Skip to main content

Association between unhealthy dietary behaviors and sleep disturbances among Japanese adolescents: a nationwide representative survey

Sleep and Biological Rhythms volume 17, pages 93–102 (2019)Cite this article

Abstract

Purpose

Dietary behaviors and sleep are important lifestyle factors to protect adolescent health. However, little is known about how dietary behaviors are related to sleep disturbances. The purpose of this study was to conduct a large-scale survey among Japanese adolescents to verify the association between unhealthy dietary behaviors and sleep disturbances.

Methods

This study included 65,688 and 99,581 students enrolled in 140 and 120 randomly selected junior and senior high schools, respectively. A total of 85,931 self-administered questionnaires were collected from 79 junior and 77 senior high schools from 2014 to 2015. The survey included questions on sleep patterns, dietary behaviors, alcohol consumption, and smoking, as well as questions on mental health. For dietary behaviors, we adopted the items on meal habits in the National Health and Nutrition Survey including, the frequency of eating breakfast, the frequency of family meals, and subjective diet quality. We performed a multivariate analysis on the relationship between the dietary behaviors and sleep disturbance.

Results

Data from 84,988 questionnaires were analyzed. Boys and girls with less healthy dietary behaviors had a significantly higher prevalence for each sleep disturbance. Subjective sleep quality and insomnia were significantly associated with breakfast frequency, family meal frequency, and diet quality. Short sleep duration was significantly associated with breakfast frequency and family meal frequency, but not with subjective diet quality.

Conclusions

Our study suggested that sleep and dietary behaviors affect one another. Those involved in public health education should encourage adolescents to establish healthy sleep patterns as well as healthy dietary behaviors.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Kim SY, Sim S, Park B, Kong IG, Kim JH, Choi HG. Dietary habits are associated with school performance in adolescents. Medicine. 2016;95:e3096.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Song WO, Chun OK, Kerver J, Cho S, Chung CE, Chung S-J. Ready-to-eat breakfast cereal consumption enhances milk and calcium intake in the US population. J Acad Nutr Diet. 2006;106:1783–9.

    Google Scholar 

  3. Ashcroft J, Semmler C, Carnell S, van Jaarsveld CHM, Wardle J. Continuity and stability of eating behaviour traits in children. Eur J Clin Nutr. 2007;62:985.

    Article  PubMed  Google Scholar 

  4. Moreno LA, Rodriguez G, Fleta J, Bueno-Lozano M, Lazaro A, Bueno G. Trends of dietary habits in adolescents. Crit Rev Food Sci Nutr. 2010;50:106–12.

    Article  PubMed  Google Scholar 

  5. Marshall S, Burrows T, Collins CE. Systematic review of diet quality indices and their associations with health-related outcomes in children and adolescents. J Hum Nutr Diet. 2014;27:577–98.

    Article  CAS  PubMed  Google Scholar 

  6. Reicks M, Banna J, Cluskey M, Gunther C, Hongu N, Richards R, et al. Influence of parenting practices on eating behaviors of early adolescents during independent eating occasions: implications for obesity prevention. Nutrients. 2015;7:5431.

    Article  Google Scholar 

  7. Wu WC, Luh DL, Lin CI, Chiang YC, Hung CC, Wang S, et al. Reciprocal relationship between unhealthy eating behaviours and depressive symptoms from childhood to adolescence: 10-year follow-up of the child and adolescent behaviors in long-term evolution study. Public Health Nutr. 2016;19:1654–65.

    Article  PubMed  Google Scholar 

  8. Li C, Ford ES, Zhao G, Mokdad AH. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005–2006. Diabetes Care. 2009;32:342–7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kreisel K. Evaluation of a computer-based nutrition education tool. Public Health Nutrition. 2004;7:271–7.

    Article  PubMed  Google Scholar 

  10. Gradisar M, Gardner G, Dohnt H. Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep Med. 2011;12:110–8.

    Article  PubMed  Google Scholar 

  11. Blunden SL, Chapman J, Rigney GA. Are sleep education programs successful? The case for improved and consistent research efforts. Sleep Med Rev. 2012;16:355–70.

    Article  PubMed  Google Scholar 

  12. Ohida T, Osaki Y, Doi Y, Tanihata T, Minowa M, Suzuki K, et al. An epidemiologic study of self-reported sleep problems among Japanese adolescents. Sleep. 2004;27:978–85.

    Article  PubMed  Google Scholar 

  13. Kaneita Y, Ohida T, Osaki Y, Tanihata T, Minowa M, Suzuki K, et al. Insomnia among Japanese adolescents: a nationwide representative survey. Sleep. 2006;29:1543–50.

    Article  PubMed  Google Scholar 

  14. Kaneita Y, Yokoyama E, Harano S, Tamaki T, Suzuki H, Munezawa T, et al. Associations between sleep disturbance and mental health status: a longitudinal study of Japanese junior high school students. Sleep Med. 2009;10:780–6.

