Association of largest meal timing and eating frequency with body mass index and obesity.

BACKGROUND AND AIMS: The circadian pattern of eating behaviors has garnered increasing interest as a strategy for obesity prevention and weight loss. It is believed that the benefits stem from aligning food intake with the body's natural daily rhythms. However, the existing body of evidence is limited in scale and scope and there has been insufficient evaluation of temporal eating behaviors, such as the specific time of day in which the highest calorie consumption occurs, meal frequency, and distribution. This research aims to explore the association between the timing of the largest meal of the day and eating frequency with Body Mass Index (BMI) and obesity. METHODS: Participants (n = 2050, 18-65y) were part of an exploratory cross-sectional and population-based research, with data collection in a virtual environment. Linear regression analyses and restricted cubic splines evaluated differences in BMI associated with independent eating variables [timing of the largest meal, number of meals/day (as continuous and categorical: ≤3 or >3/day), and each largest meal of the day (breakfast/lunch/dinner)]. Logistic regression models were fitted to assess Odds Ratios (OR) and 95 % Confidence Intervals (CI) of obesity associated with the same independent variables. RESULTS: Our main findings were that the timing of the largest meal and reporting dinner as the largest meal were associated with higher values of BMI (respectively, 0.07 kg/m2 and 0.85 kg/m2) and increased odds of obesity [respectively OR(95%CI):1.04(1.01,1.08), and OR(95%CI):1.67(1.18,2.38)]. Those who realized more than 3 meals/day presented lower values of BMI (-0.14 kg/m2) and 32 % lower odds of having obesity [OR(95%CI):0.68(0.52,0.89)]. Reporting lunch as the largest meal also protected against obesity [OR(95%CI):0.71(0.54,0.93)]. These associations were statistically significant and independent of sex, age, marital status, education level, diet quality, sleep duration, and weekly frequency of physical exercise. CONCLUSION: Having the largest meal earlier in the day, concentrating the majority of caloric intake during lunch, and consuming more than three meals a day, may present a promising intervention for preventing and treating obesity/overweight.

Association between sleep duration and latency, nocturnal awakenings, and body mass index among infants / Associação entre duração e latência do sono, despertares noturnos e índice de massa corporal de lactentes

ABSTRACT Objective: To investigate the association between sleep duration, nocturnal awakenings, and sleep latency with body mass index (BMI) at six and 12 months of age. Methods: 179 children from a birth cohort were enrolled. At six and 12 months of age, anthropometric data were obtained using standardized techniques and infants' mothers answered the Brief Infant Sleep Questionnaire for sleep data. The association of BMI with the independent variables (sleep duration, latency, and nocturnal awakenings) was assessed by linear regression models. Analyses were adjusted for potential confounders and a p-value<0.05 was adopted to define statistical significance. Results: For each additional hour of sleep duration, BMI was reduced by 0.15 kg/m² (95% confidence interval [CI] -0.28; -0.01; p=0.03) and each additional minute of sleep latency increased BMI by 0.01 kg/m² (95%CI -0.00; 0.03; p=0.02). These associations were independent of gestational age, child sex, birth weight, duration of exclusive breastfeeding, smoking during pregnancy, and mother's BMI, education, and marital status. Nocturnal awakenings showed no association with the outcome. Conclusions: Our findings suggest that sleep duration and sleep latency time are associated with BMI in the first year of life. Insights into the influence of sleep early in life on weight status may be helpful to complement future nutritional recommendations and prevent and treat obesity.

RESUMO Objetivo: Investigar a associação entre duração do sono, despertares noturnos e latência do sono com o índice de massa corporal (IMC) aos seis e 12 meses de idade. Métodos: foram incluídas 179 crianças de uma coorte de nascimentos. Aos seis e 12 meses de idade, dados antropométricos foram obtidos por meio de técnicas padronizadas e as mães dos lactentes responderam ao Brief Infant Sleep Questionnaire para dados do sono. A associação do IMC com as variáveis independentes (duração do sono, latência e despertares noturnos) foi avaliada por modelos de regressão linear. As análises foram ajustadas para potenciais fatores de confusão e o p-valor<0,05 foi adotado para definir a significância estatística. Resultados: Para cada hora adicional de duração do sono, o IMC foi reduzido em 0,15 kg/m² (intervalo de confiança [IC]95% -0,28; -0,01; p=0,03) e cada minuto adicional no tempo de latência resultou em aumento de 0,01 kg/m² (IC95% -0,00; 0,03; p=0,02) no IMC. Essas associações foram independentes da idade gestacional, sexo da criança, peso ao nascer, duração do aleitamento materno exclusivo, tabagismo durante a gravidez e IMC, escolaridade e estado civil da mãe. Os despertares noturnos não apresentaram associação com o desfecho. Conclusões: Nossos achados sugerem que a duração e a latência do sono estão associadas ao IMC no primeiro ano de vida. Informações sobre a influência do sono no início da vida sobre o status do peso podem ser úteis para complementar futuras recomendações nutricionais e prevenir e tratar a obesidade.

