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Ethnic variation in the association between sleep and body mass among US adolescents

Abstract

Objective:

We investigate whether differences in sleep duration help explain ethnic disparities in body mass index (BMI) among US adolescents. We also evaluate the functional form of the association between sleep duration and BMI, and investigate whether this association varies by sex and ethnicity.

Participants and methods:

We analyzed restricted-use data from the first two waves of the National Longitudinal Study of Adolescent Health (n=30 133) to evaluate linear and quadratic associations between sleep duration and BMI. Through a series of models that incorporated interaction terms between sex, ethnicity and sleep duration, we also assessed whether (1) sleep duration mediates associations between ethnicity and BMI, and (2) associations between sleep duration and BMI differ for girls and boys from different ethnic groups.

Results:

A linear association between sleep duration and BMI best fits the data in this large sample of US adolescents. We find no evidence that sleep duration contributes substantially to ethnic disparities in BMI. However, we detect significant differences in the association between sleep duration and BMI by sex and ethnicity. Sleep duration is negatively associated with BMI among White, Hispanic and Asian boys, positively associated with BMI among Black girls and is not related to BMI among Black boys or girls from White, Hispanic or Asian ethnic groups.

Conclusions:

Despite significant associations between sleep duration and BMI for certain groups of adolescents, we find no evidence that ethnic differences in sleep duration exacerbate ethnic disparities in BMI. Future research should explore mechanisms that underlie ethnic differences in the association between sleep and BMI.

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References

  1. McLaren L . Socioeconomic status and obesity. Epidemiol Rev 2007; 29: 29–48.

    Article  PubMed  Google Scholar 

  2. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP . The continuing epidemics of obesity and diabetes in the United States. JAMA 2001; 286: 1195–1200.

    Article  CAS  PubMed  Google Scholar 

  3. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM . Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006; 295: 1549–1555.

    Article  CAS  PubMed  Google Scholar 

  4. Komlos J, Breitfelder A, Sunder M . The transition to post-industrial BMI values among US children. Am J Hum Biol 2009; 21: 151–160.

    Article  PubMed  Google Scholar 

  5. Reither EN, Hauser RM, Yang Y . Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States. Soc Sci Med 2009; 69: 1439–1448.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ogden CL, Flegal KM, Carroll MD, Johnson CL . Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002; 288: 1728–1732.

    Article  PubMed  Google Scholar 

  7. Liu X, Liu L, Owens JA, Kaplan DL . Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics 2005; 115: 241–249.

    Article  PubMed  Google Scholar 

  8. Mercer PW, Merritt SL, Cowell JM . Differences in reported sleep need among adolescents. J Adolesc Health 1998; 23: 259–263.

    Article  CAS  PubMed  Google Scholar 

  9. Smaldone A, Honig JC, Byrne MW . Sleepless in America: inadequate sleep and relationships to health and well-being of our nation's children. Pediatrics 2007; 119: S29–S37.

    Article  PubMed  Google Scholar 

  10. Wolfson AR, Carskadon MA . Sleep schedules and daytime functioning in adolescents. Child Dev 1998; 69: 875–887.

    Article  CAS  PubMed  Google Scholar 

  11. Van Cauter E, Knutson KL . Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol 2008; 159: S59–S66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. National Science Foundation. Sleep in America Poll. National Sleep Foundation: Washington, DC, USA, 2006.

  13. Patel SR, Hu FB . Short sleep duration and weight gain: a systematic review. Obesity 2008; 16: 643–653.

    Article  PubMed  Google Scholar 

  14. Magee L, Hale L . Longitudinal associations between sleep duration and subsequent weight gain: a systematic review. Sleep Med Rev 2011; 16: 231–241.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Knutson KL . Sex differences in the association between sleep and body mass index in adolescents. J Pediatr 2005; 147: 830–834.

    Article  PubMed  Google Scholar 

  16. Lytle LA, Pasch KE, Farbakhsh K . The relationship between sleep and weight in a sample of adolescents. Obesity 2011; 19: 324–331.

