The association between obstructive sleep apnea and dietary choices among obese individuals during middle to late childhood

Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Sleep Medicine (Impact Factor: 3.15). 08/2011; 12(8):797-9. DOI: 10.1016/j.sleep.2010.12.020
Source: PubMed


Determine whether obstructive sleep apnea (OSA) is associated with the dietary choices of obese individuals during middle- to late-childhood. It was hypothesized that OSA would be associated with increased caloric content of a dinner order, particularly with high carbohydrate food choices. Secondarily, we examined the relationships between sleep duration and dietary choices.
42 obese subjects aged 10-16.9 years participated in a cross-sectional study that involved systematic collection of sleep duration (based on actigraphy), presence and severity of obstructive sleep apnea (obstructive apnea+hypopnea index [AHI] from inpatient polysomnography) and the macronutrient content of dinners ordered from a standardized hospital menu the evening before the polysomnogram.
Primary analyses using Spearman rank-order correlations found that AHI was significantly associated with total calories, as well as grams of fat and carbohydrate, but not protein. These macronutrient variables did not correlate with sleep duration across a week, nor the night before the meal. Findings were unchanged after correcting for age- and sex-adjusted BMI.
More severe OSA appears to be associated with an increased preference for calorie-dense foods that are high in fat and carbohydrates in a manner that is independent of degree of obesity. Although this novel finding awaits replication, it has potential implications for the clinical care of obese youth and individuals with OSA, adds to the limited data that relate sleep to dietary choices and may have implications for OSA-related morbidity.

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    • "Diet in our study was calculated based on weight maintenance energy requirements, and balanced for macronutrient content. This is important since OSA severity is associated with increased preference for calorie-rich foods high in fat and carbohydrate [12]. Our small sample size likely contributes to variance in the data, although this may be mitigated by the crossover design. "
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    • "There is some evidence for a dysregulation of appetite-regulating hormones in OSA patients, with increased leptin levels, suggestive of leptin resistance60616263, and increased ghrelin [62] relative to controls. This aspect of energy balance has not been extensively studied in OSA, although AHI was found to be positively associated with the caloric as well as fat and carbohydrate content of a self-selected meal from a standard hospital menu in adolescents [64]. Food choice and energy intake should be systematically studied in OSA patients to determine how the disorder may influence body weight management. "
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    • "Several studies have shown an increased preference for calorie dense foods, specifically fats and carbohydrates, in patients with OSA, independent from obesity.45,48,49 This preference may be tied to sleep fragmentation but has not been clearly elucidated.46 "
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