Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
School Feeding Coordination, Secretariat of Education of São Paulo, São Paulo, Brazil.
Chronobiol Int. 2021 Mar;38(3):387-399. doi: 10.1080/07420528.2020.1851704. Epub 2021 Jan 13.
It is well recognized that sleep and food intake exhibit 24-h patterns and disturbances of these patterns can lead to health problems. Cross-sectional and prospective studies suggest that diet quality and eating behaviors are negatively affected by short sleep duration. Adolescence is a particularly vulnerable period for the emergence of inadequate sleep and diet patterns. The aim of the study was to investigate associations, from a chrononutrition perspective, of diet quality, nutrients intake, and eating behaviors (eating frequency, eating period, and time-interval between eating occasions) in relation to sleep duration among a multi-ethnic cohort of Brazilian adolescents. Data were collected by the 2015 ISA-Capital survey, a population-based cross-sectional study comprising 419 adolescents of both sexes (12-19 years old) of São Paulo, Brazil. Demographic, socioeconomic, anthropometric, and lifestyle, including sleep duration, data were obtained from an interviewer-administered structured questionnaire. Dietary data were obtained by 24-h dietary recall (24-HDR), and diet quality was assessed by the Brazilian Healthy Eating Index - Revised (BHEI-R), validated for the Brazilian population. The independent associations between sleep duration categories (i.e., <8 h as short sleep and 8-10 h as adequate sleep), and dietary variables were assessed after adjustments for covariates. Multiple linear, logistic, and Poison regression models were used, depending on the variable. Diet quality, nutrients intake, and eating behaviors differed according to adolescents' sleep duration. Approximately 36% of adolescents were sleep deprived. They presented poorer diet quality (53 points, = .034) and eating behaviors characterized by lower probability of having lunch (88%, < .001) and dinner (71%, < .001) and higher probabilities of eating breakfast (87%, < .001) and morning snack (26%, = .001). These adolescents compared to those with adequate sleep duration also had, from snacks and in the 24-h cycle, higher contribution of available carbohydrates (8%, < .001; 50%, = .024) and total sugar (6%, < .001; 21%, < .001) and added sugar (3%, < .001; 15%, < .001). The chrononutrition characteristics of sleep-deprived adolescents were marked by longer eating periods (12 h, < .001) and time-interval between eating occasions (3 h, < .001) than adolescents with adequate sleep duration. These differences point to the relevance of the interrelation between sleep and diet, i.e., disruption of circadian cycles and consequent metabolic health problems, to inform public health policies and clinical interventions.
众所周知,睡眠和食物摄入都呈现出 24 小时的模式,而这些模式的紊乱可能会导致健康问题。横断面和前瞻性研究表明,饮食质量和饮食习惯会因睡眠时间短而受到负面影响。青少年时期是出现睡眠不足和饮食模式不当的特别脆弱时期。本研究旨在从时间营养的角度,研究巴西多民族青少年群体中与睡眠持续时间相关的饮食质量、营养素摄入和饮食习惯(进食频率、进食时间和进食间隔时间)之间的关联。数据来自 2015 年 ISA-Capital 调查,这是一项基于人群的横断面研究,包括巴西圣保罗的 419 名男女青少年(12-19 岁)。通过采访者管理的结构化问卷获得人口统计学、社会经济、人体测量和生活方式(包括睡眠持续时间)数据。通过 24 小时膳食回顾(24-HDR)获得饮食数据,并使用经过验证的巴西健康饮食指数修订版(BHEI-R)评估饮食质量。在调整协变量后,评估了睡眠持续时间类别(即<8 小时为睡眠不足和 8-10 小时为充足睡眠)与饮食变量之间的独立关联。根据变量的不同,使用了多元线性、逻辑和泊松回归模型。饮食质量、营养素摄入和饮食习惯因青少年的睡眠持续时间而异。大约 36%的青少年睡眠不足。他们的饮食质量较差(53 分, =.034),饮食行为特征为午餐(88%, <.001)和晚餐(71%, <.001)的可能性较低,而早餐(87%, <.001)和早间零食(26%, =.001)的可能性较高。与睡眠充足的青少年相比,这些青少年从零食和 24 小时周期中摄入的可利用碳水化合物(8%, <.001;50%, =.024)和总糖(6%, <.001;21%, <.001)和添加糖(3%, <.001;15%, <.001)更高。睡眠不足的青少年的时间营养特征表现为更长的进食时间(12 小时, <.001)和进食间隔时间(3 小时, <.001),而睡眠充足的青少年则更长。这些差异表明睡眠和饮食之间的相互关系的重要性,即昼夜节律周期的中断和随之而来的代谢健康问题,以告知公共卫生政策和临床干预措施。