    Article  PubMed  Google Scholar 

  17. Kong AP, Wing Y-K, Choi KC, Li AM, Ko GTC, Ma RC et al. Associations of sleep duration with obesity and serum lipid profile in children and adolescents. Sleep Med 2011; 12: 659–665.

    Article  PubMed  Google Scholar 

  18. Danielsen YS, Pallesen S, Stormark KM, Nordhus IH, Bjorvatn B . The relationship between school day sleep duration and body mass index in Norwegian children (aged 10–12). Int J Pediatr Obes 2010; 5: 214–220.

    Article  PubMed  Google Scholar 

  19. Eisenmann JC, Ekkekakis P, Holmes M . Sleep duration and overweight among Australian children and adolescents. Acta Pædiatr 2006; 95: 956–963.

    Article  PubMed  Google Scholar 

  20. Hitze B, Bosy-Westphal A, Bielfeldt F, Settler U, Plachta-Danielzik S, Pfeuffer M et al. Determinants and impact of sleep duration in children and adolescents: data of the Kiel Obesity Prevention Study. Eur J Clin Nutr 2008; 63: 739–746.

    Article  PubMed  Google Scholar 

  21. Drescher AA, Goodwin JL, Silva GE, Quan SF . Caffeine and screen time in adolescence: associations with short sleep and obesity. J Clin Sleep Med 2011; 7: 337–342.

    PubMed  PubMed Central  Google Scholar 

  22. Silva GE, Goodwin JL, Parthasarathy S, Sherrill DL, Vana KD, Drescher AA et al. Longitudinal association between short sleep, body weight, and emotional and learning problems in Hispanic and Caucasian children. Sleep 2011; 34: 1197–1205.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hassan F, Davis MM, Chervin RD . No independent association between insufficient sleep and childhood obesity in the National Survey of Children's Health. J Clin Sleep Med 2011; 7: 153–157.

    PubMed  PubMed Central  Google Scholar 

  24. Gordon-Larsen P, Adair LS, Nelson MC, Popkin BM . Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health. Am J Clin Nutr 2004; 80: 569–575.

    CAS  PubMed  Google Scholar 

  25. Scharoun-Lee M, Adair LS, Kaufman JS, Gordon-Larsen P . Obesity, race/ethnicity and the multiple dimensions of socioeconomic status during the transition to adulthood: a factor analysis approach. Soc Sci Med 2009; 68: 708–716.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Spilsbury JC, Storfer-Isser A, Drotar D, Rosen CL, Kirchner LH, Benham H et al. Sleep behavior in an urban US sample of school-aged children. Arch Pediatr Adolesc Med 2004; 158: 988–994.

    Article  PubMed  Google Scholar 

  27. Crosby B, LeBourgeois MK, Harsh J . Racial differences in reported napping and nocturnal sleep in 2- to 8-year-old children. Pediatrics 2005; 115: 225–232.

    Article  PubMed  Google Scholar 

  28. Milan S, Snow S, Belay S . The context of preschool children's sleep: racial/ethnic differences in sleep locations, routines, and concerns. J Fam Psychol 2007; 21: 20–28.

    Article  PubMed  Google Scholar 

  29. Jenni OG, O'Connor BB . Children's sleep: an interplay between culture and biology. Pediatrics 2005; 115: 204–216.

    Article  PubMed  Google Scholar 

  30. McLaughlin Crabtree V, Beal Korhonen J, Montgomery-Downs HE, Faye Jones V, O'Brien LM, Gozal D . Cultural influences on the bedtime behaviors of young children. Sleep Med 2005; 6: 319–324.

    Article  PubMed  Google Scholar 

  31. Krueger PM, Friedman EM . Sleep duration in the United States: a cross-sectional population-based study. Am J Epidemiol 2009; 169: 1052–1063.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hale L, Do DP . Racial differences in self-reports of sleep duration in a population-based study. Sleep 2007; 30: 1096–1103.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lavigne JV, Arend R, Rosenbaum D, Smith A, Weissbluth M, Binns HJ et al. Sleep and behavior problems among preschoolers. J Dev Behav Pediatr 1999; 20: 164–169.

