Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
Department of Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
Child Obes. 2021 Mar;17(2):125-135. doi: 10.1089/chi.2020.0259. Epub 2021 Jan 25.
Shorter sleep duration and lower sleep quality have been previously associated with greater obesity risk among adult samples. Food insecurity has also been found to impact sleep patterns and obesity. Yet few studies have explored associations between sleep, food insecurity, and obesity in adolescent populations, who may have more irregular sleep patterns. Thus, the objectives of this study were to determine associations between measures of sleep, food insecurity, and weight status. Data were obtained from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, an online cross-sectional study of parent and adolescent (12-17-year old) dyads. Participants were drawn from a Consumer Opinion Panel representative of the general population of the United States with respect to sex, education, income, age, household size, and region. First, multinomial logistic regression analyses were conducted to determine associations between sleep measures (adolescent-reported average nighttime sleep duration, having a regular bedtime, and having difficulty staying asleep), food insecurity (a validated two-item parent-reported measure), and weight status (being underweight, of healthy weight, overweight, and obese). Weight status was based upon adolescent BMI z-scores using Centers for Disease Control and Prevention growth charts using information from parent report of adolescent height and weight and adolescent-reported age and sex among adolescents ( = 1544). Conditional process models were also fitted to the data to determine whether food insecurity moderates the associations between sleep measures and weight status, and to determine whether the association between food insecurity and weight status is mediated by average sleep duration. Compared to those with food security, a greater percentage of those with food insecurity reported having difficulties staying asleep and a longer average sleep duration. Multinomial logistic regression models demonstrated that having a regular bedtime was associated with lower odds of having obesity, having difficulties staying asleep was associated with greater odds of being underweight, and having food insecurity was associated with greater odds of being overweight. Conditional process models demonstrated that food insecurity did not moderate associations between sleep measures and weight status and that average nighttime sleep duration did not mediate the association between food insecurity and weight status. This is one of the first studies to examine associations between sleep, food insecurity, and weight status among adolescents. Results provide additional support for the need to uncover mechanisms for how sleep and food insecurity affect pediatric obesity using longitudinal data.
先前的研究表明，睡眠时间较短和睡眠质量较低与成年人肥胖风险增加有关。食物不安全也被发现会影响睡眠模式和肥胖。然而，很少有研究探讨青少年人群中睡眠、食物不安全和肥胖之间的关系，而青少年的睡眠模式可能更不规律。因此，本研究的目的是确定睡眠、食物不安全和体重状况之间的关系。
数据来自家庭生活、活动、阳光、健康和饮食（FLASHE）研究，这是一项针对父母和青少年（12-17 岁）的在线横断面研究。参与者是从消费者意见小组中抽取的，代表了美国一般人群在性别、教育、收入、年龄、家庭规模和地区方面的情况。首先，进行了多项逻辑回归分析，以确定睡眠测量（青少年报告的平均夜间睡眠时间、有规律的就寝时间和难以入睡）、食物不安全（经过验证的父母报告的两项措施）和体重状况（体重不足、健康体重、超重和肥胖）之间的关系。体重状况是根据青少年 BMI z 分数确定的，使用疾病控制和预防中心的生长图表，使用来自父母报告的青少年身高和体重以及青少年报告的年龄和性别信息（ = 1544）。还对数据进行了条件过程模型拟合，以确定食物不安全是否调节睡眠测量和体重状况之间的关联，以及食物不安全与体重状况之间的关联是否通过平均睡眠时间来介导。
与食物安全的人相比，食物不安全的人更有可能报告入睡困难和平均睡眠时间较长。多项逻辑回归模型表明，有规律的就寝时间与肥胖的几率较低相关，入睡困难与体重不足的几率较高相关，而食物不安全与超重的几率较高相关。条件过程模型表明，食物不安全并没有调节睡眠测量和体重状况之间的关联，也没有调节食物不安全和体重状况之间的关联。
这是第一项研究青少年睡眠、食物不安全和体重状况之间关系的研究之一。研究结果为使用纵向数据揭示睡眠和食物不安全如何影响儿科肥胖的机制提供了更多支持。
