Abstract：
A significant increase in the prevalence of short sleep among children has been observed. Short sleep may be associated with unhealthy breakfast and snacking behaviors. The purpose of the current study was to explore the associations of short sleep with breakfast and snacking behaviors among children. Data were obtained from the 2010-2012 China National Nutrition and Health Surveillance (CNNHS). A total of 5254 children aged 6 to 17 years were included. Sleep duration was classified into three categories: moderate sleep, slightly short sleep, and severely short sleep. Breakfast behaviors included skipping breakfast, food diversity, intake of energy and macronutrients, and their proportion of daily total intake. Snack behaviors included snack consumption rate/frequency, types, intake of energy and macronutrients, and proportion of daily total intake. Multiple linear regression and multivariate logistic regression were used for analysis, with models adjusted for the potential effects of gender, age, region, and family income level. The bootstrapping method was used to calculate the 95% confidence intervals of the model statistics. Results showed that slightly short sleep (OR = 1.15, 95%CI: 1.00, 1.33)) and severely short sleep (OR = 1.36, 95%CI: 1.04, 1.77) was related to higher rates of skipping breakfast compared to moderate sleep. Severely short sleep was associated with higher energy (β = 28.44, 95%CI: 31.97, 44.70), carbohydrate (β = 6.62, 95%CI: 8.29, 8.84) and protein (β = 1.17, 95%CI: 1.44, 1.70) intake at breakfast and breakfast accounted for a higher proportion of total daily energy (β = 1.39, 95%CI: 1.48, 2.52), protein (β = 2.26, 95%CI: 3.16, 5.84) and carbohydrate (β = 0.83, 95%CI: 0.07, 3.41). Severely short sleep was associated with higher energy (β = 27.4, 95%CI: 18.64, 69.41), protein (β = 0.8, 95%CI: 0.48, 2.40), and fat (β = 1.40, 95%CI: 1.21, 3.16) intake at snacks and snacks accounted for a higher proportion of total daily protein intake (β = 1.23, 95%CI: 0.71, 3.58) and fat intake (β = 2.74, 95%CI: 3.13, 6.09). Slightly short sleep was associated with higher energy (β = 7.28, 95%CI: 0.15, 28.13) and carbohydrate (β = 1.67, 95%CI: 0.86, 5.73) intake at snacks and snacks accounted for a higher proportion of total daily carbohydrate intake. Children with severely short sleep were more likely to choose sugar-sweetened beverages (SSBs) as snacks (16.5%) and intake them more frequently, at a daily consumption of 204.7 g and 26.7 g per night. Overall, short sleep was associated with unhealthy breakfast patterns and snack behaviors among children. Children with short sleep had higher intake of energy and macronutrients at breakfast and snacks compared with those with moderate sleep. Promoting adequate sleep among children may have a positive effect on developing healthy eating behaviors.
摘要：
观察到儿童睡眠不足的患病率显着增加。短暂睡眠可能与不健康的早餐和零食行为有关。本研究的目的是探讨儿童短暂睡眠与早餐和零食行为的关系。数据来自2010-2012年中国国民营养与健康监测（CNNHS）。共包括5254名6至17岁的儿童。睡眠持续时间分为三类：适度睡眠，睡眠稍短，严重的睡眠不足。早餐行为包括不吃早餐，食物多样性,能量和大量营养素的摄入，以及它们在每日总摄入量中的比例。零食行为包括零食消费率/频率，类型,能量和大量营养素的摄入，和每日总摄入量的比例。采用多元线性回归和多变量logistic回归进行分析,根据性别的潜在影响调整了模型，年龄,区域,和家庭收入水平。使用自举方法计算模型统计量的95%置信区间。结果显示，与适度睡眠相比，睡眠稍短（OR=1.15，95CI：1.00，1.33））和严重睡眠不足（OR=1.36，95CI：1.04，1.77）与不吃早餐的比率更高。严重短暂睡眠与高能量相关(β=28.44,95CI:31.97,44.70),早餐中碳水化合物(β=6.62,95CI:8.29,8.84)和蛋白质(β=1.17,95CI:1.44,1.70)的摄入量占每日总能量(β=1.39,95CI:1.48,2.52)的比例较高,蛋白质(β=2.26,95CI:3.16,5.84)和碳水化合物(β=0.83,95CI:0.07,3.41)。严重短眠与高能量相关(β=27.4,95CI:18.64,69.41),蛋白质（β=0.8，95CI：0.48，2.40），零食和零食的脂肪（β=1.40，95CI：1.21，3.16）摄入量占每日蛋白质总摄入量（β=1.23，95CI：0.71，3.58）和脂肪摄入量（β=2.74，95CI：3.13，6.09）的比例较高。略短睡眠与较高的能量（β=7.28，95CI：0.15，28.13）和碳水化合物（β=1.67，95CI：0.86，5.73）摄入零食和零食占每日总碳水化合物摄入量的比例较高。严重睡眠不足的儿童更有可能选择含糖饮料（SSB）作为零食（16.5％），并更频繁地摄入它们。每天消费204.7克和每晚26.7克。总的来说,儿童睡眠不足与不健康的早餐模式和零食行为有关。与中等睡眠的儿童相比，睡眠时间短的儿童在早餐和零食中摄入的能量和大量营养素更多。促进儿童充足的睡眠可能对发展健康的饮食行为产生积极影响。
