title: Sleep duration and quality in children: interactions with food choices, energy balance, and digital screen-time
Creators: name: Shamsi, Roya 
Publisher: name: Memorial University of Newfoundland
Year: 2023

description: Introduction Chronic obesity is a complex health problem that affects millions of people globally, including many children. Childhood obesity is a multifactorial condition affected by genetic and lifestyle factors that, if ignored, can cause serious health consequences such as insulin resistance, type 2 diabetes, and cardiovascular diseases. It is essential to identify modifiable lifestyle habits associated with childhood obesity, including sleep, dietary habits, physical activity (PA), and screen time (ST). The primary objective of this pilot and feasibility study was to evaluate the viability of implementing a larger-scale interventional trial in an identical cohort. This involved assessing recruitment rate, retention, attrition, data collection procedures, protocol adherence, data management, and potential obstacles or challenges to putting the intervention approach into practice. These preliminary findings establish the groundwork for future research while providing insights into the intervention's feasibility. Methods Participants (n=22) aged 9-12 years were recruited for this pilot and feasibility study. Anthropometric measurements were performed according to the WHO guidelines. Data on the demographic characteristics and ST were collected using different questionnaires. Sleep and PA data were obtained by using both actigraphy and questionnaires. The Automated Self-Administered 24-hour Dietary Assessment Tool (Canada-2018) was used to collect and analyze the dietary intake data from two dietary recalls. Linear regression analyses were adjusted for age, sex, parental education, and household income. Results In this pilot and feasibility study, the participant recruiting method demonstrated effective involvement, resulting in a 36.7% recruitment rate. With logistical obstacles, the study retained all 22 participants, obtaining a remarkable 100% retention rate. Participants followed study guidelines, thoroughly completing multiple parts such as questionnaires, dietary recalls, and actigraphy wear. The time required to collect data ranged from 5 to 35 minutes. Among the 22 participants (10.5 ±1.2 y, 59% girls, 68% Caucasian), 52% slept for less than eight hours based on the actigraphy report. Actigraphy measurements significantly differed from child- and parent-reported sleep durations (p < 0.001). Sleep duration had a positive correlation with sugar consumption (r = 0.647, p = 0.001), while other sleep parameters did not significantly correlate with intrinsic sugar, fruit, and vegetable intake. The relationship between sleep parameters, screen time, and physical activity level showed no significant associations. Conclusion In this pilot and feasibility study, participants engaged proactively, data was collected efficiently, and research procedures were implemented effectively, highlighting the study's practicality and success. Our data indicate that more than half of the participants slept less than the Canadian recommendation. It has been shown that sleep parameters may play a role in adolescents' choices of healthy and unhealthy foods. These data suggest that sleep patterns may be the target of intervention studies and obesity prevention programs.