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From sleep duration to childhood obesity—what are the pathways?

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Abstract

Sleep duration has been identified as risk factor for obesity already in children. Besides investigating the role of fat mass (FM), this study addressed the question whether endocrine mechanisms act as intermediates in the association between sleep duration and overweight/obesity. Within the framework of the IDEFICS study, the present research was conducted in 609 German resident children aged 2–9 years with information on fasting insulin, C-reactive protein and cortisol levels next to anthropometric measurements and parental questionnaires. Emphasising methodological aspects, an age-specific measure of sleep duration was derived to account for alteration in sleep duration during childhood/period of growth. Multivariate linear regression and quantile regression models confirmed an inverse relationship between sleep duration and measures of overweight/obesity. The estimate for the association of sleep duration and body mass index (BMI) was approximately halved after adjustment for FM, but remained significant. The strength of this association was also markedly attenuated when adjusting for insulin mainly for the upper BMI quantiles (Q80, β = −0.36 vs. β = −0.26; Q95, β = −0.87 vs. β = −0.47). Adjustment for cortisol and CrP did not yield this attenuation. Conclusion: The inverse relationship between sleep duration and BMI is mainly explained by the association between sleep duration and FM. Insulin may explain part of this association, in particular at the upper tail of the BMI distribution.

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Acknowledgements

This work was done as part of the IDEFICS Study (www.idefics.eu). We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD).

Ethical statement

The study was approved by the national Ethics Committees. Study subjects (or in this case, the children’s parents) gave written informed consent to participate in the study. This is an original research work that has not been published and is not submitted or under simultaneous consideration for publication elsewhere.

Conflict of interests

The authors declare that there is no conflict of interests.

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Authors and Affiliations

  1. Department of Biometry and Data Management, BIPS - Institute for Epidemiology and Prevention Research, University of Bremen, Bremen, Germany

    Claudia Börnhorst

  2. Department of Epidemiological Methods and Etiologic Research, BIPS - Institute for Epidemiology and Prevention Research, University of Bremen, Bremen, Germany

    Sabrina Hense, Wolfgang Ahrens & Antje Hebestreit

  3. Copenhagen Business School, Institute for Intercultural Communication and Management, Frederiksberg, Denmark

    Lucia Reisch

  4. National Research Council, Institute of Food Science, Epidemiology and Population Genetics, Avellino, Italy

    Gianvincenzo Barba

  5. Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians University of Munich, Munich, Germany

    Rüdiger von Kries & Otmar Bayer

  6. BIPS - Institute for Epidemiology and Prevention Research, Achterstraße 30, 28359, Bremen, Germany

    Wolfgang Ahrens

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  1. Claudia Börnhorst
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Correspondence to Wolfgang Ahrens.

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Börnhorst, C., Hense, S., Ahrens, W. et al. From sleep duration to childhood obesity—what are the pathways?. Eur J Pediatr 171, 1029–1038 (2012). https://doi.org/10.1007/s00431-011-1670-8

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  • DOI: https://doi.org/10.1007/s00431-011-1670-8

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