Abstract
Background: Shorter sleep duration and lower sleep quality have been previously associated with greater obesity risk among adult samples. Food insecurity has also been found to impact sleep patterns and obesity. Yet few studies have explored associations between sleep, food insecurity, and obesity in adolescent populations, who may have more irregular sleep patterns. Thus, the objectives of this study were to determine associations between measures of sleep, food insecurity, and weight status. Methods: Data were obtained from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, an online cross-sectional study of parent and adolescent (12-17-year old) dyads. Participants were drawn from a Consumer Opinion Panel representative of the general population of the United States with respect to sex, education, income, age, household size, and region. First, multinomial logistic regression analyses were conducted to determine associations between sleep measures (adolescent-reported average nighttime sleep duration, having a regular bedtime, and having difficulty staying asleep), food insecurity (a validated two-item parent-reported measure), and weight status (being underweight, of healthy weight, overweight, and obese). Weight status was based upon adolescent BMI z-scores using Centers for Disease Control and Prevention growth charts using information from parent report of adolescent height and weight and adolescent-reported age and sex among adolescents (N = 1544). Conditional process models were also fitted to the data to determine whether food insecurity moderates the associations between sleep measures and weight status, and to determine whether the association between food insecurity and weight status is mediated by average sleep duration. Results: Compared to those with food security, a greater percentage of those with food insecurity reported having difficulties staying asleep and a longer average sleep duration. Multinomial logistic regression models demonstrated that having a regular bedtime was associated with lower odds of having obesity, having difficulties staying asleep was associated with greater odds of being underweight, and having food insecurity was associated with greater odds of being overweight. Conditional process models demonstrated that food insecurity did not moderate associations between sleep measures and weight status and that average nighttime sleep duration did not mediate the association between food insecurity and weight status. Conclusions: This is one of the first studies to examine associations between sleep, food insecurity, and weight status among adolescents. Results provide additional support for the need to uncover mechanisms for how sleep and food insecurity affect pediatric obesity using longitudinal data.