Serial Studies On The Effect Of Sleep On Eating Habits And Physical Activity In Children

Part I The Association between Sleep and Dietary Patterns in Preschool Children OBJECTIVE: To investigate the sleep habits and dietary patterns of Chinese preschool children and to examine the effect of sleep on dietary patterns in preschool children.METHODS: A clustered sampling design was used to recruit subjects from 11 kindergartens in Hongkou district of Shanghai. Participants included 1,650 preschool children(aged 5.07±0.97) years, of which 49.5% were boys. Socio-demographic information and sleep and dietary patterns were obtained from parental questionnaires.RESULTS: The average total sleep duration was 9.41±0.54 hours. Two major dietary patterns were identified in the study based on principal component analysis; i.e., traditional and western dietary patterns. Later midpoints of sleep were associated with fewer times consuming fruit(?2 = 25.18, p < 0.001) and vegetables(?2 = 36.06, p < 0.001) but more frequent intake of soft drinks(?2 = 38.05, p < 0.001). And after controlling for gender, age, body mass index, parent education level, household income, BMI and children's sleep duration, our study showed that individuals who had later sleep midpoints had lower traditional dietary pattern scores(? =-0.14, p < 0.001) and higher western dietary pattern scores(? = 0.16, p < 0.001) However, no significant difference in dietary patterns among different sleep duration groups was found.CONCLUSIONS: Later midpoints of sleep were significantly associated with western dietary patterns in preschool children. Our findings may be helpful in the management of preschool childhood obesity.Part II Association between Sleep and Infant Feeding Methods OBJECTIVE: To investigate sleep and feeding habits of infants and to examine the effect of feeding method on infant and maternal sleep.METHODS: 263 healthy pregnant women and their infants from Shanghai were enrolled during August 2012 to August 2013.The sleep and feeding information was obtained at infants' 6 weeks and 3,6, 9 months. Infant sleep was reported by parents by the Brief Infant Sleep Questionnaire(BISQ).Infant feeding information was assessed by Infant Feeding Questionnaire. In addition, when the infants were 6 months old, actigraphy was used to objectively measure infant sleep, and 3-day food diary to assess nutrition intake. Maternal postpartum sleep was evaluated by the Pittsburgh Sleep Quality Index(PSQI).RESULTS: Boys accounted for 51.3 % of the sample. At 6 weeks, 3 months, and 6 months, the proportion of breast fed infants accounted for 42.9%, 52.8%, and 37.6%, respectively. Total energy intake of 6 month infants was(582.72±147.32) Kcal/d, and the consumption of protein, fat, carbohydrates per day were(18.95±7.61) g/d,(22.47±6.27)g/d and(77.78±25.89)g/d, respectively.From 6 weeks to 9 months, infants' bedtime became earlier(F=8.13,p<0.001), with increasing night sleep time(F=39.58,p<0.001), longest night sleep time(F=77.67,p<0.001), and night sleep quality(F=35.37,p<0.001), while the day time sleep(F=155.30,p<0.001), total sleep time(F=26.31,p<0.001), night waking frequency(F=50.57,p<0.001) and the duration of night waking(F=94.87,p<0.001) decreased. At 6 months, the objective recorded infant day sleep time(t=12.79,p<0.001) and total sleep time(t=-9.86,p<0.001) were less than subjective reported, and the objective bedtime was later(t=-2.45,p=0.016).As the infant grows, the maternal postpartum night sleep duration(F=29.24,p<0.001), sleep quality(F=30.12,p<0.001) increases while the night waking frequency(F=42.29,p<0.001), night waking duration(F=6.79,p<0.001) and PSQI score(F=3.27,p=0.027)decreased.After adjusting for infants' age, sex, BMI, parents' education and household income, compared to breast fed infants at 6 months, the mixed fed infants had objective recorded later bedtime(?=0.22,p=0.015) and shorter sleep duration(?=-0.24,p=0.010).In addition, the multiple linear regression model showed that comparing with the breast fed infants,the mixed fed(?=-0.19, p=0.035)and artificial fed(?