Issue: March 2018
Perspective from Jean-Philippe Chaput, PhD
January 26, 2018
3 min read

Poor sleep quality associated with higher BMI in children

Issue: March 2018
Perspective from Jean-Philippe Chaput, PhD
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Bernard Fuemmeler
Bernard Fuemmeler

Children who sleep fewer hours per night or have greater alterations in rest patterns are more likely to have a higher BMI and waist circumference compared with children who have better sleep quality, according to findings presented at the American Association for Cancer Research Special Conference, Obesity and Cancer: Mechanisms Underlying Etiology and Outcomes.

“We know from a growing number of studies that less sleep increases the risk for childhood obesity,” Bernard Fuemmeler, PhD, MPH, professor and associate director for cancer prevention and control at Virginia Commonwealth University’s Massey Cancer, told Endocrine Today. “Less is known about how sleep quality and circadian patterns might impact childhood obesity and eating behaviors.”

Fuemmeler and colleagues analyzed data from 92 children born to mothers participating in the Newborn Epigenetic Study, a pre-birth cohort (mean age, 8 years; 62% black; 51% boys). Children wore accelerometers continuously for 24 hours over a minimum 5-day period, and completed the eating in the absence of hunger (EAH) task, a lab-based assessment of how much children eat beyond satiety from an ad libitum meal. Researchers used regression analysis to evaluate the association between components of the sleep-wake cycle, BMI z score and calories consumed during the eating task.

Researchers found that a shorter sleep duration, measured in hours, was associated with a higher BMI z score (beta = –0.17; P = .03). Each additional hour of sleep was associated with a 0.13 decrease in BMI z score and with a 1.29 cm decrease in waist circumference, according to researchers.

Additionally, more fragmented circadian rhythms were associated with higher BMI z score (beta = –1.87; P = .03), as was intra-daily variability, a measure of rest-activity rhythm fragmentation (beta = –1.46; P = .05).

Researchers also found that a later onset of diurnal activity was associated with greater caloric intake in EAH task (beta = –0.001; P = .01).

“We found that less sleep duration, less regular rhythm patterns and more frequent and greater alterations in rest to active patterns was associated with a greater waist circumference,” Fuemmeler said. “Eating behaviors were also related to sleep duration and the timing of day when children were the most active. The data, though preliminary, highlight that to better understand the sleep-obesity link, we need to look beyond just how long one is asleep. Circadian patterns also help shed light on eating behaviors and greater adiposity that deserve a closer look.”

The findings, Fuemmeler said, support the importance of establishing sufficient sleep and more regular sleep-activity routines for children to promote child health.

“More opportunities for activity and less screen time in bed may go a long way to help children develop good sleep patterns,” Fuemmeler said. “Children with chronic sleep problems can be stressful for parents and the family, and they may need the help of physicians and sleep experts who can help children develop healthy sleep patterns.” – by Regina Schaffer


Fuemmeler B, et al. Abstract PR11. Presented at: American Association for Cancer Research Special Conference; Jan. 27-30, 2018; Austin, Texas.

Disclosures: The National Institute of Child Health and Human Development funded this study. Fuemmeler reports no relevant financial disclosures.