Short sleep duration and large variability in sleep duration are independently associated with dietary risk factors for obesity in Danish school children.
BACKGROUND
Lack of sleep and increased consumption of energy-dense foods and sugar-sweetened beverages (SSBs) have all been suggested as factors contributing to the increased prevalence of overweight and obesity.


OBJECTIVE
To evaluate whether objectively measured sleep duration (average and day-to-day variability) as well as parent-reported sleep problems are independently associated with proposed dietary risk factors for overweight and obesity in 8-11-year-old children.


METHODS
In this cross-sectional study, data on sleep duration and day-to-day variability in sleep duration were measured in 676 Danish, apparently healthy children by an objective measure (actigraphy) for 8 nights, and the Children's Sleep Habits Questionnaire (CSHQ) was filled out by the parents. Diet was recorded using a web-based food record for 7 consecutive days. Fasting blood samples were obtained for measurements of plasma leptin and ghrelin levels.


RESULTS
Sleep duration (h per night) was negatively associated with energy density (ED) of the diet (β = -0.32 kJ g(-1)), added sugar (β = -1.50 E%) and SSBs (β = -1.07 E%) (all P ≤ 0.003). Furthermore, variability in sleep duration (10-min per night) was positively associated with SSBs (β = 0.20 E%, P = 0.03), independent of sleep duration, and CSHQ score was positively associated with ED (β = 0.16 kJ g(-1), P = 0.04). All of these associations were independent of potential confounders (age, sex, pubertal status, height, weight, screen time, moderate-to-vigorous physical activity and parental education and ethnicity).


CONCLUSIONS
Our study suggests that short sleep duration, high sleep duration variability and experiencing sleep problems are all associated with a poor, obesity-promoting diet in children.
1] Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark [2] Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
J S
JS
Kjeldsen
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
M F
MF
Hjorth
Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark.
R
R
Andersen
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
K F
KF
Michaelsen
Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark.
I
I
Tetens
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
A
A
Astrup
Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
J-P
JP
Chaput
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
A
A
Sjödin
D000704:Analysis of Variance; D001628:Beverages / Q000009:adverse effects; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003430:Cross-Sectional Studies; D003718:Denmark; D004032:Diet / Q000009:adverse effects*; D004040:Dietary Carbohydrates / Q000009:adverse effects; D004041:Dietary Fats / Q000009:adverse effects; D019422:Dietary Sucrose / Q000009:adverse effects; D002149:Energy Intake; D005215:Fasting / Q000097:blood; D005247:Feeding Behavior; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D020738:Leptin / Q000097:blood*; D010290:Parents; D063766:Pediatric Obesity / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D020178:Sleep Disorders, Circadian Rhythm / Q000097:blood / Q000150:complications* / Q000517:prevention & control; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D019422:Dietary Sucrose; D054439:Ghrelin; D020738:Leptin