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  • The linear regression showed an inverse correlation between

    2018-11-05

    The linear regression showed an inverse correlation between the total sleep time and BMI (β=−0.829, P=0.021), FM% (β=−0.526, P=0.025) and WC (β=−0.426, P=0.045). Similar results were found also for weekdays sleep time (Table 4). Instead a direct association was found between the PDSS score and BMI (β=0.529, P=0.041) and FM% (β=0.435, P=0.039), but not with WC and FFM. Regarding selected weight-related food groups and behaviors, order ABT737 and vegetable intake was positively associated with total and weekdays sleep time, but not with weekend sleep time and PDSS. Consumption of sweets, snacks, and the eating outside habit were more frequent in shorter sleep adolescent and directly related with PDSS. On the contrary, breakfast habit and physical activity were not related to sleep duration or PDSS. The assumption of linearity for the continuous variables was confirmed by plotting the residuals versus the predicted values (data not shown). A significant linear direct relation between the KIDMED score and PDSS, weekdays sleep time and total sleep time was found (Fig. 1).
    Discussion The result showed that male adolescents were significantly more likely to develop overweight and obesity compared to females. This data are consistent with recent investigations assessing a high prevalence of overweight and obesity in Southern Italy and Italian islands, especially among boys [22]. This might be due to a higher attention to physical appearance, weight and body shape among teenage girls, but also hormonal differences and maturational status could have an important effect in both sleep and metabolic control [23]. Adolescents reporting higher level of parents’ education and occupation were significantly less likely to be overweight/obese. Lifestyle habits of young adolescents dependent on parental control with a progressive decrease with age [24]. Parents with a higher level of education and SES seems to provide their children food of a higher nutritional quality, including more fruits and vegetables [25]. However, it has been estimated than more than a half of parents underestimate their children\'s weight, encouraging their sons to eat more [26]. Weekdays, total sleep duration and EL sleeping category were inversely associated with BMI, FM% and WC. Although the association between short sleep duration and adolescent obesity has been reported by several studies, the potential mechanism remains unclear. We investigated not only BMI levels but also effective FM because it has been shown to be better correlated with hormonal and metabolic alteration in human body [27,28]. In fact, imbalance of two opposite hormones, leptin and ghrelin involved in food intake and energy balance, has been reported in many studies investigating sleep duration and weight gain [29–32]. Leptin is secreted from white adipocytes, and acts on the central nervous system, in the arcuate nucleus of the hypothalamus, through the inhibition of hunger and by the stimulation of energy expenditure. Moreover, leptin is involved in other pathophysiological processes including atherosclerosis, tolerance and insulin sensitivity and also is liked to cardiovascular diseases and the metabolic syndrome [33,34]. On the contrary, ghrelin is mainly secreted from the stomach and by acting on the hypothalamus, stimulates hunger and fat production. Short sleep has been associated with decreased circulating leptin level and increased ghrelin, a hormonal pattern leading to an increased appetite and fat production with a decreased energy expenditure [29]. Although this pathophysiological mechanism seems to be the one with the greater consensus, other studies showed conflicting results [35,36]. Moreover, not only sleep duration may induce hormonal changes, but also sleep quality seems to lead to a pro-fat hormonal pattern. Sleep disturbance increase morning cortisol levels, reduce insulin sensitivity and growth hormone secretion [37,38], supporting the associations between poor sleep quality and obesity, as found in other studies [39,40].