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Poor sleep quality associated with higher BMI in children
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Children who sleep fewer hours per night or have greater alterations in rest patterns are more likely to have a higher BMI and waist circumference compared with children who have better sleep quality, according to findings presented at the American Association for Cancer Research Special Conference, Obesity and Cancer: Mechanisms Underlying Etiology and Outcomes.
“We know from a growing number of studies that less sleep increases the risk for childhood obesity,” Bernard Fuemmeler, PhD, MPH, professor and associate director for cancer prevention and control at Virginia Commonwealth University’s Massey Cancer, told Endocrine Today. “Less is known about how sleep quality and circadian patterns might impact childhood obesity and eating behaviors.”
Fuemmeler and colleagues analyzed data from 92 children born to mothers participating in the Newborn Epigenetic Study, a pre-birth cohort (mean age, 8 years; 62% black; 51% boys). Children wore accelerometers continuously for 24 hours over a minimum 5-day period, and completed the eating in the absence of hunger (EAH) task, a lab-based assessment of how much children eat beyond satiety from an ad libitum meal. Researchers used regression analysis to evaluate the association between components of the sleep-wake cycle, BMI z score and calories consumed during the eating task.
Researchers found that a shorter sleep duration, measured in hours, was associated with a higher BMI z score (beta = –0.17; P = .03). Each additional hour of sleep was associated with a 0.13 decrease in BMI z score and with a 1.29 cm decrease in waist circumference, according to researchers.
Additionally, more fragmented circadian rhythms were associated with higher BMI z score (beta = –1.87; P = .03), as was intra-daily variability, a measure of rest-activity rhythm fragmentation (beta = –1.46; P = .05).
Researchers also found that a later onset of diurnal activity was associated with greater caloric intake in EAH task (beta = –0.001; P = .01).
“We found that less sleep duration, less regular rhythm patterns and more frequent and greater alterations in rest to active patterns was associated with a greater waist circumference,” Fuemmeler said. “Eating behaviors were also related to sleep duration and the timing of day when children were the most active. The data, though preliminary, highlight that to better understand the sleep-obesity link, we need to look beyond just how long one is asleep. Circadian patterns also help shed light on eating behaviors and greater adiposity that deserve a closer look.”
The findings, Fuemmeler said, support the importance of establishing sufficient sleep and more regular sleep-activity routines for children to promote child health.
“More opportunities for activity and less screen time in bed may go a long way to help children develop good sleep patterns,” Fuemmeler said. “Children with chronic sleep problems can be stressful for parents and the family, and they may need the help of physicians and sleep experts who can help children develop healthy sleep patterns.” – by Regina Schaffer
Reference:
Fuemmeler B, et al. Abstract PR11. Presented at: American Association for Cancer Research Special Conference; Jan. 27-30, 2018; Austin, Texas.
Disclosures: The National Institute of Child Health and Human Development funded this study. Fuemmeler reports no relevant financial disclosures.
Perspective
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Jean-Philippe Chaput, PhD
This study fits well with what we know so far. This idea of a lack of sleep leading to weight gain started many years ago. For the past few years, we have learned more about why short sleepers gain weight. They eat more because they have more time and opportunities for eating, and are more likely to engage in sedentary screen time. What was novel about this study is the fact that children had waist-worn accelerometers, and not just self-reported sleep measures, like in many previous studies. This study is more robust, though it was a small, cross-sectional sample. So, we cannot say that lack of sleep leads to weight gain, just that short sleep is associated with excess weight. It could also be that children with obesity sleep less because of their weight. However, in intervention studies where sleep is restricted, we see that participants gain weight over time. That is the most robust proof that there is a cause-effect association.
This study went beyond the amount of sleep, and looked at other characteristics of sleep as well. Sleep duration is one thing, but it is important to examine the timing of sleep and the quality of sleep, as well as sleep consistency and sleep hygiene. There are many things that are important, beyond sleep duration.
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