Associations between sleep and overweight/obesity in adolescents vary by race/ethnicity and socioeconomic status
Date
2022-11-28
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Advanced Nursing
Abstract
Aim
To examine the interaction between sleep and social determinants of health (SDOH) [race/ethnicity and socioeconomic status (SES)] on overweight/obesity in adolescents.
Design
Cross-sectional.
Methods
We conducted a secondary analysis using the 2017–2018 National Survey of Children's Health data. We included adolescents (10–17 years old) who had sleep and body mass index (BMI) data available (n = 24,337) in analyses (samples with BMI <5th percentile excluded). Parents reported children's sleep duration and regularity. High BMI (≥85th percentile) for age defines overweight/obesity. We selected SDOH (race/ethnicity, family income, primary caregiver education and neighbourhood condition) and covariates (age, sex, smoking, exercise and depression) using a hierarchical model-building approach. Accounting for complex survey design, logistic regression estimated the interaction between sleep and SDOH.
Results
There were significant interactions between sleep duration and SDOH. The association between increasing sleep and decreasing odds of overweight/obesity only showed in the following subgroups: White, family income ≥400% federal poverty level (FPL) or primary caregiver' education ≥ high school. Compared with these subgroups, Hispanic adolescents and adolescents whose family income was below 100% FPL and whose caregiver education was below high school had weakened and reversed associations. Sleep regularity was not associated with overweight/obesity.
Conclusions
Increasing sleep duration was associated with a decreased risk of overweight/obesity, but the association was not present in adolescents from racial/ethnic minority groups (i.e. Hispanic) and those with low SES.
Impact
The study findings suggest that associations between sleep and overweight/obesity vary by race and SES. Identification of additional mechanisms for obesity is needed for racial/ethnic minority groups and those from families with low SES. Also, the complexity of these relationships underscores the importance of community-based needs assessment in the design of targeted and meaningful interventions to address complex health conditions such as poor sleep and obesity.
Description
This is the peer reviewed version of the following article: Ji, X., Covington, L. B., Patterson, F., Ji, M., & Brownlow, J. A. (2022). Associations between sleep and overweight/obesity in adolescents vary by race/ethnicity and socioeconomic status. Journal of Advanced Nursing, 00, 1– 12. https://doi.org/10.1111/jan.15513, which has been published in final form at https://doi.org/10.1111/jan.15513. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. This article will be embargoed until 11/28/2023.
Keywords
sleep, adolescent health, obesity, social determinants of health, health disparity, public health nursing, no poverty
Citation
Ji, X., Covington, L. B., Patterson, F., Ji, M., & Brownlow, J. A. (2022). Associations between sleep and overweight/obesity in adolescents vary by race/ethnicity and socioeconomic status. Journal of Advanced Nursing, 00, 1– 12. https://doi.org/10.1111/jan.15513