The Combined Impact of Sleep and Diet on Adiposity in Infants, Toddlers, and Young Children: A Systematic Review

Objective: Short sleep duration and poor dietary habits may contribute to increased adiposity; however, the impact of the interaction between these variables on adiposity is less understood. To evaluate research investigating the combined effects of sleep and diet on adiposity in infants, toddlers, and young children. Methods: Systematic searches of electronic databases (PubMed, CINAHL, and Web of Science) from inception through April 2017 were conducted. All studies published in English that had at least 1 sleep (e. g., sleep duration and night awakenings), diet (e. g., 24-hour diet recall and breastfeeding duration), and adiposity (e. g., body mass index z-score and weight-for-length) measure were eligible for inclusion. Abstract and full-text article reviews were conducted by 2 independent reviewers. Data were extracted into a standardized spreadsheet. Results: Of the 17 full-text articles reviewed, 14 studies were included. Mediation (n = 2) and moderation (n = 2) were seldom used. Investigation of the combined effects of sleep and diet on adiposity demonstrated a substantial lack of evidence. Synthesis of articles suggests that the relationship between sleep and diet may be interactive and their effects additive in their impact when targeted simultaneously within interventions. Conclusion: Without consideration of interaction effects among variables of interest, a substantial gap in the literature persists. Both diet and sleep need to be assessed simultaneously and repetitively in future longitudinal research.