The effect of modest changes in sleep on dietary intake and eating behavior in children: secondary outcomes of a randomized crossover trial

Silke Morrison; Rosie Jackson; Jillian J Haszard; Barbara C Galland; Kim A Meredith-Jones; Elizabeth A Fleming; Aimee L Ward; Dawn E Elder; Dean W Beebe; Rachael W Taylor

doi:10.1016/j.ajcnut.2022.10.007

The effect of modest changes in sleep on dietary intake and eating behavior in children: secondary outcomes of a randomized crossover trial

Am J Clin Nutr. 2023 Feb;117(2):317-325. doi: 10.1016/j.ajcnut.2022.10.007.

Authors

Affiliations

¹ Department of Medicine, University of Otago, Dunedin, New Zealand.
² Biostatistics Centre, University of Otago, Dunedin, New Zealand.
³ Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
⁴ Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
⁵ Department of Medicine, University of Otago, Dunedin, New Zealand; Department of Geography, Kent State University, Kent, OH, USA.
⁶ Department of Pediatrics and Child Health, University of Otago, Wellington, New Zealand.
⁷ Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA.
⁸ Department of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: Rachael.taylor@otago.ac.nz.

PMID: 36863827
DOI: 10.1016/j.ajcnut.2022.10.007

Abstract

Background: Insufficient sleep duration increases obesity risk in children, but the mechanisms remain unclear.

Objectives: This study seeks to determine how changes in sleep influence energy intake and eating behavior.

Methods: Sleep was experimentally manipulated in a randomized, crossover study in 105 children (8-12 y) who met current sleep guidelines (8-11 h/night). Participants went to bed 1 h earlier (sleep extension condition) and 1 h later (sleep restriction condition) than their usual bedtime for 7 consecutive nights, separated by a 1-wk washout. Sleep was measured via waist-worn actigraphy. Dietary intake (2 24-h recalls/wk), eating behaviors (Child Eating Behavior Questionnaire), and the desire to eat different foods (questionnaire) were measured during or at the end of both sleep conditions. The type of food was classified by the level of processing (NOVA) and as core or noncore (typically energy-dense foods) foods. Data were analyzed according to 'intention to treat' and 'per protocol,' an a priori difference in sleep duration between intervention conditions of ≥30 min.

Results: The intention to treat analysis (n = 100) showed a mean difference (95% CI) in daily energy intake of 233 kJ (-42, 509), with significantly more energy from noncore foods (416 kJ; 6.5, 826) during sleep restriction. Differences were magnified in the per-protocol analysis, with differences in daily energy of 361 kJ (20, 702), noncore foods of 504 kJ (25, 984), and ultraprocessed foods of 523 kJ (93, 952). Differences in eating behaviors were also observed, with greater emotional overeating (0.12; 0.01, 0.24) and undereating (0.15; 0.03, 0.27), but not satiety responsiveness (-0.06; -0.17, 0.04) with sleep restriction.

Conclusions: Mild sleep deprivation may play a role in pediatric obesity by increasing caloric intake, particularly from noncore and ultraprocessed foods. Eating in response to emotions rather than perceived hunger may partly explain why children engage in unhealthy dietary behaviors when tired. This trial was registered at Australian New Zealand Clinical Trials Registry; ANZCTR as CTRN12618001671257.

Keywords: child; core/noncore foods; crossover design; eating behavior; energy intake; obesity; sleep; ultraprocessed foods.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Australia
Child
Cross-Over Studies
Eating
Feeding Behavior*
Humans
Sleep Deprivation
Sleep*

Associated data

ANZCTR/CTRN12618001671257