    Article  PubMed  Google Scholar 

  15. Chang PP, Ford DE, Mead LA, Cooper-Patrick L, Klag MJ. Insomnia in young men and subsequent depression. The Johns Hopkins precursors study. Am J Epidemiol. 1997;146:105–14.

    Article  CAS  PubMed  Google Scholar 

  16. Weiss A, Xu F, Storfer-Isser A, Thomas A, Ievers-Landis CE, Redline S. The association of sleep duration with adolescents’ fat and carbohydrate consumption. Sleep. 2010;33:1201–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Javaheri S, Storfer-Isser A, Rosen CL, Redline S. Association of short and long sleep durations with insulin sensitivity in adolescents. J Pediatr. 2011;158:617–23.

    Article  PubMed  Google Scholar 

  18. Narang I, Manlhiot C, Davies-Shaw J, Gibson D, Chahal N, Stearne K, et al. Sleep disturbance and cardiovascular risk in adolescents. CMAJ. 2012;184:E913-20.

    Article  PubMed  Google Scholar 

  19. Kim S, DeRoo LA, Sandler DP. Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutr. 2011;14:889–95.

    Article  PubMed  Google Scholar 

  20. Kant AK, Graubard BI. Association of self-reported sleep duration with eating behaviors of American adults: NHANES 2005–2010. Am J Clin Nutr. 2014;100:938–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1:e62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Hoppe C, Rothausen BW, Biltoft-Jensen A, Matthiessen J, Groth MV, Chaput JP, et al. Relationship between sleep duration and dietary intake in 4- to 14-year-old Danish children. J Nutr Sci. 2013;2:e38.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Westerlund L, Ray C, Roos E. Associations between sleeping habits and food consumption patterns among 10-11-year-old children in Finland. Br J Nutr. 2009;102:1531–7.

    Article  CAS  PubMed  Google Scholar 

  24. Khan MKA, Faught EL, Chu YL, Ekwaru JP, Storey KE, Veugelers PJ. Is it nutrients, food items, diet quality or eating behaviours that are responsible for the association of children’s diet with sleep? J Sleep Res. 2017;26:468–76.

    Article  PubMed  Google Scholar 

  25. Khan MK, Chu YL, Kirk SF, Veugelers PJ. Are sleep duration and sleep quality associated with diet quality, physical activity, and body weight status? A population-based study of Canadian children. Can J Public Health. 2015;106:e277-82.

    Article  PubMed  Google Scholar 

  26. Cespedes EM, Hu FB, Redline S, Rosner B, Gillman MW, Rifas-Shiman SL, et al. Chronic insufficient sleep and diet quality: contributors to childhood obesity. Obesity (Silver Spring Md). 2016;24:184–90.

    Article  Google Scholar 

  27. Osaki Y, Minowa M. Cigarette smoking among junior and senior high school students in Japan. J Adolesc Health. 1996;18:59–65.

    Article  CAS  PubMed  Google Scholar 

  28. Ikeda N, Takimoto H, Imai S, Miyachi M, Nishi N. Data resource profile: the Japan National Health and Nutrition Survey (NHNS). Int J Epidemiol. 2015;44:1842–9.

    Article  PubMed  Google Scholar 

  29. Kaneita Y, Munezawa T, Suzuki H, Ohtsu T, Osaki Y, Kanda H, et al. Excessive daytime sleepiness and sleep behavior among Japanese adolescents: a nation-wide representative survey. Sleep Biol Rhythms. 2010;8:282–94.

    Article  Google Scholar 

  30. Goldberg DP, Rickels K, Downing R, Hesbacher P. A comparison of two psychiatric screening tests. Br J Psychiatry. 1976;129:61–7.

    Article  CAS  PubMed  Google Scholar 

  31. Doi Y, Minowa M. Factor structure of the 12-item general health questionnaire in the Japanese general adult population. Psychiatry Clin Neurosci. 2003;57:379–83.

    Article  PubMed  Google Scholar 

  32. Suzuki H, Kaneita Y, Osaki Y, Minowa M, Kanda H, Suzuki K, et al. Clarification of the factor structure of the 12-item General Health Questionnaire among Japanese adolescents and associated sleep status. Psychiatry Res. 2011;188:138–46.

    Article  PubMed  Google Scholar 

  33. Morioka H, Itani O, Kaneita Y, Ikeda M, Kondo S, Yamamoto R, et al. Associations between sleep disturbance and alcohol drinking: a large-scale epidemiological study of adolescents in Japan. Alcohol (Fayetteville NY). 2013;47:619–28.

    Article  Google Scholar 

  34. Morioka H, Itani O, Osaki Y, Higuchi S, Jike M, Kaneita Y, et al. Association between smoking and problematic internet use among Japanese adolescents: large-scale nationwide epidemiological study. Cyberpsychol Behav Soc Netw. 2016;19:557–61.

