Each month, the pediatric obesity committee posts a pediatric-focused obesity research update to help keep you up to date about the latest findings. Below the article you can also find links to more resources related to pediatric obesity.
Pediatric Obesity Research Updates
Role of Sleep Quality in the Metabolic Syndrome
This summary was written by Susma Vaidya, MD, MPH. Dr. Vaidya is a pediatrician at Children’s National in Washington, D.C. View the original article.
Although an unhealthy diet and sedentary lifestyle have been causally linked to metabolic syndrome, sleep disorders are considered risk factors as well. In this review article, Koren et al., summarize the medical literature linking sleep disturbances to the development of metabolic syndrome in adults, prepubertal children, and adolescents. Depending on the criteria used to define metabolic syndrome in children, prevalence ranges between 30-50% among children with obesity.
Almost one-third of children and half of adolescents sleep fewer than the recommended number of hours for their age. The National Sleep Foundation recommends 10-13 hours of sleep for preschool-aged children, 9-11 hours for school-aged children (ages 6-13), and 8-10 hours for adolescents (14-18 years). Several pediatric studies have demonstrated that inadequate sleep can increase the risk of central obesity and increased adipose tissue, which persists into adulthood. Chronic sleep insufficiency is also associated with individual components of metabolic syndrome, including high blood pressure, insulin resistance, and high glucose levels. Experimental studies in sleep restriction in children demonstrate weight gain as well as increased calorie and high-glycemic-index food consumption.
The literature supports a link between obstructive sleep apnea and insulin resistance, elevated blood pressure, and increase in fasting glucose. Obstructive sleep apnea (OSA) has been strongly associated with metabolic syndrome in children and adolescents. Data suggests that OSA can lead to worsening obesity because of daytime somnolence, decreased physical activity, and an increase in leptin resistance; however, there have been many studies in children, which have demonstrated an increase in weight after a tonsillectomy and adenoidectomy. This is likely mediated through a decrease in energy expenditure after the OSA has resolved. Although the authors of the paper have observed in their research that treatment of OSA with a tonsillectomy and adenoidectomy in children resulted in improved lipid panels, improved insulin sensitivity, and a decrease in inflammatory biomarkers, other studies have not supported this conclusion. In summary, there is observational and experimental data in the medical literature to support the importance of addressing sleep insufficiency and OSA in the treatment of pediatric obesity and concomitant individual components of metabolic syndrome.
Links to More Pediatric Obesity Resources
- American Academy of Pediatrics Institute for Healthy Childhood Weight
- Children’s Hospital Association
- National Institute for Children’s Health Quality (NICHQ)
- Children, Adolescents, and Television
- Prevention of Pediatric Overweight and Obesity
- Soft Drinks in Schools
- California Child & Adolescent Obesity Provider Toolkit
- Childhood Obesity Research Demonstration Project (CORD)
- USDA Team Nutrition Resources
- Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement
- The Great Cafeteria Takeover
- American Academy of Pediatrics Practice Management Resources
- Nationwide Children’s Hospital’s Center for Healthy Weight and Nutrition
- We Can!