Abstract
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The rising prevalence
of obesity poses a considerable threat to population health. Shorter
nighttime sleep has emerged as a novel risk factor for overweight and
obesity, and the association appears to be stronger at young ages.
Experimental studies in adults suggest that increasing energy intake drives
weight gain during periods of sleep curtailment. However, there have been few
studies addressing the association between free-living sleep and weight in
children. Using data from the Gemini twin birth cohort, the objective of this
thesis was to advance the understanding habitual sleep behaviour in early
childhood and how it may operate to influence the development of adiposity. Study
1 identified the predictors and pathways to shorter sleep at age 15 months,
demonstrating that multiple environmental factors are associated with shorter
sleep in children, with several operating through a later bedtime. Studies 2
and 3 examined the association between sleep and energy intake at age 21
months. Study 2 identified a linear relationship between shorter sleep and
energy intake, before an association between sleep and weight was observed.
Study 3 demonstrated that shorter sleeping children consumed more calories at
night only, and predominantly from milk drinks. Study 4 showed that shorter
sleep was significantly associated with weight at age 5 years; and at this
age shorter sleep was associated with higher food responsiveness, which could
partly explain the association with a higher weight. Findings from study 5
highlight the role of the home environment, demonstrating a stronger
association between sleep and weight among children living in higher risk
home food environments. Overall, the results of this thesis highlight the
importance of an early bedtime, and strongly suggest that shorter sleep in
early life may lead to a greater propensity to over-consume. Shorter sleeping
toddlers may consume more because of parents' inclination to feed to soothe
at night, but changes in sensitivity to food stimuli may increase food intake
and weight in older children with a greater autonomy over their eating
behaviour. Implications, limitations and avenues for future research are
discussed.
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