Association between sleep duration and latency, nocturnal awakenings, and body mass index among infants.

OBJECTIVE: To investigate the association between sleep duration, nocturnal awakenings, and sleep latency with body mass index (BMI) at six and 12 months of age. METHODS: 179 children from a birth cohort were enrolled. At six and 12 months of age, anthropometric data were obtained using standardized techniques and infants' mothers answered the Brief Infant Sleep Questionnaire for sleep data. The association of BMI with the independent variables (sleep duration, latency, and nocturnal awakenings) was assessed by linear regression models. Analyses were adjusted for potential confounders and a p-value<0.05 was adopted to define statistical significance. RESULTS: For each additional hour of sleep duration, BMI was reduced by 0.15 kg/m² (95% confidence interval [CI] -0.28; -0.01; p=0.03) and each additional minute of sleep latency increased BMI by 0.01 kg/m² (95%CI -0.00; 0.03; p=0.02). These associations were independent of gestational age, child sex, birth weight, duration of exclusive breastfeeding, smoking during pregnancy, and mother's BMI, education, and marital status. Nocturnal awakenings showed no association with the outcome. CONCLUSIONS: Our findings suggest that sleep duration and sleep latency time are associated with BMI in the first year of life. Insights into the influence of sleep early in life on weight status may be helpful to complement future nutritional recommendations and prevent and treat obesity.

Sleep and circadian hygiene practices association with sleep quality among Brazilian adults.

Objective: To investigate the association of sleep and circadian hygiene practices (sleep-promoting and sleep-disturbing behaviors) with sleep quality indicators. Methods: Participants (n = 2050; 18-65 y) were part of virtual population-based research. Logistic regression models were fitted to assess differences in the OR (95% CI) of poor quality with sleep-promoting/disturbing practices (time-of-day of exercise, pre-bedtime routine, naps, electronic devices with illuminated screens, caffeine and alcohol consumption, and smoking). Linear regression analyses evaluated differences in sleep duration, latency, and awakenings associated with the same variables. Restricted cubic splines were used to study the shape of the association of screen time before bed with sleep duration, latency, and awakenings. Analyses were adjusted for age, sex, region, marital status, educational level, evening diet quality, and BMI. Results: Evening use of electronic devices with illuminated screens showed a negative effect on all sleep parameters. Reporting dinner as the largest meal and evening caffeine consumption was associated with shorter sleep duration and longer sleep latency. Smokers had higher odds of longer latency. A protective effect of morning exercises was demonstrated on sleep quality, latency, and awakenings. Alcohol consumers presented lower odds of poor quality and lower frequency of awakenings. Pre-bedtime practices showed no or negative effect on sleep outcomes. Conclusions: Recommendations to promote sleep quality and prevent sleep-related problems, with corresponding circadian health benefits, should include engaging in regular exercise, preferably in the morning, and avoiding naps, heavy meals close to bedtime, caffeine, smoking, and evening screen exposure.

