Chronic insufficient sleep and diet quality: Contributors to childhood obesity

Objective To examine associations of chronic insufficient sleep with diet and whether diet explains the sleep‐adiposity relationship. Methods In Project Viva, 1,046 parents reported children's sleep duration at 6 m and annually until midchildhood (7 y). The main exposure was a sleep curtailment score (6 m‐7 y) ranging from 0 (maximal curtailment) to 13 (adequate sleep). In mid‐childhood, parents reported children's diet; researchers measured height/weight. Multivariable linear regression assessed associations of sleep with diet (Youth Healthy Eating Index [YHEI]); sleep with BMI z ‐score adjusting for YHEI; and, secondarily, joint associations of sleep and YHEI with BMI. Results Mean (SD) sleep and YHEI scores were 10.21 (2.71) and 58.76 (10.37). Longer sleep duration was associated with higher YHEI in mid‐childhood (0.59 points/unit sleep score; 95% CI: 0.32, 0.86). Although higher YHEI was associated with lower BMI z ‐score (−0.07 units/10‐point increase; 95% CI: −0.13, −0.01), adjustment for YHEI did not attenuate sleep‐BMI associations. Children with sleep and YHEI scores below the median (<11 and <60) had BMI z‐scores 0.34 units higher (95% CI: 0.16, 0.51) than children with sleep and YHEI scores above the median. Conclusions While parent‐reported diet did not explain inverse associations of sleep with adiposity, both sufficient sleep and high‐quality diets are important to obesity prevention.