=-0.22,p=0.011) infant at 3 months had shorter objective night sleep time at 6 months. But the maternal night sleep time, sleep efficiency, PSQI score and night waking were no significant difference among different feeding groups.CONCLUSIONS:Breast feeding may protect infants' night sleep time to some extent, and showed no negative effect on maternal sleep duration.We should monitor infant feeding behaviors and promote more breast feeding, which would be beneficial for the development of infant sleep and their later eating habits. Association between Sleep and Physical Activity in Children Part I The Association between Sleep and Physical Activity in School Children OBJECTIVE: To investigate the sleep and physical activity of Chinese school children and to explore whether sleep had an effect on children's physical activityMETHODS: Multi-stage cluster sampling method was used to enroll participants, and finally15470 children were recruited. Basic information was surveyed by the Shanghai Children's Medical Center socio-demographic questionnaire. Children's sleep parameters were collected by parental questionnaire, and the Chinese Version of the Children's Leisure Activities Study Survey questionnaire was used to access the physical activity of the children.RESULTS: The average age of the children was 9.24±1.50 years with 53.4% being boys. Children's sleep duration was 9.31±0.55 hours. The average vigorous physical activity, moderate physical activity, light physical activity and sedentary activity were 30.2±39.7 min/day, 84.7±72.7 min/day, 182.6±122.3 min/day and 64.6±76.5 min/day, respectively. Boys had more vigorous physical activity(t=7.64,p<0.001) and sedentary activity(t=7.65,p<0.001), while girls had more moderate physical activity(t=-6.13,p<0.001) and light physical activity(t=-6.00,p<0.001). Older children had more physical activity than younger children. Children of higher educated father or mother or higher household income showed longer physical activity time and shorter sedentary activity time. After adjusting for child's age, sex, BMI,parental education level, household income, children with shorter sleep duration had more light physical activity(?=0.05, p<0.001).And children with earlier midpoint of sleep had less sedentary activity(?=-0.11, p<0.001).Children with shorter sleep duration had more light physical activity, and children in which the sleep midpoints were earlier showed less sedentary activity. Vigorous and moderate physical activity in our children should be encouraged. Besides, bedtimes and wake up times might be modifiable risk factors for children's sedentary activity. Part II The Association between Infant Sleep and Physical Activity OBJECTIVE: To investigate the physical activity of infant and to explore the association between sleep and infant physical activity.METHODS: In our birth cohort study, we assessed infants' sleep and activity level using actigraphy at 6 months. Infants' weight, height, biceps circumference, subscapular and triceps skinfold thickness were also measured at 6 and 9 months.RESULTS: Complete data of 148 infants(boys accounted for 48.7%) were used.. At 6 months, the average weight was 8.46±1.07 kg and height was 67.79±2.30 cm. The average biceps circumference, subscapular and triceps skinfold thickness were 14.96±1.58 cm, 9.92±2.07 mm and 9.13±2.01 mm, respectively. And at 9 months, the infants' weight was 9.37±1.14 kg and height was 71.76±2.27 cm. The biceps circumference, subscapular and triceps skinfold thickness were 15.16±1.24 cm, 9.62±2.29 mm and 8.40±1.99 mm, respectively.Actigraphy recorded infant night sleep time was 9.20±0.97 h, and the average activity(count per minute) was 315.13± 112.82. After controlling for infants' age of months, sex, BMI, parents' education and household income, infants with higher proportion of night sleep time taking up the total sleep time had more physical activity during the waking time(?=0.27,p=0.002). The infants who had more activity showed lower BMI(?=-0.20,p =0.028), biceps circumference(?=-0.23, p=0.006), subscapular(?=-0.32,p<0.001) and triceps skinfold thickness(?=-0.25,p=0.003) at 6 months, and lower BMI(?=-0.26,p=0.007), subscapular(?=-0.32,p=0.001)and triceps skinfold thickness(?=-0.24,p=0.017) at 9 months.CONCLUSIONS:Infants with higher higher proportion of night sleep time taking up the total sleep time showed more physical activity during waking state. Infants' physical activity had negative correlation with BMI and skinfold thickness, and therefore we need to monitor infants' physical activity. It's meaningful to cultivate mature infants Sleep-wake pattern, to improve the night time sleep ratio which might eventually have positive effect on infants' physical activity.