Consumo de alimentos açucarados e qualidade do sono no primeiro ano de vida: dados de uma coorte de nascimentos no nordeste do Brasil / Consumo de alimentos azucarados y calidad del sueño en el primer año de vida: datos de una cohorte de nacimiento en el noreste de Brasil / Consumption of sugary foods and quality of sleep in the first year of life: data from a birth cohort in northeastern Brazil

RESUMO Objetivo: investigar a duração do sono (DS), a frequência de despertares noturnos (DN) e o consumo de alimentos açucarados no primeiro ano de vida e verificar a associação entre o consumo desses alimentos e a má qualidade do sono. Métodos: a população do estudo foi composta de 179 crianças integrantes de uma coorte de nascimentos de Rio Largo-AL. As mães foram questionadas sobre a oferta regular de alimentos açucarados (açúcar/farinhas de cereais instantâneas com açúcar/bebidas açucaradas/doces) e o sono foi investigado pelo questionário traduzido e validado Brief Infant Sleep Questionnaire. Foram considerados indicadores de má qualidade do sono DS<12h e DN>2. Os testes de qui-quadrado de Pearson e exato de Fisher foram adotados para verificar associações entre o consumo de açucarados e a má qualidade do sono aos seis e 12 meses (p<0,05). Resultados: mais da metade das crianças apresentou DS<1 2h (60,3%) e cerca de » DN>2. O consumo regular de pelo menos uma das categorias de açucarados foi verificado entre 50,6, 91,1 e 100% das crianças aos três, seis e 12 meses de idade, respectivamente. Não foram encontradas associações entre o consumo desses alimentos e os indicadores de má qualidade de sono. Conclusão: o consumo de açucarados e a má qualidade de sono foram frequentes em nosso estudo, no entanto, não se identificou associação entre as variáveis. Mais investigações são necessárias para elucidar como o sono e a alimentação se inter-relacionam e se potencializam mutuamente como fatores determinantes do crescimento e desenvolvimento de lactentes.

RESUMEN Objetivo: investigar la duración del sueño (DS), la frecuencia de despertares nocturnos (DN) y el consumo de alimentos azucarados en el primer año de vida y verificar la asociación entre el consumo de estos alimentos y la mala calidad del sueño. Métodos: la población de estudio consistió en 179 niños de una cohorte de nacimiento en Rio Largo-AL. Se preguntó a las madres sobre el suministro regular de alimentos azucarados (azúcar / harinas de cereales instantáneas con azúcar / bebidas endulzadas / dulces) y se investigó el sueño mediante el cuestionario traducido y validado BriefInfantSleepQuestionnaire. Fueron considerados indicadores de mala calidad del sueño DS <12h y DN> 2. Se utilizaron las pruebas de chi-cuadrado de Pearson y exacta de Fisher para verificar las asociaciones entre el consumo de azúcar y la mala calidad del sueño a los seis y 12 meses (p <0.05). Resultados: más de la mitad de los niños tenían DS <1 2 h (60,3%) y alrededor de » DN> 2. Se verificó el consumo regular de al menos una de las categorías azucaradas entre el 50,6, el 91,1 y el 100% de los niños a los tres, seis y 12 meses de edad, respectivamente. No se encontraron asociaciones entre el consumo de estos alimentos y los indicadores de mala calidad del sueño. Conclusión: el consumo de azucarados y la mala calidad del sueño fueron frecuentes en nuestro estudio, sin embargo, no se identificó asociación entre las variables. Se necesita más investigación para dilucidar cómo el sueño y la alimentación se interrelacionan y se mejoran mutuamente como determinantes del crecimiento y desarrollo infantil.

ABSTRACT Objective: to investigate sleep duration (SD), frequency of night awakenings (NA) and consumption of sugary foods in the first year of life and to verify the association between consumption of these foods and poor sleep quality. Methods: the study population consisted of 179 children from a birth cohort in Rio Largo-AL. Mothers were asked about the regular supply of sugary foods (sugar/instant cereal flours with sugar/sweetened drinks/sweets) and sleep was investigated by the translated and validated Brief Infant Sleep Questionnaire. DS<12h and AN>2 were considered indicators of poor sleep quality. Pearson's chi-square and Fisher's exact tests were used to verify associations between sugary consumption and poor sleep quality at six and 12 months (p<0.05). Results: more than half of the children had SD<1 2h (60.3%) and about » AN>2. Regular consumption of at least one of the sugary categories was verified among 50.6, 91.1 and 100% of children at three, six and 12 months of age, respectively. No associations were found between the consumption of these foods and indicators of poor sleep quality. Conclusion: sugary consumption and poor sleep quality were frequent in our study; however, no association was identified between the variables. More investigations are needed to elucidate how sleep and feeding are interrelated and mutually potentiate as determinants of infant growth and development.