Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study
Open accessAbstract
OBJECTIVES: To determine whether reduced sleep is associated with differences in body composition and the risk of becoming overweight in young children. DESIGN: Longitudinal study with repeated annual measurements. SETTING: Dunedin, New Zealand. PARTICIPANTS: 244 children recruited from a birth cohort and followed from age 3 to 7. MAIN OUTCOME MEASURES: Body mass index (BMI), fat mass (kg), and fat free mass (kg) measured with bioelectrical impedance; dual energy x ray absorptiometry; physical activity and sleep duration measured with accelerometry; dietary intake (fruit and vegetables, non-core foods), television viewing, and family factors (maternal BMI and education, birth weight, smoking during pregnancy) measured with questionnaire. RESULTS: After adjustment for multiple confounders, each additional hour of sleep at ages 3-5 was associated with a reduction in BMI of 0.48 (95% confidence interval 0.01 to 0.96) and a reduced risk of being overweight (BMI ≥ 85th centile) of 0.39 (0.24 to 0.63) at age 7. Further adjustment for BMI at age 3 strengthened these relations. These differences in BMI were explained by differences in fat mass index (-0.43, -0.82 to -0.03) more than by differences in fat free mass index (-0.21, -0.41 to -0.00). CONCLUSIONS: Young children who do not get enough sleep are at increased risk of becoming overweight, even after adjustment for initial weight status and multiple confounding factors. This weight gain is a result of increased fat deposition in both sexes rather than additional accumulation of fat free mass.
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In pediatric populations, all 12 longitudinal studies found a positive association between short sleep and later obesity risk.
“This pattern is particularly consistent in pediatric populations (all 12 studies had positive findings; reviewed in [80]; additional references: [21, 38, 89, 150]).”
From Sleep and metabolic function (2012) · cites this paper as [21]
Among 28 longitudinal studies on short sleep and later obesity risk in children and adults, 22 found that short sleep was linked to greater weight gain, obesity, or fat mass after a few years.
“Of the 28 longitudinal studies that examined the impact of short sleep on obesity risk in children and adults, 22 reported that short sleep is associated with an increased risk of weight gain or development of obesity and/or increased fat mass a few years later”
From Sleep and metabolic function (2012) · cites this paper as [21]
The only pediatric prospective study with objective sleep, weight, and body-composition measures showed that greater weight gain in children who slept less came from selective fat deposition.
“Importantly, the only pediatric prospective study that obtained concomitant objective measurements of sleep, weight, and body composition demonstrated that the increased weight gain in children sleeping less was the result of selective increased fat deposition [21].”
From Sleep and metabolic function (2012) · cites this paper as [21]
Only one included study used polysomnography and three used accelerometry to assess sleep.
“Only one used the gold-standard polysomnography 36 and three used accelerometry.29,45,56”
From Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and meta-analysis of prospective studies (2018) · cites this paper as [29]
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“only pediatric prospective study that obtained concomitant objective measurements of sleep, weight, and body composition demonstrated that the increased weight gain in children sleeping less was the result of selective increased fat deposition [21].”
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- Authors
- Carter, P. J., Taylor, B. J., Williams, S. M., & Taylor, R. W.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Taylor, B. J.
- Taylor, R. W.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2011-05-26
- Volume
- 342
- Issue
- may26 2
- Pages
- d2712-d2712
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC3102792
- OpenAlex
- W2143436885
- Cited by
- 226
- References
- 54
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 10 · 2023: 12 · 2022: 11 · 2021: 13 · 2020: 14 · 2019: 20 · 2018: 10 · 2017: 19 · 2016: 22 · 2015: 16 · 2014: 19 · 2013: 18 · 2012: 21
- FWCI
- 28.45
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- University of Otago
- National Heart Foundation of New Zealand
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep duration, childhood obesity, body mass index, body composition, fat mass, fat-free mass, overweight risk, young children, Dunedin birth cohort, television viewing, maternal body mass index, birth weight, physical activity
- MeSH terms
- Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, New Zealand, Sleep, Cohort Studies, Body Mass Index, Adiposity
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