Lu Ma1, Yixin Ding1, Dorothy T Chiu2, Yang Wu3, Zhiyong Wang4, Xin Wang5, Youfa Wang6,7. 1. Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. 2. Community Health Sciences Division, School of Public Health, University of California, Berkeley, Berkeley, CA, USA. 3. Department of Sociology, Center for Asian & Pacific Economic & Social Development, Research Institute for Female Culture, Jiangxi University of Finance and Economics, Nanchang, Jiangxi, China. 4. Department of Chronic Non-communicable Diseases, Nanjing Center for Disease Control and Prevention, Nanjing, Jiangsu, China. 5. Institute of Nutrition and Food Safety Risk Monitoring, Shaanxi Center for Disease Control and Prevention, Xi'an, Shaanxi, China. 6. Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. youfawang@gmail.com. 7. Fisher Institute of Health and Well-Being, Department of Nutrition and Health Science, College of Health, Ball State University, Muncie, IN, USA. youfawang@gmail.com.
Abstract
BACKGROUND: The aim of the study was to examine correlates of sleep and assess its associations with weight status and related behaviors. METHODS: Data were collected in 2015-2017 for 3298 children aged 6-17 years and their parents in 5 Chinese mega-cities. One thousand six hundred and ninety-one children with measured weight, height, and waist circumference in ≥2 surveys were included for longitudinal data analyses. Sleep and behaviors were self-reported. RESULTS: Cross-sectional data analyses found that older (β = -0.29, 95% CI: -0.32, -0.27) and secondary school children (β = -1.22, 95% CI: -1.31, -1.13) reported shorter sleep than their counterparts. Children with ≥college-educated (vs <college) fathers (β = 0.17, 95% CI: 0.04, 0.31) or mothers (β = 0.16, 95% CI: 0.04, 0.29) reported longer sleep. Longer sleep was longitudinally associated with less sugar-sweetened beverage intake (β = -0.12 days/h sleep, 95% CI: -0.20, -0.03), more healthy snacks intake (β = 0.13 days/h sleep, 95% CI: 0.02, 0.25) and having breakfast (β = 0.07 days/h sleep, 95% CI: 0.04, 0.11), and shorter total screen time (β = -0.22 h/h sleep, 95% CI: -0.65, -0.21) and surfing the internet/computer time (β = -0.06 h/h sleep, 95% CI: -0.09, -0.04) among all children. Longer sleep reduced the risk of central obesity (OR = 0.46, 95% CI: 0.25, 0.85) for girls. CONCLUSIONS: Sleep among urban Chinese children varies by demographic factors. Longer sleep is associated with healthier weight-related behaviors and lower central obesity risk. IMPACT: Longer sleep was observed in younger, primary school children and children with college-educated parents. Longer sleep increased healthier weight-related behaviors and reduced general and central obesity risk. Provides data on the correlates of sleep duration of children. Gives insights on longitudinal relationships of sleep duration with weight-related behaviors and obesity risk. Findings help inform sleep interventions to increase sleep duration to prevent childhood obesity and unhealthy weight-related behaviors in urban settings of developing countries.
BACKGROUND: The aim of the study was to examine correlates of sleep and assess its associations with weight status and related behaviors. METHODS: Data were collected in 2015-2017 for 3298 children aged 6-17 years and their parents in 5 Chinese mega-cities. One thousand six hundred and ninety-one children with measured weight, height, and waist circumference in ≥2 surveys were included for longitudinal data analyses. Sleep and behaviors were self-reported. RESULTS: Cross-sectional data analyses found that older (β = -0.29, 95% CI: -0.32, -0.27) and secondary school children (β = -1.22, 95% CI: -1.31, -1.13) reported shorter sleep than their counterparts. Children with ≥college-educated (vs <college) fathers (β = 0.17, 95% CI: 0.04, 0.31) or mothers (β = 0.16, 95% CI: 0.04, 0.29) reported longer sleep. Longer sleep was longitudinally associated with less sugar-sweetened beverage intake (β = -0.12 days/h sleep, 95% CI: -0.20, -0.03), more healthy snacks intake (β = 0.13 days/h sleep, 95% CI: 0.02, 0.25) and having breakfast (β = 0.07 days/h sleep, 95% CI: 0.04, 0.11), and shorter total screen time (β = -0.22 h/h sleep, 95% CI: -0.65, -0.21) and surfing the internet/computer time (β = -0.06 h/h sleep, 95% CI: -0.09, -0.04) among all children. Longer sleep reduced the risk of central obesity (OR = 0.46, 95% CI: 0.25, 0.85) for girls. CONCLUSIONS: Sleep among urban Chinese children varies by demographic factors. Longer sleep is associated with healthier weight-related behaviors and lower central obesity risk. IMPACT: Longer sleep was observed in younger, primary school children and children with college-educated parents. Longer sleep increased healthier weight-related behaviors and reduced general and central obesity risk. Provides data on the correlates of sleep duration of children. Gives insights on longitudinal relationships of sleep duration with weight-related behaviors and obesity risk. Findings help inform sleep interventions to increase sleep duration to prevent childhood obesity and unhealthy weight-related behaviors in urban settings of developing countries.