Background: While insufficient sleep duration is a strong, independent risk factor for obesity in children, the mechanisms remain unclear. Emerging research suggests that sleep loss may impact dietary intake, resulting in weight gain over time. Therefore, the objective of this study was to determine how mild sleep loss influenced food intake in children.
Design: Using a randomized, cross-over study design, 100 healthy children (8-12 years) with normal reported sleep (~8-11 hours/night) were randomized to go to bed one hour earlier (sleep extension) or one hour later (sleep restriction) than their usual bedtime, over two intervention weeks, separated by one washout-week. Sleep was measured via actigraphy and dietary intake by multiple 24-hour recalls. Type of food was classified by level of processing, and as core and non-core food. Data were analyzed according to ‘intention to treat’ and as ‘per protocol’, set at a 30-minute difference in sleep duration between intervention conditions. Mixed effects regression models were used to determine mean differences (95% CI) between the two sleep conditions.
Results: Compared with sleep extension, during sleep restriction children consumed significantly more carbohydrates [10.7 grams (1.6, 19.7)], total sugar [6.2 grams (1.4, 10.9)] and energy from non-core foods [416 kJ (6.5, 826)] daily. Trends of increased total energy intake [233 kJ (-42, 509; p = 0.096)] and increased intake of ultra-processed food and beverages [326 kJ (-57, 708; p = 0.095)] were noted. These trends were confirmed by the per protocol analysis (n=59) with findings of significantly greater energy intake [361 kJ (20,702)] and ultra-processed foods consumption [523 kJ (93.4, 952)] when at least 30 minutes of sleep was truly lost.
Conclusion: Findings indicate that mild sleep loss in children may play a role in pediatric obesity by increasing energy intake, mainly from carbohydrates, total sugar, non-core foods and ultra-processed foods.