Potential interaction effect on obesity between sleep duration and dietary patterns in preschool children in Bengbu City in 2018-2019

Abstract

To examine the interaction effect between sleep duration and dietary patterns on obesity, in order to explore the possible risk factors for preschool children's obesity. During September of 2018 to March of 2019(1148 boys and 981 girls, 1199 living in urban and 930 living in rural, 756 only child and 1373 not only child), a total of 2129 preschool children used two-stage cluster sampling method from 22 kindergartens aged 3-6 years old were investigated. Social-demographic information(included sex, age, only child or not, left-behind children or not, economic status of family, parents 'cultural level and caregivers' information), sleep duration and dietary intake were collected through "Sleep Duration and Physical Development Questionnaire(SDPDQ) of children aged 3-6 years old in Bengbu city". Factor analysis was applied to determine major dietary patterns, unconditional Logistic regression was used to analyze the multiplication interaction effect between sleep duration and dietary patterns on obesity. Four dietary patterns-"traditional", "animal", "calcium" and "snack" were identified in our study by principal component analysis. The factor contribution rate of the four dietary patterns was 16. 568%, 11. 462%, 7. 317% and 4. 562%, respectively, the total variance was 39. 909%. Among the preschool children, the prevalence of overweight and obesity were 18. 0%(n=383) and 10. 5%(n=223), respectively. After controlling the confounding factors, the shorter sleep duration(OR=1. 25, 95%CI 1. 07-1. 72), scores in the top quintile of "animal" pattern(OR=1. 32, 95%CI 1. 15-1. 54) and "snack" pattern(OR=1. 46, 95%CI 1. 16-1. 78) showed greater odds with the prevalence of overweight/obesity among preschool children. Both multiplication and additive interactions were observed between levels of low sleep duration and animal dietary pattern with overweight/obesity(OR=1. 23, 95%CI 1. 16-1. 32). Multiplication interaction was observed between lower sleep time and the snack dietary pattern(OR=1. 16, 95%CI 1. 09-1. 24), with RERI, AP and SI was 0. 38, 0. 20 and 1. 24, respectively. However, neither multiplication interaction or additive interaction was noticed between sleep duration and the traditional dietary pattern, the calcium dietary pattern with OR=0. 76(95%CI 0. 51-1. 11) vs. OR=1. 04(95%CI 0. 65-1. 73), respectively. Levels of low sleep duration presented a risk factor for overweight/obesity in preschool children. Both multiplication and additive interactions were observed between low sleep time and the animal dietary pattern. Multiplication interaction was noticed between children's sleep duration and the snack dietary pattern.