-calorie 99% plant-based diet, consisting in 73% of mostly unrefined/unprocessed carbohydrates, 17% fat and 10% protein. They, and most likely also our forefathers, do/did most likely only eat twice a day, at noon and early evening. Calorie-restriction (CR) and also fasting was early recommended and has been so during thousands of years - early Greek medicine and giants such as Hippocrates, Galenus and later also Paracelsus prescribed restrictions in eating and fasting. So did Middle Age physicians and other nutrition experts such as Louis Cornado. Today it is again practiced around the World. Overeating and heavy postprandial metabolism is a great burden to the body causing elevated levels in blood of endotoxin, increased inflammatory and oxidative stress, release of tumor necrosis factor-α, and other pro-inflammatory cytokines, increases in numbers of and activating of leukocytes, a reaction that is potentiated by the presence of large-chain fatty acids and sugars. Various metabolic, uremic, microbiota-derived and environmental poisons accumulate in large amounts in the adipose tissues. High levels of poisons in the adipose tissues decreases the turnover of fats in order to protect other organs. The content in adipose of POPs - altogether 17 dioxins/furans and 18 polychlorinated biphenyl congeners, has been reported to be 2-3 times higher in obese compared to lean persons. Daily fasting consisting in 16 to 18 hours of avoidance of calorie intake offers an interesting alternative. An attractive policy is to abstain from eating between 18:00 in the evening and 10:00 or 12:00 AM, a plan, which I personally have practiced during many years.

Relative Contribution of Obesity, Sedentary Behaviors and Dietary Habits to Sleep Duration Among Kuwaiti Adolescents

The aim of this study was to investigate whether body mass index (BMI), eating habits and sedentary behaviours were associated with sleep duration among Kuwaiti adolescents. The study is part of the Arab Teens Lifestyle Study (ATLS), which is a school-based cross-sectional multi-center collaborative study. A sample of 906 adolescents (boys and girls) aged 14-19 years was randomly selected from 6 Kuwaiti Governances using a multistage stratified cluster sampling technique. The findings revealed that the prevalence of overweight and obesity was 50.5% in boys and 46.5% in girls. The majority of boys (76%) and of girls (74%) fell into the short sleep duration category (6 hours/day or less). Sleep duration were found to be negatively associated with BMI (girls only). Watching television (boys and girls) and working on computers (boys only) were also negatively associated with sleep duration. While the consumption of breakfast (both genders) and milk (boys only) was positively associated with sleep duration (p<0.05). In contrast, the consumption of fast foods (both genders), sugar-sweetened drinks and sweets (boys only) potatoes (girls only) were negatively associated with sleep duration (p<0.05). It can be concluded that the majority of Kuwaiti adolescents exhibit insufficient sleep duration which was associated with obesity measure, a combination of poor eating habits and more sedentary behaviors. The findings also suggest gender differences in these associations. Therefore, adequate sleep is an important modifiable risk factor to prevent obesity and was positively associated with some unhealthy lifestyle habits.