title: A pilot study to determine the short-term effects of milk with differing glycaemic properties on sleep among toddlers: a randomised controlled trial.
abstract: BACKGROUND
  Sleep is important for children as it directly impacts their mental and physical development. Sleep is not only influenced by the timing but also the macronutrient (carbohydrate and protein) content of meals. Glycaemic index (GI) and glycaemic load (GL) describe the quality of carbohydrates in a food and the burden of these foods on the body's blood glucose response. Diets with a high GI/GL may increase the risk of developing obesity and type 2 diabetes mellitus in adulthood. The present study is piloted to evaluate the short-term impact of milk products with differing glycaemic properties on the sleep patterns of toddlers.
  
  
  METHODS
  Toddlers were recruited from various day care centres. Informed consent was obtained from both the mothers and the centres. A double-blind randomised controlled trial with a between-subjects design was adopted. The toddlers were randomised to either one of two types of milk with a differing GI ("Low" = 23 and "High = 65") for a period of 3.5 days. There were no other dietary restrictions imposed except that the enrolled child did not consume any other milk during the study period. The sleep patterns were recorded using a Phillips Actiwatch-2, which was worn on the wrist for 24 h over 4 days. The parameters used to measure the sleep pattern were sleep-onset latency (SOL), total sleep time (TST), wake after sleep onset (WASO) and sleep efficiency (SE).
  
  
  RESULTS
  A total of 56 toddlers completed the study. The toddlers had a mean age of 19.9 ± 4.3 months. There were no significant differences (p > 0.05) between the two GI groups for SOL, TST, WASO and SE at the end of the feeding period.
  
  
  CONCLUSIONS
  Sleep patterns of toddlers on low-GI milk did not differ from those with high-GI milk consumed over a short period. Future studies should consider the glycaemic effects of other foods, along with milk with differing GI, consumed for a longer feeding duration.
  
  
  BACKGROUND
  ClinicalTrial.gov NCT01589003.
authors.affiliation: Division of Nutrition and Dietetics, International Medical University, 57000, Kuala Lumpur, Malaysia. snigdha_misra@imu.edu.my.
authors.forename: Snigdha
authors.initials: S
authors.lastname: Misra
authors.affiliation: Division of Nutrition and Dietetics, International Medical University, 57000, Kuala Lumpur, Malaysia. geoklin_khor@imu.edu.my.
authors.forename: Geok L
authors.initials: GL
authors.lastname: Khor
authors.affiliation: Department of Psychology, University of Nottingham, Malaysia Campus, 43500, Semenyih, Selangor Darul Ehsan, Malaysia. Peter.Mitchell@nottingham.edu.my.
authors.forename: Peter
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Department of Psychology, Monash University, Sunway Campus, 47500, Subang Jaya, Selangor, Malaysia. shamsul@monash.edu.my.
authors.forename: Samsul
authors.initials: S
authors.lastname: Haque
authors.affiliation: Department of Psychology, University of Swansea, Swansea, SA2 8PP, Wales, UK. d.benton@swansea.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Benton
mesh_terms: D056044:Actigraphy; D000818:Animals; D000886:Anthropometry; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D000067940:Glycemic Load; D006801:Humans; D007223:Infant; D008297:Male; D008892:Milk / Q000737:chemistry*; D010865:Pilot Projects; D012890:Sleep / Q000502:physiology*; D011795:Surveys and Questionnaires; D013997:Time Factors