Association between Sleep Duration and Body Mass Index among South Korean Adolescents

Article information

Korean J Health Promot. 2015;15(1):16-23

Publication date (electronic) : 2015 December 19

doi : https://doi.org/10.15384/kjhp.2015.15.1.16

Department of Nursing, University of Ulsan College of Medicine, Ulsan, Korea

￭ Corresponding author：Bokim Lee, PhD Department of Nursing, University of Ulsan College of Medicine, 93 Daehak-ro, Nam-gu, Ulsan 680-749, Korea Tel: +82-52-259-1283, Fax: +82-52-259-1236 E-mail: bokimlee@ulsan.ac.kr

Received 2014 June 12; Accepted 2014 November 28.

Abstract

Background

Recently, there has been a growing interest in sleep duration as a risk factor for obesity. The link between sleep duration and obesity has been well established in adults, but there are limited studies in adolescents. Also, little research had been done involving South Korean adolescents. This study aimed to investigate the relationship between sleep duration and body mass index in South Korea adolescents.

Methods

This was a secondary analysis of the data collected from the 2013 Korean Youth Risk Behavior Web-based Survey. The sample included 59,367 adolescents. The questionnaires used for this study assessed gender, age, mother's education level, academic performance, smoking, alcohol use, eating behaviors, physical activity, duration of internet use, perceived stress level, and perceived health status. Data were analyzed with χ²-test, ANOVA, and logistic regression analysis using SPSS Version 21.

Results

The percentage of obese subjects was the greatest among respondents reporting less than 5 h of sleep (11.0%) and the lowest among those reporting 8 or more hours of sleep (8.4%). In the results of logistic regression analysis, compared with sleep duration of 8h or more, the adjusted odds ratio was 1.11 for 7-8 h, 1.19 for 6-7 h, 1.19 for 5-6 h, and 1.19 for <5 h of sleep, with other factors controlled.

Conclusions

The results of this study showed that a shortsleep duration is significantly associated with obesity among South Korea adolescents. In managing obesity in this population, health professionals should attend to how much sleep they are getting.

Keywords: Adolescent; Body mass index; Sleep

Table 1.

General characteristics of the study sample according to BMI (N [%] or mean ± SD^a)

Table 2.

Health behavior characteristics of the study sample according to BMI (N [%] or mean±SD^a)

Table 3.

Psychosocial characteristics of the study sample according to BMI (N [%] or mean ± SD^a)

Table 4.

Sleep duration on school nights according to BMI (N [%]^a)

Table 5.

Association between sleep duration and BMI^a

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Table 1.

General characteristics of the study sample according to BMI (N [%] or mean ± SD^a)

BMI category	Underweight (n=3,387)	Normal (n=47,370)	Overweight (n=2,719)	Obese (n=5,891)	Total (n=59,367)	χ² (P)^e
Gender						609.59 (<0.001)
Male	1,829 (6.4)	23,082 (78.2)	640 (2.0)	3,937 (13.4)	29,488 (100.0)
Female	1,558 (5.3)	24,288 (81.7)	2,079 (6.8)	1,954 (6.2)	29,879 (100.0)
Mother's education level						67.02 (<0.001)
≤Middle school	121 (6.0)	1,627 (76.5)	104 (4.6)	271 (12.9)	2,123 (100.0)
High school diploma	1,480 (5.9)	20,469 (79.0)	1,223 (4.5)	2,730 (10.6)	25,902 (100.0)
≥Bachelor’s degree	1,229 (5.6)	18,181 (81.2)	941 (4.1)	2,030 (9.2)	22,381 (100.0)
Unknown	557 (6.2)	7,093 (79.5)	451 (4.8)	860 (9.5)	8,961 (100.0)
Age, y	15.41±0.05	14.96±0.03^d	14.12±0.06^d	15.38±0.03^c	14.99±0.03	205.55 (<0.001)
Economic statusb	3.15±0.04^d	3.18±0.03^d	3.15±0.04	3.11±0.02^c	3.17±0.02	10.56 (<0.001)
Academic performanceb	2.95±0.04^d	3.03±0.03^d	2.93±0.04^d	2.85±0.02^c	3.00±0.02	40.11 (<0.001)

Abbreviations: BMI, body mass index; SD, standard deviation.

