Highlights
- •Sleep duration seems to influence weight gain in children.
- •The underlying mechanisms playing a role in sleep deprivation leading to increased weight gain are still uncertain.
- •The role of insulin resistance, sedentarism and unhealthy dietary patterns as mediators could be confirmed.
Abstract
Aim
The prevalence of obesity is continually increasing worldwide. Determining risk factors
for obesity may facilitate effective preventive programs. The present review focuses
on sleep duration as a potential risk factor for childhood obesity. The aim is to
summarize the evidence on the association of sleep duration and obesity and to discuss
the underlying potential physiological and/or pathophysiological mechanisms.
Data Synthesis
The Ovid MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL)
databases were searched for papers using text words with appropriate truncation and
relevant indexing terms. All studies objectively measuring sleep duration and investigating
the association between sleep duration and obesity or factors (lifestyle and hormonal)
possibly associated with obesity were included, without making restrictions based
on study design or language. Data from eligible studies were extracted in tabular
form and summarized narratively.
After removing duplicates, 3540 articles were obtained. Finally, 33 studies (including
3 randomized controlled trials and 30 observational studies) were included in the
review.
Conclusion
Sleep duration seems to influence weight gain in children, however, the underlying
explanatory mechanisms are still uncertain. In our review only the link between short
sleep duration and the development of insulin resistance, sedentarism and unhealthy
dietary patterns could be verified, while the role of other mediators, such as physical
activity, screen time, change in ghrelin and leptin levels, remained uncertain. There
are numerous evidence gaps. To answer the remaining questions, there is a need for
studies meeting high methodological standards and including a large number of children.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Nutrition, Metabolism and Cardiovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Report of the commission on ending childhood obesity.World Health Organization, Geneva2016
- Risk factors of obesity in a five year old population. Parental versus environmental factors.Int J Obes Relat Metab Disord. 1992; 16: 721-729
- Association between self-reported sleep duration and dietary quality in European adolescents.Br J Nutr. 2013; 110: 949-959https://doi.org/10.1017/S0007114512006046
- Dietary carbohydrate and nocturnal sleep duration in relation to children's BMI: findings from the idefics study in eight European countries.Nutrients. 2015; 7: 10223-10236https://doi.org/10.3390/nu7125529
- Sleep duration or bedtime? Exploring the association between sleep timing behaviour, diet and BMI in children and adolescents.Int J Obes. 2013; 37: 546-551https://doi.org/10.1038/ijo.2012.212
- Factors that influence weekday sleep duration in European children.Sleep. 2011; 34: 633-639https://doi.org/10.1093/sleep/34.5.633
- Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study.Int J Obes (Lond). 2011; 35: 1308-1317https://doi.org/10.1038/ijo.2011.149
- Association between sleep duration and overweight: the importance of parenting.Int J Obes. 2012; 36: 1278-1284https://doi.org/10.1038/ijo.2012.119
- Sleep and obesity in preschool children.J Pediatr. 2009; 154: 814-818https://doi.org/10.1016/j.jpeds.2008.12.043
- Determinants and impact of sleep duration in children and adolescents: data of the Kiel Obesity Prevention Study.Eur J Clin Nutr. 2009; 63: 739-746https://doi.org/10.1038/ejcn.2008.41
- Childhood sleep duration and quality in relation to leptin concentration in two cohort studies.Sleep. 2014; 37: 613-620https://doi.org/10.5665/sleep.3510
- Is sleep duration associated with childhood obesity? A systematic review and meta-analysis.Obesity (Silver Spring). 2008; 16: 265-274https://doi.org/10.1038/oby.2007.63
- Short sleep duration and weight gain: a systematic review.Obesity (Silver Spring). 2008; 16: 643-653https://doi.org/10.1038/oby.2007.118
- The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity.Arch Dis Child. 2006; 91: 881-884https://doi.org/10.1136/adc.2005.093013
- Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth.Appl Physiol Nutr Metab. 2016; 41: S266-S282https://doi.org/10.1139/apnm-2015-0627
- Meta-Analysis of short sleep duration and obesity in children and adults.Sleep. 2008; 31: 619-626https://doi.org/10.1093/sleep/31.5.619
- Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis.Obes Rev. 2015; 16: 137-149https://doi.org/10.1111/obr.12245
- Longitudinal associations between sleep duration and subsequent weight gain: a systematic review.Sleep Med Rev. 2012; 16: 231-241https://doi.org/10.1016/j.smrv.2011.05.005
- Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence.Obes Rev. 2011; 12: 78-92https://doi.org/10.1111/j.1467-789X.2010.00724.x
- Sleep duration and overweight/obesity in children: review and implications for pediatric nursing.J Spec Pediatr Nurs. 2012; 17: 193-204https://doi.org/10.1111/j.1744-6155.2012.00332.x
- Is shortened sleep duration a risk factor for overweight and obesity during adolescence? A review of the empirical literature.Sleep Med. 2012; 13: 779-786https://doi.org/10.1016/j.sleep.2012.03.016
- Relationship between lifestyle behaviors and obesity in children ages 9–11: results from a 12-country study.Obesity. 2015; 23: 1696-1702https://doi.org/10.1002/oby.21152
- Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study.BMJ. 2011; 342https://doi.org/10.1136/bmj.d2712
- Is it time for bed? Short sleep duration increases risk of obesity in Mexican American children.Sleep Med. 2014; 15: 1484-1489https://doi.org/10.1016/j.sleep.2014.09.009
- Changes in children's sleep duration on food intake, weight, and leptin.Pediatrics. 2013; 132: e1473-e1480https://doi.org/10.1542/peds.2013-1274
- Short sleep duration is independently associated with overweight and obesity in Canadian children.Can J Diabetes. 2011; 35: 143-144https://doi.org/10.1016/S1499-2671(11)52027-1
- Dietary intake following experimentally restricted sleep in adolescents.Sleep. 2013; 36: 827-834https://doi.org/10.5665/sleep.2704
- Change in sleep duration and proposed dietary risk factors for obesity in Danish school children.Pediatr Obes. 2014; 9: e156-e159https://doi.org/10.1111/ijpo.264
- Associations between sleep patterns and lifestyle behaviors in children: an international comparison.Int J Obes Suppl. 2015; 5: S59-S65https://doi.org/10.1038/ijosup.2015.21
- Sleep and eating in childhood: a potential behavioral mechanism underlying the relationship between poor sleep and obesity.Sleep Med. 2014; 15: 71-75https://doi.org/10.1016/j.sleep.2013.07.015
- Short sleep duration and large variability in sleep duration are independently associated with dietary risk factors for obesity in Danish school children.Int J Obes (Lond). 2014; 38: 32-39https://doi.org/10.1038/ijo.2013.147
- Short sleep duration in middle childhood: risk factors and consequences.Sleep. 2008; 31: 71-78https://doi.org/10.1093/sleep/31.1.71
- Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study.Int J Behav Nutr Phys Act. 2013; 10: 82https://doi.org/10.1186/1479-5868-10-82
- Correlates of sedentary time in children: a multilevel modelling approach.BMC Public Health. 2014; 14: 890https://doi.org/10.1186/1471-2458-14-890
- Relationships of objectively measured physical activity and sleep with BMI and academic outcomes in 8-year-old children.Appl Nurs Res. 2013; 26: 63-70https://doi.org/10.1016/j.apnr.2013.02.001
- Do more active children sleep more? A repeated cross-sectional analysis using accelerometry.PLoS One. 2014; 9e93117https://doi.org/10.1371/journal.pone.0093117
- In search of lost sleep: secular trends in the sleep time of school-aged children and adolescents.Sleep Med Rev. 2012; 16: 203-211https://doi.org/10.1016/j.smrv.2011.03.005
- Never enough sleep: a brief history of sleep recommendations for children.Pediatrics. 2012; 129: 548-556https://doi.org/10.1542/peds.2011-2039
- Sleep and food intake: a multisystem review of mechanisms in children and adults.J Health Psychol. 2015; 20: 794-805https://doi.org/10.1177/1359105315573427
- Relationships between sleeping habits, sedentary leisure activities and childhood overweight and obesity.Psychol Heal Med. 2014; 19: 667-672https://doi.org/10.1080/13548506.2013.878805
- Sleep duration and activity levels in Estonian and Swedish children and adolescents.Eur J Appl Physiol. 2011; 111: 2615-2623https://doi.org/10.1007/s00421-011-1883-6
- Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: a longitudinal study in 8–11 year old Danish children.PLoS One. 2014; 9e104677https://doi.org/10.1371/journal.pone.0104677
- Acute sleep restriction reduces insulin sensitivity in adolescent boys.Sleep. 2013; 36: 1085-1090https://doi.org/10.5665/sleep.2816
- Effects of poor and short sleep on glucose metabolism and obesity risk.Nat Rev Endocrinol. 2009; 5: 253-261https://doi.org/10.1038/nrendo.2009.23
- Sleep and the epidemic of obesity in children and adults.Eur J Endocrinol. 2008; 159: 59-66https://doi.org/10.1530/EJE-08-0298
- A causal role for hyperinsulinemia in obesity.J Endocrinol. 2017; 3https://doi.org/10.1530/JOE-16-0449
- Preteen insulin levels interact with caloric intake to predict increases in obesity at ages 18–19 years: a 10-year prospective study of black and white girls.Metabolism. 2010; 59: 718-727https://doi.org/10.1016/j.metabol.2009.09.016
- Insulin resistance as a modifier of the relationship between dietary fat intake and weight gain.Int J Obes Relat Metab Disord. 2004; 28: 803-812https://doi.org/10.1038/sj.ijo.0802621
- Familial risk moderates the association between sleep and zBMI in children.J Pediatr Psychol. 2013; 38: 775-784https://doi.org/10.1093/jpepsy/jst031
- Objectively measured physical activity, sedentary time and sleep duration: independent and combined associations with adiposity in Canadian children.Nutr Diabetes. 2014; 4: e117https://doi.org/10.1038/nutd.2014.14
- Overweight and obesity in Portuguese children: prevalence and correlates.Int J Environ Res Public Heal Electron Resour. 2014; 11: 11398-11417https://doi.org/10.3390/ijerph111111398
- Is obesity associated with poor sleep quality in adolescents?.Am J Hum Biol. 2002; 14: 762-768https://doi.org/10.1002/ajhb.10093
- Habitual sleep variability, not sleep duration, is associated with caloric intake in adolescents.Sleep Med. 2015; 16: 856-861https://doi.org/10.1016/j.sleep.2015.03.004
- Sleep duration modifies effects of free ad libitum school meals on adiposity and blood pressure.Appl Physiol Nutr Metab. 2016; 41: 33-40https://doi.org/10.1139/apnm-2015-0319
- Association of short and long sleep durations with insulin sensitivity in adolescents.J Pediatr. 2011; 158: 617-623https://doi.org/10.1016/j.jpeds.2010.09.080
- No relation between sleep duration and adiposity indicators in 9–36 months old children: the SKOT cohort.Pediatr Obes. 2012; 8 (e14-8)https://doi.org/10.1111/j.2047-6310.2012.00109.x
- Mother-reported sleep, accelerometer-estimated sleep and weight status in Mexican American children: sleep duration is associated with increased adiposity and risk for overweight/obese status.J Sleep Res. 2014; 23: 326-334https://doi.org/10.1111/jsr.12114
- Children's sleep quality: relation with sleep duration and adiposity.Public Health. 2014; 128: 488-490https://doi.org/10.1016/j.puhe.2014.02.003
- Sleep duration, sleep regularity, body weight, and metabolic homeostasis in school-aged children.Pediatrics. 2011; 127: e345-e352https://doi.org/10.1542/peds.2010-0497
- Sleep and physical growth in infants during the first 6 months.J Sleep Res. 2010; 19: 103-110https://doi.org/10.1111/j.1365-2869.2009.00772.x
- Relationship of sleep quality, baseline weight status, and weight-loss responsiveness in obese adolescents in an immersion treatment program.Sleep Med. 2015; 16: 432-434https://doi.org/10.1016/j.sleep.2014.11.007
- Multiple lifestyle behaviours and overweight and obesity among children aged 9–11 years: results from the UK site of the International Study of Childhood Obesity, Lifestyle and the Environment.BMJ Open. 2016; 6e010677https://doi.org/10.1136/bmjopen-2015-010677
- Sleep duration of underserved minority children in a cross-sectional study.BMC Public Health. 2013; 13: 648https://doi.org/10.1186/1471-2458-13-648
- Association between sleep architecture and glucose tolerance in children and adolescents.J Diabetes. 2015; 7: 10-15https://doi.org/10.1111/1753-0407.12138
Article info
Publication history
Published online: July 24, 2017
Accepted:
July 13,
2017
Received in revised form:
July 12,
2017
Received:
March 9,
2017
Handling Editor: A. SianiIdentification
Copyright
© 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
