Adolescent sleep restriction, macronutrient consumption, and self-reported hunger: A randomized clinical trial

Rising pediatric obesity rates relate to negative physical and psychosocial health outcomes. Poor sleep predicts increased overall 24-h macronutrient consumption and contributes to weight gain. However, the impact of poor sleep on macronutrient intake at specific timepoints within a 24-h period is less well understood. This study assessed the effects of sleep duration, sex, and BMI on objective food consumption during adolescents' first meal of the day and time-matched self-reported hunger variables as first steps in pinpointing key times for behavioral intervention.

Baseline assessments evaluated sleep, macronutrient consumption, and BMI. Sixty-one adolescents completed two sleep conditions (restricted [∼4 h] and adequate [∼9 h]) in a randomized order, each followed by a laboratory visit. Twenty-four hours prior to the laboratory visits, participants began tracking food consumption via self-report food logs. Twelve-hours prior to each laboratory visit, participants began fasting. At visits, participants self-reported hunger, fullness, and ability and desire to eat, and chose their first meal of the day from a buffet. Macronutrient consumption was determined via the Nutrition Data System for Research.

Restricted sleep (M_Duration = 4 h 12 min, SD_Duration = 50.7 min) predicted reduced calorie, fat, protein, and saturated fatty acid consumption with medium to large effect sizes (ps < 00.05; η_p² = 0.08-0.12) regardless of BMI and sex. However, while females reported decreased hunger and desire to eat following sleep restriction (M_Duration = 8 h 54 min, SD_Duration = 58.0 min), males reported increased hunger (ps < 00.05; η_p² = 0.09-0.15).

Restricted sleep predicts restricted food consumption at the first meal of the day. This may lead to overeating later in the day and increase risk for obesity. Behavioral health interventions may be optimized by considering sleep duration and targeting key moments, such as breakfast, for timed behavioral intervention. REGISTRATION NUMBER OF CLINICAL TRIAL: #NCT04346433.