N: non-weighted, %: weighted, mean: weighted, SD: weighted.

1(low)-5(high).

Reference category.

Significantly different group from the reference category.

Calculated by chi-square test or analysis of variance.

Table 2.

Health behavior characteristics of the study sample according to BMI (N [%] or mean±SD^a)

BMI category	Underweight	Normal	Overweight	Obese	Total	χ² (P)^b
Smoking						102.07 (<0.001)
Yes	323 (6.1)	4,306 (80.3)	108 (1.9)	628 (11.7)	5,365 (100.0)
No	3,064 (5.8)	43,064 (79.8)	2,611 (4.6)	5,263 (9.8)	54,002 (100.0)
Alcohol use						36.22 (<0.001)
Yes	524 (5.7)	7,573 (79.7)	297 (2.9)	1,094 (11.7)	9,488 (100.0)
No	2,863 (5.9)	39,797 (79.9)	2,422 (4.6)	4,797 (9.6)	49,879 (100.0)
Eat vegetables						73.02 (<0.001)
None	131 (7.0)	1,643 (80.1)	84 (4.1)	185 (8.8)	2,043 (100.0)
1-2 times/wk	623 (6.9)	7,406 (80.5)	394 (4.1)	805 (8.6)	9,228 (100.0)
3-4 times/wk	820 (6.0)	11,276 (79.9)	634 (4.3)	1,368 (9.9)	14,098 (100.0)
5-6 times/wk	486 (5.9)	6,618 (79.7)	382 (4.5)	816 (9.9)	8,302 (100.0)
1 serving/d	374 (5.2)	5,931 (80.3)	336 (4.1)	755 (10.3)	7,396 (100.0)
2 serving/d	437 (5.3)	6,585 (79.3)	405 (4.6)	907 (10.7)	8,334 (100.0)
≥3serving/d	516 (5.3)	7,911 (79.4)	484 (4.6)	1,055 (10.7)	9,966 (100.0)
Eat a snack						146.24 (<0.001)
None	507 (4.9)	8,014 (77.2)	542 (4.8)	1,347 (13.1)	10,410 (100.0)
1-2 times/wk	1,315 (5.2)	20,341 (79.3)	1,297 (4.8)	2,754 (10.7)	25,707 (100.0)
3-4 times/wk	1,037 (6.6)	13,210 (81.3)	646 (3.8)	1,333 (8.3)	16,226 (100.0)
5-6 times/wk	268 (6.9)	3,342 (83.7)	130 (3.0)	269 (6.3)	4,009 (100.0)
1 serving/d	178 (9.5)	1,684 (81.4)	69 (3.2)	117 (6.0)	2,048 (100.0)
2 serving/d	47 (8.3)	506 (82.5)	17 (2.5)	42 (6.7)	612 (100.0)
≥serving/d	35 (9.2)	273 (78.3)	18 (3.6)	29 (8.9)	355 (100.0)
Eat fast food						111.58 (<0.001)
None	963 (5.3)	14,450 (78.7)	955 (5.0)	2,025 (11.0)	18,393 (100.0)
1-2 times/wk	1,941 (5.9)	26,948 (80.3)	1,491 (4.1)	3,183 (9.6)	33,563 (100.0)
3-4 times/wk	363 (6.6)	4,782 (80.6)	217 (3.7)	548 (9.1)	5,910 (100.0)
5-6 times/wk	68 (7.2)	761 (82.0)	34 (3.3)	70 (7.5)	933 (100.0)
1 serving/d	31 (10.2)	264 (74.9)	14 (4.0)	40 (10.9)	349 (100.0)
2 serving/d	14 (12.7)	76 (75.3)	4 (5.1)	8 (7.0)	102 (100.0)
≥serving/d	7 (5.4)	89 (77.6)	4 (2.7)	17 (14.3)	117 (100.0)
Exercise (d/wk)	2.67±0.07^c	2.88±0.06^c	2.79±0.08^c	2.00±0.03^d	1.87±0.03	23.17 (<0.001)
Walking time (min/d)	61.02±2.74	61.80±2.06	60.77±2.95	60.79±1.00^d	61.61±2.11	0.48 (0.684)

