Biostatistics Centre, University of Otago, Dunedin, New Zealand.
Department of Medicine, University of Otago, PO Box 56, Dunedin, 9016, New Zealand.
Int J Behav Nutr Phys Act. 2024 Jun 4;21(1):61. doi: 10.1186/s12966-024-01607-5.
Although inadequate sleep increases the risk of obesity in children, the mechanisms remain unclear. The aims of this study were to assess how sleep loss influenced dietary intake in children while accounting for corresponding changes in sedentary time and physical activity; and to investigate how changes in time use related to dietary intake.
A randomized crossover trial in 105 healthy children (8-12 years) with normal sleep (~ 8-11 h/night) compared sleep extension (asked to turn lights off one hour earlier than usual for one week) and sleep restriction (turn lights off one hour later) conditions, separated by a washout week. 24-h time-use behaviors (sleep, wake after sleep onset, physical activity, sedentary time) were assessed using waist-worn actigraphy and dietary intake using two multiple-pass diet recalls during each intervention week. Longitudinal compositional analysis was undertaken with mixed effects regression models using isometric log ratios of time use variables as exposures and dietary variables as outcomes, and participant as a random effect.
Eighty three children (10.2 years, 53% female, 62% healthy weight) had 47.9 (SD 30.1) minutes less sleep during the restriction week but were also awake for 8.5 (21.4) minutes less at night. They spent this extra time awake in the day being more sedentary (+ 31 min) and more active (+ 21 min light physical activity, + 4 min MVPA). After adjusting for all changes in 24-h time use, losing 48 min of sleep was associated with consuming significantly more energy (262 kJ, 95% CI:55,470), all of which was from non-core foods (314 kJ; 43, 638). Increases in sedentary time were related to increased energy intake from non-core foods (177 kJ; 25, 329) whereas increases in MVPA were associated with higher intake from core foods (72 kJ; 7,136). Changes in diet were greater in female participants.
Loss of sleep was associated with increased energy intake, especially of non-core foods, independent of changes in sedentary time and physical activity. Interventions focusing on improving sleep may be beneficial for improving dietary intake and weight status in children.
Australian New Zealand Clinical Trials Registry ANZCTR ACTRN12618001671257, Registered 10th Oct 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true.
尽管睡眠不足会增加儿童肥胖的风险，但其中的机制仍不清楚。本研究的目的是评估睡眠不足如何影响儿童的饮食摄入，同时考虑到相应的久坐时间和体力活动的变化；并探讨与饮食摄入相关的时间利用变化。
一项针对 105 名健康儿童（8-12 岁）的随机交叉试验，他们的睡眠正常（每晚 8-11 小时），比较了睡眠延长（要求一周内比平时早睡一小时）和睡眠限制（比平时晚睡一小时）条件，两者之间有一周的洗脱期。通过佩戴在腰部的活动记录仪评估 24 小时时间使用行为（睡眠、睡眠后醒来、体力活动、久坐时间），并在每个干预周内使用两次多次通过饮食回忆法评估饮食摄入。使用混合效应回归模型进行纵向组成分析，以等距对数比的时间使用变量作为暴露，饮食变量作为结果，并以参与者为随机效应。
83 名儿童（10.2 岁，53%为女性，62%为健康体重）在限制周内睡眠减少了 47.9（SD 30.1）分钟，但夜间醒来的时间也减少了 8.5（21.4）分钟。他们在白天多花了这段额外的清醒时间，久坐不动的时间增加了 31 分钟，活动时间增加了 21 分钟（轻度体力活动增加 21 分钟，中度到剧烈体力活动增加 4 分钟）。在调整了 24 小时时间使用的所有变化后，每晚少睡 48 分钟与摄入的能量显著增加（262kJ，95%CI：55,470）有关，这些能量全部来自非核心食物（314kJ；43,638）。久坐时间的增加与非核心食物摄入的能量增加有关（177kJ；25,329），而中度到剧烈体力活动的增加与核心食物摄入的能量增加有关（72kJ；7,136）。女性参与者的饮食变化更大。
睡眠不足与能量摄入增加有关，尤其是非核心食物的摄入增加，这与久坐时间和体力活动的变化无关。专注于改善睡眠的干预措施可能有助于改善儿童的饮食摄入和体重状况。
澳大利亚新西兰临床试验注册中心 ANZCTR ACTRN12618001671257，注册于 2018 年 10 月 10 日，https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true。
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