    Article  CAS  PubMed  Google Scholar 

  34. Redline S, Tishler PV, Schluchter M, Aylor J, Clark K, Graham G . Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med 1999; 159: 1527–1532.

    Article  CAS  PubMed  Google Scholar 

  35. Spilsbury JC, Storfer-Isser A, Kirchner HL, Nelson L, Rosen CL, Drotar D et al. Neighborhood disadvantage as a risk factor for pediatric obstructive sleep apnea. J Pediatr 2006; 149: 342–347.

    Article  PubMed  Google Scholar 

  36. Hale L, Berger LM, LeBourgeois MK, Brooks-Gunn J . Social and demographic predictors of preschoolers’ bedtime routines. J Dev Behav Pediatr 2009; 30: 394–402.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sun Y, Sekine M, Kagamimori S . Lifestyle and overweight among Japanese adolescents: the Toyama Birth Cohort Study. J Epidemiol 2009; 19: 303–310.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Knutson KL . Association between sleep duration and body size differs among three Hispanic groups. Am J Hum Biol 2011; 23: 138–141.

    Article  PubMed  Google Scholar 

  39. Boonstra H . The ‘Add Health’ Survey: origins, purposes and design. In: The Guttmacher Report on Public Policy. Vol. 4. Guttmacher: New York, 2001, pp 10–12.

    Google Scholar 

  40. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z et al. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 2002; 246: 1–190.

    Google Scholar 

  41. Rubin DB . Multiple Imputation for Nonresponse in Surveys. Wiley: New York, NY, USA, 1987.

    Book  Google Scholar 

  42. Chantala K . Guidelines for Analyzing Add Health Data. University of North Carolina at Chapel Hill, Carolina Population Center: Chapel Hill, NC, 2006.

    Google Scholar 

  43. Kleinbaum DG, Kupper LL, Nizam A, Muller KE (eds). Applied Regression Analysis and Other Multivariable Methods. 3rd edn. Duxbury: Belmont, CA, USA, 1998.

  44. Knutson KL, Lauderdale DS . Sociodemographic and behavioral predictors of bed time and wake time among US adolescents aged 15 to 17 years. J Pediatr 2009; 154 3: 430 e1.

    Article  Google Scholar 

  45. Adam EK, Snell EK, Pendry P . Sleep timing and quantity in ecological and family context: a nationally representative time-diary study. J Fam Psychol 2007; 21: 4–19.

    Article  PubMed  Google Scholar 

  46. Moore M, Kirchner HL, Drotar D, Johnson N, Rosen C, Redline S . Correlates of adolescent sleep time and variability in sleep time: the role of individual and health related characteristics. Sleep Med 2011; 12: 239–245.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Araujo J, Severo M, Ramos E . Sleep duration and adiposity during adolescence. Pediatrics 2012; 130: e1146–e1154.

    Article  PubMed  Google Scholar 

  48. Vgontzas AN, Bixler EO, Kales A, Criley C, Vela-Bueno A . Differences in nocturnal and daytime sleep between primary and psychiatric hypersomnia: diagnostic and treatment implications. Psychosom Med 2000; 62: 220–226.

    Article  CAS  PubMed  Google Scholar 

  49. Vgontzas AN, Bixler EO, Chrousos GP . Obesity-related sleepiness and fatigue: the role of the stress system and cytokines. Ann N Y Acad Sci 2006; 1083: 329–344.

    Article  CAS  PubMed  Google Scholar 

  50. Jackson JS, Knight KM, Refferty JA . Race and unhealthy behaviors: chronic stress, the HPA axis, and physical and mental health disparities over the life course. Am J Public Health 2010; 100: 933–939.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Krueger PM, Saint Onge JM, Chang VW . Race/ethnic differences in adult mortality: the role of perceived stress and health behaviors. Soc Sci Med 2011; 73: 1312–1322.