    Article  PubMed  Google Scholar 

  35. Ohida T, Kamal AM, Uchiyama M, Kim K, Takemura S, Sone T, et al. The influence of lifestyle and health status factors on sleep loss among the Japanese general population. Sleep. 2001;24:333–8.

    Article  CAS  PubMed  Google Scholar 

  36. Wang M, Zhong JM, Wang H, Zhao M, Gong WW, Pan J, et al. Breakfast consumption and its associations with health-related behaviors among school-aged adolescents: a cross-sectional study in Zhejiang Province, China. Int J Environ Res Public Health. 2016;13:761

    Article  PubMed Central  Google Scholar 

  37. Al-Hazzaa HM, Musaiger AO, Abahussain NA, Al-Sobayel HI, Qahwaji DM. Lifestyle correlates of self-reported sleep duration among Saudi adolescents: a multicentre school-based cross-sectional study. Child Care Health Dev. 2014;40:533–42.

    Article  CAS  PubMed  Google Scholar 

  38. Parrino L, Ferri R, Bruni O, Terzano MG. Cyclic alternating pattern (CAP): the marker of sleep instability. Sleep Med Rev. 2012;16:27–45.

    Article  PubMed  Google Scholar 

  39. Elgar FJ, Craig W, Trites SJ. Family dinners, communication, and mental health in Canadian adolescents. J Adolesc Health. 2013;52:433–8.

    Article  PubMed  Google Scholar 

  40. Harrison ME, Norris ML, Obeid N, Fu M, Weinstangel H, Sampson M. Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Can Fam Physician. 2015;61:e96–106.

    PubMed  PubMed Central  Google Scholar 

  41. Katagiri R, Asakura K, Kobayashi S, Suga H, Sasaki S. Low intake of vegetables, high intake of confectionary, and unhealthy eating habits are associated with poor sleep quality among middle-aged female Japanese workers. J Occup Health. 2014;56:359–68.

    Article  PubMed  Google Scholar 

  42. Kurotani K, Kochi T, Nanri A, Eguchi M, Kuwahara K, Tsuruoka H, et al. Dietary patterns and sleep symptoms in Japanese workers: the Furukawa nutrition and health study. Sleep Med. 2015;16:298–304.

    Article  PubMed  Google Scholar 

  43. Newby PK. Are dietary intakes and eating behaviors related to childhood obesity? A comprehensive review of the evidence. J Law Med Ethics. 2007;35:35–60.

    Article  CAS  PubMed  Google Scholar 

  44. Spaeth AM, Dinges DF, Goel N. Effects of experimental sleep restriction on weight gain, caloric intake, and meal timing in healthy adults. Sleep. 2013;36:981–90.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Med Rev. 2008;12:197–210.

    Article  PubMed  Google Scholar 

  46. Morselli L, Leproult R, Balbo M, Spiegel K. Role of sleep duration in the regulation of glucose metabolism and appetite. Best Pract Res Clin Endocrinol Metab. 2010;24:687–702.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Rothman KJ. Causal inference in epidemiology. In: Rothman KJ, editor. Modern epidemiology. Boston: Little, Brown and Co; 1987. pp. 16–20.

    Google Scholar 

Download references

Acknowledgements

The authors thank the staff and participants of the schools. This study was supported by a health science Research Grant from the Ministry of Health, Labor and Welfare of the Japanese Government.

Author information

Authors and Affiliations

  1. Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan

    Yuichiro Otsuka, Yoshitaka Kaneita, Osamu Itani, Sachi Nakagome, Maki Jike & Takashi Ohida

  2. Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, 683-8503, Japan

    Yoneatsu Osaki

  3. National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, 239-0841, Japan

    Susumu Higuchi

  4. Department of Public Health, Shimane University Faculty of Medicine, Matsue, Shimane, 693-0021, Japan

    Hideyuki Kanda

Authors
  1. Yuichiro Otsuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshitaka Kaneita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Osamu Itani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoneatsu Osaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susumu Higuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hideyuki Kanda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sachi Nakagome
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Maki Jike
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Takashi Ohida
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshitaka Kaneita.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of Nihon University School of Medicine.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Y. Otsuka, Y. Kaneita, O. Itani, Y. Osaki, S. Higuchi, H. Kanda, S. Nakagome, M. Jike, and T. Ohida declare that they have no conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Otsuka, Y., Kaneita, Y., Itani, O. et al. Association between unhealthy dietary behaviors and sleep disturbances among Japanese adolescents: a nationwide representative survey. Sleep Biol. Rhythms 17, 93–102 (2019). https://doi.org/10.1007/s41105-018-0193-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41105-018-0193-3

Keywords

  • Sleep quality
  • Sleep disturbance
  • Dietary behaviors
  • Insomnia
  • Diet quality
  • Adolescent health