Sleep, nutritional status and eating behavior in children: a review study

Hermes, Fernanda Nascimento; Nunes, Eryclis Eduardo Miguel; Melo, Camila Maria de

doi:10.1590/1984-0462/2022/40/2020479IN

Brasil

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REVIEW ARTICLE • Rev. paul. pediatr. 40 • 2022 • https://doi.org/10.1590/1984-0462/2022/40/2020479IN linkcopy

Sleep, nutritional status and eating behavior in children: a review study

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ABSTRACT

Objective: To review the current literature on the relationship between sleep, nutritional status and eating behavior, as well as mechanisms associated with these elements in children.

Data source: The literature research was conducted in the PubMed, LILACS and Scopus databases, using the following terms: “Child”; “Nutritional status”; “Sleep”; “Physical activity OR Physical activities OR Exercise”. The articles included were those that met the research objective. Review articles, letters to authors, or guidelines were excluded.

Data synthesis: 402 articles were initially found in the literature search. After careful analyses of the title and abstract, and application of inclusion criteria, only 24 studies were included in the present review. Most studies (n=13) suggest that short sleep duration (<9-10 hours/night) is associated with overweight/obesity in children. Only three studies did not show associations between overweight/obesity and sleep variables. Short sleep duration is also associated with poor food quality, higher intake of soft drinks and stimulant beverages before bedtime, as well as micronutrient deficiency.

Conclusions: Sleep duration is related to overweight and obesity development in infants. Changes in dietary pattern are also related to sleep debt, being one of the mechanisms that contribute to excessive weight gain. It is necessary that health professionals understand the importance of sleep quality in the nutritional status maintenance in children.

Keywords: Sleep; Nutritional status; Physical activity; Child

Author (year)	Goals and Sample	Main results
King (2017)⁷	To analyze the association between soft drink consumption and child behavior, according to food safety status and sleep patterns; 2,829 children; ±5 years old.	Sleep problems were associated with soft drink intake in food-insecure children.
Carrillo-Larco et al. (2014)¹⁶	To describe nutritional status and sleep duration in children from four countries; >8,000 children; ±8 years old.	Sleep duration <10h was associated with 15% increased incidence of obesity. Maternal education and family income attenuated this relationship.
Na et al. (2019)³²	To examine the association between food insecurity and child sleep outcomes; 362 preschoolers; 7-8 years old.	Child food insecurity was associated with a 2.25 times increase in poor child sleep quality in the adjusted model.
Ruotolo et al. (2016)³³	To verify whether nocturnal eating habits can influence sleep and parasomnia in children; 226 children; 7-8 years old.	45% of children who presented parasomnia during the night consumed stimulant caffeine-rich food before bedtime. Late dinner was associated with late bedtime.
Kordas et al. (2007)³⁴	To investigate the relationship between lead exposure, micronutrient status, sleep, classroom behavior and physical activity in Mexican children; 602 children; 6-8 years old.	Blood lead≥10μg/dL was associated with later waking time and shorter duration of sleep. Anemia was linked to earlier bedtime, and shorter sleep onset.
Kordas et al. (2008)³⁵	To investigate the relationship between iron deficiency anemia (ADI), swimming and maternal sleep reports; 1,270 children; 6-18 months of age.	Iron deficiency, low length and stunting were associated short sleep duration and higher frequency of night wakening; stunting was related to shorter nap duration.
Durán et.al. (2012)³⁷	To determine the association of sleep duration and obesity; 155 schoolchildren; 5-7 years old.	Sleeping >10 hours/night, exercising, and not eating chocolate at night are associated factors for obesity.

Author (year)	Goals and sample	Main results
Marques et al. (2018)⁶	To analyze the association between sleep duration and nutritional status of school-age children studying in Portugal; 829 students; ±9 years old.	There was a weak but significant correlation between sleep duration and body mass index z-score (r=0.15; p<0.01).
Agüero et al. (2017)¹⁹	To establish a relationship between sleep duration, nutritional status and consumption patterns of caffeinated beverages; 805 school-age children; 6-10 years old.	Normal weight (NW) subjects slept significantly more hours than obese participants (9.8±0.9 vs. 9.6±0.9). Sleep duration during the week was inversely associated to obesity (OR 3.5, 95%CI 1.3-9.2).
Chamorro et al. (2014)¹⁵	To compare the characteristics of sleep microstructure (CAP) in overweight (OW) and normal weight children; 58 children; 10 years old.	CAP time and CAP rate showed significant associations with body mass index z-score. Obese subjects might have less stable slow wave sleep episodes.
Corso et al. (2012)²⁴	To analyze the association between OW/obesity (OB) and hours spent with TV/computer, hours of sleep and physical activity; 4,964 schoolchildren; 6-10 years old.	OW and OB were associated with weekly sports practice and sleep hours per night.

Author (year)	Goals and Sample	Main results
Agüero and Rivera (2016)¹⁷	To investigate sleep and eating habits, physical activity and nutritional status; 1,810 children; 6-11 years old.	Positive associations between sleep and risk of being obese, even when adjusted for confounders.
Bazán et al. (2018)¹⁸	To describe factors associated with overweight (OW)/obesity (OB); 3,752 children; 2-15 years old.	OB was higher in children who sleep less than the recommended hours of sleep.
Cicek et al. (2009)²⁰	To examine the risk factors associated with arm fat area (AFA) in Turkish children and adolescents; 5,358 schoolchildren; 6-17 years old.	Sleeping 8-9 h and ≤8 h significantly predicted OW for boys; while sleeping 9-10 h, 8-9 h and ≤8 h significantly predicted OW for girls.
Katsa et al. (2018)²²	To investigate the effect of life habits on Child Metabolic Syndrome; 480 children; 5-12 years old.	Late bedtime was associated with increased weight, waist circumference, lower height and blood glucose.
Guo et al. (2012)²³	To compare health-related factors among Chinese children and adolescents with normal weight (NW), OW and OB; 4,262 children and adolescents; 5-18 years old.	NW children had a higher change of having a longer sleep duration than OB. OB children were less likely to sleep longer (≥7.5 h) than the NW.
Jong et al. (2012)²⁶	To establish an association between sleep duration and OW in childhood; 4,072 children; 4-13 years old.	Short sleep duration was associated with watching TV during meals and eating sugar-rich foods.
Aravena et al. (2017)²⁸	To study nutritional status and sleep duration in Chilean children; 481 schoolchildren; 6-15 years old.	The numbers for OB children were not different from those for NW children who sleep the recommended hours.
Giovaninni et al. (2014)²⁹	To analyze clock gene polymorphism and presence of OB and sleep duration; 370 children; 6-13 years old.	Trend toward higher prevalence of OW in children <9h/night of sleep vs >10h/night.
Golley et al. (2013)³⁰	To investigate if sleep time is associated with diet; 2,200 children and adolescents; 9-16 years old.	Late bedtime group had higher body mass index (BMI); there were significant associations between BMI, sleep duration and energy intake.
Jiang et al. (2014)²¹	To investigate the association between sleep duration and somatic growth; 143 children; 10-11 years old.	Children that slept >10h/night had higher weight, height and BMI.
Christoph et al. (2017)²⁷	To investigate weight-related factors in rural and urban schoolchildren; 148 schoolchildren; 11-16 years old.	BMI was positively related to being female, rural, more active and having higher subjective sleep quality.
Hitze et al. (2009)³¹	To investigate the determinants of sleep duration in children; 414 adolescents; 13 years old.	Short vs long sleep was associated with 5.5-/2.3-fold higher risks for OB in girls.

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