    Article  PubMed  Google Scholar 

  52. Pampel FC, Rogers RG . Socioeconomic status, smoking, and health: a test of competing theories of cumulative advantage. J Health Soc Behav 2004; 45: 306–321.

    Article  PubMed  Google Scholar 

  53. Blaxter M . Health and lifestyles. Tavistock: London, UK, 1990.

    Book  Google Scholar 

  54. Patten E, Parker K . A Gender Reversal On Career Aspirations: Young Women Now Top Young Men in Valuing a High-Paying Career. Pew Research Center: Washington DC, 2012. Available at http://www.pewsocialtrends.org/2012/04/19/a-gender-reversal-on-career-aspirations/ (accessed 1 August 2012).

    Google Scholar 

  55. Matthews JS, Ponitz CC, Morrison FJ . Early gender differences in self-regulation and academic achievement. J Educ Psychol 2009; 101: 689–704.

    Article  Google Scholar 

  56. Wight VR, Price J, Bianchi SM, Hunt BR . The time use of teenagers. Soc Sci Res 2009; 38: 792–809.

    Article  Google Scholar 

  57. Knutson KL, Lauderdale DS . Sleep duration and overweight in adolescents: self-reported sleep hours versus time diaries. Pediatrics 2007; 119: e1056–e1062.

    Article  PubMed  Google Scholar 

  58. Sadeh A, Sharkey KM, Carskadon MA . Activity-based sleep-wake identification: an empirical test of methodological issues. Sleep 1994; 17: 201–207.

    Article  CAS  PubMed  Google Scholar 

  59. Chambers MJ . Actigraphy and insomnia: a closer look. Part 1. Sleep 1994; 17: 405–408 discussion 408–10.

    Article  CAS  PubMed  Google Scholar 

  60. Wolfson AR, Carskadon MA, Acebo C, Seifer R, Fallone G, Labyak SE et al. Evidence for the validity of a sleep habits survey for adolescents. Sleep 2003; 26: 213–216.

    Article  PubMed  Google Scholar 

  61. Guidolin M, Gradisar M . Is shortened sleep duration a risk factor for overweight and obesity during adolescence? A review of the empirical literature. Sleep Med 2012; 13: 779–786.

    Article  PubMed  Google Scholar 

  62. Mednick SC, Christakis NA, Fowler JH . The spread of sleep loss influences drug use in adolescent social networks. Plos One 2010; 5: e9775.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Marco CA, Wolfson AR, Sparling M, Azuaje A . Family socioeconomic status and sleep patterns of young adolescents. Behav Sleep Med 2011; 10: 70–80.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Storey ML, Forshee RA, Weaver AR, Sansalone WR . Demographic and lifestyle factors associated with body mass index among children and adolescents. Int J Food Sci Nutr 2003; 54: 491–503.

    Article  PubMed  Google Scholar 

  65. Dahl RE, Lewin DS . Pathways to adolescent health sleep regulation and behavior. J Adolesc Health 2002; 31: 175–184.

    Article  PubMed  Google Scholar 

  66. Ganz FD . Sleep and immune function. Crit Care Nurse 2012; 32: e19–e25.

    Article  PubMed  Google Scholar 

  67. Carskadon MA . Sleep difficulties in young people. Arch Pediatr Adolesc Med 2004; 158: 597–598.

    Article  PubMed  Google Scholar 

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Acknowledgements

This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (award number R21DK089414). We gratefully acknowledge the Eunice Kennedy Shriver National Institute of Child Health and Human Development funded University of Colorado Population Center (award number R24 HD066613) for administrative support and the provision of meeting space.

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Correspondence to E N Reither.

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Reither, E., Krueger, P., Hale, L. et al. Ethnic variation in the association between sleep and body mass among US adolescents. Int J Obes 38, 944–949 (2014). https://doi.org/10.1038/ijo.2014.18

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