Martins Raphael Corrêa, Brito Flávia Dos Santos Barbosa, Curioni Cintia Chaves
Federal Center for Technological Education Celso Suckow da Fonseca, Rio de Janeiro, Brazil.
Postgraduate Program in Food, Nutrition and Health (PPG-ANS), State University of Rio de Janeiro, Rio de Janeiro, Brazil.
PLoS One. 2025 May 30;20(5):e0322617. doi: 10.1371/journal.pone.0322617. eCollection 2025.
The mismatch between chronobiological predispositions and social demands makes it difficult for adolescents with an evening chronotype to maintain healthy habits. This study aimed to explore the interrelationships among chronobiological factors, health practices, and anthropometry in adolescents attending morning and afternoon class shifts. In this cross-sectional study, 925 adolescents (14-19 years old) completed an online questionnaire covering food practices, chronotype, sleep duration, social jetlag, screen time, socioeconomic data, physical activity, school shift, and anthropometric measurements. The interrelationships among these variables were analyzed through structural equation modeling using six path models. Food practices were categorized into "complete meals" (breakfast, lunch, dinner, and bean consumption) - as healthy practices, "unhealthy foods" (sweets, fried snacks, soft drinks, salty ultra-processed foods, and fast food) and "vegetables and fruits," stratified by shift (morning or afternoon), with body mass index by age (BMI/age) as the main outcome. Among students in the morning shift, reduced sleep time was directly associated with increased BMI/age, while longer screen time was negatively associated with complete meal practices and physical activity. In the afternoon shift, a greater tendency towards an evening chronotype among adolescents was associated with reduced complete meal practices and lower regular fruit and vegetable consumption. Sleep duration was positively associated with a greater likelihood of a complete meal practices and regular fruit consumption. Moreover, longer screen time was positively associated with unhealthy food consumption. In both shifts, physically active adolescents consumed fruits more regularly. The practice of regular consumption of complete meals, fruits, vegetables, or unhealthy foods, in addition to being directly influenced by chronotype and other variables, was also influenced by shift. Adolescents with shorter sleep duration were at a higher risk of being overweight, suggesting a direct influence of sleep on anthropometric measurements. Our findings underscore the importance of considering study shifts in future interventions.
生物钟倾向与社会需求之间的不匹配，使得具有晚睡型生物钟的青少年难以保持健康的生活习惯。本研究旨在探讨参加上午和下午课程轮班的青少年的生物钟因素、健康行为和人体测量指标之间的相互关系。在这项横断面研究中，925名青少年（14 - 19岁）完成了一份在线问卷，内容涵盖饮食行为、生物钟类型、睡眠时间、社会时差、屏幕使用时间、社会经济数据、体育活动、学校轮班情况以及人体测量指标。通过使用六个路径模型的结构方程模型分析了这些变量之间的相互关系。饮食行为被分为“完整膳食”（早餐、午餐、晚餐和豆类摄入）——作为健康行为，“不健康食品”（甜食、油炸零食、软饮料、高盐超加工食品和快餐）以及“蔬菜和水果”，按轮班情况（上午或下午）分层，以年龄别体重指数（BMI/年龄）作为主要结果。在上午轮班的学生中，睡眠时间减少与BMI/年龄增加直接相关，而较长的屏幕使用时间与完整膳食行为和体育活动呈负相关。在下午轮班中，青少年中更倾向于晚睡型生物钟与完整膳食行为减少以及常规水果和蔬菜摄入量降低有关。睡眠时间与完整膳食行为和常规水果摄入的可能性增加呈正相关。此外，较长的屏幕使用时间与不健康食品消费呈正相关。在两个轮班中，进行体育活动的青少年更经常食用水果。规律食用完整膳食、水果、蔬菜或不健康食品的行为，除了直接受到生物钟类型和其他变量的影响外，还受到轮班的影响。睡眠时间较短的青少年超重风险较高，这表明睡眠对人体测量指标有直接影响。我们的研究结果强调了在未来干预措施中考虑学校轮班情况的重要性。
