Shared determinants of poor sleep and increased adiposity and obesity in childhood and adolescence

Abstract

Introduction: Poor sleep and obesity in adolescents present significant public health challenges. Previous research has shown that sleep duration and obesity are bidirectionally associated in adolescents, however the relationship between different components of sleep and obesity, and their shared determinants, is unclear. This doctoral research investigates the relationship between sleep, obesity, and adiposity in adolescents, and identifies potential shared determinants of poor sleep and obesity.

Methodology: A mixed methods approach was used to investigate the aims of this research: (1) Systematic review - to examine the relationship between different sleep domains, obesity, and adiposity in 8-18-year-olds (SR1); and to identify shared determinants of poor sleep and obesity in 8-18-year-olds (SR2); (2) Secondary data analysis: Growing Up in Scotland dataset - to analyse the longitudinal relationships between sleep, obesity, and shared determinants across childhood and adolescence; (3) Primary cross sectional research: Teen Sleep Well Study - to identify shared determinants (components of screen time usage, diet choices and consumption behaviours, and physical activity) of poor sleep and adiposity in 11-14-year-olds.

Results: Pre-sleep outcomes and social jetlag were significantly associated with obesity in 8-18-year-olds. Sleep deteriorated between the ages of 8-14-years, and 50% of 11-14-year-olds experienced poor wellbeing and fluctuating or obesogenic growth trajectories. The shared determinants of poor sleep and obesity in adolescents include: (i) screen time: excessive late-night, early morning, and weekend use, videogaming addiction, lack of parental knowledge of child’s screen time; (ii) dietary choices and consumption behaviours: irregular meal timing, and late-night food consumption; (iii) physical activity: late-night moderate-to-vigorous physical activity; (iv) engaging in risk-taking behaviours: smoking and alcohol consumption.

Discussion: Many of the identified shared determinants of sleep and obesity act as zeitgebers that entrain the circadian rhythm of the adolescent and could be used as targets in a multi-component health-promoting intervention for adolescents (8-10-years-olds).