Sleep, energy balance, and meal timing in school-aged children

Sleep Med. 2019 Aug;60:139-144. doi: 10.1016/j.sleep.2019.02.003. Epub 2019 Feb 16.


Objective: To determine associations among objectively-measured nocturnal sleep time, bedtime and obesogenic behaviors, including dietary intake, timing of intake, and physical activity, in a diverse sample of school-aged children who presented for behavioral treatment to enhance sleep duration.

Methods: Eighty-seven children (8-11 y, 66.7% female, zBMI: 0.86 ± 1.0) who self-reported sleeping <9.5 h/night were studied for one week using wrist actigraphy to estimate sleep; hip-worn accelerometers to measure physical activity; and 24 h dietary recalls to capture dietary intake and meal timing. Pearson and Spearman's rho correlations and linear regressions controlling for age, gender and race were used for statistical analyses.

Results and conclusion: Mean bedtime was 10:31 PM (±58.2 min) and mean nocturnal sleep time was 7.7 h (±37.5 min). Although later bedtime was associated with shorter sleep time (r = -0.61, p < 0.001), the two variables were differentially related to obesity risk factors. Later bedtime, but not sleep time, correlated with greater daily fat intake, later first meal of the day, and greater after-dinner intake (all p < 0.05). Nocturnal sleep time, but not bedtime, correlated with zBMI (p = 0.04). Both sleep time and later bedtime were associated with a later last meal of the day (all p < 0.05). Findings remained consistent after controlling for demographic factors. In short-sleeping school-aged children, bedtime may be more predictive of dietary obesity risk factors whereas sleep duration may be more predictive of zBMI. Results suggest that health providers should consider both bedtime and sleep duration for reducing obesity risk in children.

Clinical trial: Enhancing Sleep Duration: Effects on Children's Eating and Activity Behaviors, NCT03186508,

Keywords: Obesity; Pediatric; Risk factors; Sleep duration; Sleep timing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Accelerometry / statistics & numerical data
  • Actigraphy / statistics & numerical data
  • Body Mass Index
  • Child
  • Diet
  • Energy Intake / physiology*
  • Exercise / physiology
  • Feeding Behavior / psychology*
  • Female
  • Humans
  • Male
  • Pediatric Obesity / prevention & control
  • Sleep / physiology*

Associated data