title: Dietary Carbohydrate and Nocturnal Sleep Duration in Relation to Children's BMI: Findings from the IDEFICS Study in Eight European Countries.
abstract: Previous research has found an association between being overweight and short sleep duration. We hypothesized that this association could be modified by a high carbohydrate (HC) diet and that the timing and type (starch or sugar) of intake may be an important factor in this context. Participants in the prospective, eight-country European study IDEFICS were recruited from September 2007 to June 2008, when they were aged two to nine years. Data on lifestyle, dietary intake and anthropometry were collected on two occasions. This study included 5944 children at baseline and 4301 at two-year follow-up. For each meal occasion (morning, midday, and evening), starch in grams and sugar in grams were divided by total energy intake (EI), and quartiles calculated. HC-starch and HC-sugar intake categories were defined as the highest quartile for each meal occasion. In a mutually adjusted linear regression model, short sleep duration as well as HC-starch in the morning were positively associated with body mass index (BMI) z-scores at baseline. HC-starch at midday was positively associated with body mass index (BMI) z-scores in children with short sleep duration, and negatively associated with BMI z-scores in those with normal sleep. After adjustment for baseline BMI z-scores, associations between total HC from starch or sugar and high BMI z-scores at two-year follow-up did not persist. Our observations offer a perspective on optimal timing for macronutrient consumption, which is known to be influenced by circadian rhythms. Reduced carbohydrate intake, especially during morning and midday meals, and following nocturnal sleep duration recommendations are two modifiable factors that may protect children from being overweight in the future.
authors.affiliation: Section for Epidemiology and Social Medicine, University of Gothenburg, P.O. Box 453, 40530 Gothenburg, Sweden. monica.hunsberger@gu.se.
authors.forename: Monica
authors.initials: M
authors.lastname: Hunsberger
authors.affiliation: Section for Epidemiology and Social Medicine, University of Gothenburg, P.O. Box 453, 40530 Gothenburg, Sweden. kirsten.mehlig@gu.se.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Mehlig
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS GmbH, Achterstrasse 30, D-28359 Bremen, Germany. boern@bips.uni-bremen.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Börnhorst
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology-BIPS GmbH, Achterstrasse 30, D-28359 Bremen, Germany. hebestr@bips.uni-bremen.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Hebestreit
authors.affiliation: Growth, Exercise, Nutrition, and Development (GENUD) research group, University of Zaragoza, Domingo Miral, 50009 Zaragoza, Spain. lmoreno@unizar.es.
authors.forename: Luis
authors.initials: L
authors.lastname: Moreno
authors.affiliation: National Institute for Health Development, P.O. Box 3012, 10504 Tallinn, Estonia. toomas.veidebaum@tai.ee.
authors.forename: Toomas
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Research and Education Institute of Child Health, 138 Limassol Ave, #205, 2015, Strovolos 510903, Cyprus. kourides@cytanet.com.cy.
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Kourides
authors.affiliation: Institute for Food Sciences, Unit of Epidemiology and Population Genetics, National Research Council, Via Roma 64, 83100 Avellino, Italy. asiani@isa.cnr.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Siani
authors.affiliation: Department of Paediatrics, Medical Faculty, University of Pécs, Jozsef A.u., 7 H-1062 Budapest, Hungary. molnar.denes@pte.hu.
authors.forename: Dénes
authors.initials: D
authors.lastname: Molnar
authors.affiliation: Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000 Ghent, Belgium. isabelle.sioen@ugent.be.|Research Foundation-Flanders, Egmonstraat 5, B-1000 Brussels, Belgium. isabelle.sioen@ugent.be.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sioen
authors.affiliation: Section for Epidemiology and Social Medicine, University of Gothenburg, P.O. Box 453, 40530 Gothenburg, Sweden. lauren.lissner@gu.se.
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D002149:Energy Intake; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009765:Obesity; D050177:Overweight / Q000517:prevention & control; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D013213:Starch / Q000008:administration & dosage / Q000737:chemistry
chemical_list: D004040:Dietary Carbohydrates; D013213:Starch
keywords: breakfast consumption; childhood overweight; nocturnal sleep duration; proportion carbohydrate intake at main meals; starch; sugar