0160 Sleep and high body mass index in adolescents: Ethnicity and socioeconomic status as moderators

Abstract

Abstract Introduction Sleep deficiency and obesity disproportionately affect racial/ethnic minorities and those with lower socioeconomic status (SES). Considerable research has linked sleep deficiency to overweight/obesity. Less clear is the interactive effects of sleep duration (SD) and social determinants (i.e., SES, race/ethnicity) on weight status in adolescents. This study examined the role of race/ethnicity and SES as moderators of associations between SD and overweight/obesity in a nationally representative adolescent sample. Methods Using the National Survey of Children’s Health 2017-2018 dataset, we included adolescents (10-17 y.o.) with available SD and Body Mass Index (BMI) data (n=24,337). Parents reported children’s SD and sleep regularity. Adolescents with a BMI ≥85th percentile were classified as overweight/obese. We used a stepwise approach to identify SES factors and covariates to include in the model. Accounting for complex survey design, as well as sleep regularity and selected covariates (i.e., age, sex, smoking, exercise, and depression, diabetes), logistic regression (STATA 16.0) estimated the interaction between SD and selected social determinants (i.e., race/ethnicity, family income, primary caregiver education, neighborhood condition) in adolescents. Results Every hour increase in SD was associated with a 7% decrease in the odds of high BMI (OR=0.93, p=0.03) regardless of race/ethnicity and SES. There were significant interactions between SD and social determinants. Compared with the White (OR=0.88, p<0.001), the association between longer sleep and lower odds of high BMI was weakened and even reversed in Hispanic adolescents (OR=1.20, p=0.02). Similarly, family income below 100% FPL (versus 300% or above) (OR=1.19, p=0.02) and primary caregiver having education below high school (versus high school or above) (OR=1.15, p=0.03) also attenuated the associations. Poor neighborhood condition was not a moderator but independently associated with high BMI (OR=1.57, p=0.02). Conclusion Adolescence may be a sensitive period that sets the stage for the interaction between sleep and social risk factors on overweight/obesity. Increasing sleep duration is associated with decreased risk of overweight/obesity, but the protective role is dampened in Hispanic adolescents and those with the low SES. Our findings suggest that sleep-related prevention and intervention efforts should target at-risk populations who experience health disparities. Support (If Any)