Abbreviations: BMI, body mass index; SD, standard deviation.

N: non-weighted, %: weighted, mean: weighted, SD: weighted.

Calculated by chi-square test or analysis of variance.

Significantly different group from the reference category.

Reference category.

Table 3.

Psychosocial characteristics of the study sample according to BMI (N [%] or mean ± SD^a)

BMI category	Underweight	Normal	Overweight	Obese	Total	F (P)^b
Using internet (min/d)	102.98±4.56^c	95.15±3.65^c	89.95±4.59^c	126.31±1.89^d	98.48±3.74	111.53 (<0.001)
Stresse	3.31±0.05	3.32±0.03	3.45±0.04^c	3.33±0.01^d	3.32±0.03	16.36 (<0.001)
Health statusf	3.69±0.03^c	3.89±0.03^c	3.78±0.03	3.74±0.01^d	3.86±0.03	39.78 (<0.001)

Abbreviations: BMI, body mass index; SD, standard deviation.

N: non-weighted, %: weighted, mean: weighted, SD: weighted.

Calculated by analysis of variance.

Significantly different group from the reference category.

Reference category.

1(never)-5(very frequently).

1(very unhealthy)-5(very healthy).

Table 4.

Sleep duration on school nights according to BMI (N [%]^a)

Sleep duration	Underweight	Normal	Overweight	Obese	Total	χ² (P)^b
<5 h	454 (5.8)	6,268 (79.4)	312 (3.8)	869 (11.0)	7,903 (100.0)	98.48 (<0.001)
5h≤, <6 h	705 (5.7)	10,023 (79.8)	488 (3.7)	1,314 (10.8)	12,530 (100.0)
6h≤, <7 h	812 (5.8)	11,741 (79.6)	659 (4.2)	1,534 (10.4)	14,746 (100.0)
7h≥, <8 h	799 (5.8)	11,338 (80.1)	718 (5.0)	1,303 (9.1)	14,158 (100.0)
≥8 h	617 (6.2)	8,000 (80.4)	542 (5.0)	871 (8.4)	10,030 (100.0)

Abbreviation: BMI, body mass index.

N: non-weighted, %: weighted.

Calculated by chi-square test.

Table 5.

Association between sleep duration and BMI^a

Sleep duration	Underweight			Normal			Overweight			Obese
Sleep duration	OR	95% CI	P	OR	95% CI	P	OR	95% CI	P	OR	95% CI	P
<5 h	0.58	0.50-0.67	<0.001	1.03	0.94-1.13	0.485	1.20	1.02-1.42	0.032	1.19	1.05-1.34	0.005
5h≤, <6 h	0.60	0.53-0.69	<0.001	1.03	0.96-1.11	0.432	1.11	0.95-1.29	0.186	1.19	1.07-1.32	0.001
6h≤, <7 h	0.69	0.61-0.78	<0.001	0.99	0.92-1.06	0.771	1.05	0.92-1.19	0.483	1.19	1.08-1.31	<0.001
7h≤, <8 h	0.85	0.75-0.96	0.011	0.98	0.91-1.05	0.507	1.01	0.89-1.14	0.928	1.11	1.01-1.22	0.037
≥8 h	1.00			1.00			1.00			1.00

Abbreviations: BMI, body mass index; OR, odds ratio; CI, confidence interval.

Calculated by logistic regression analysis, adjusted for gender, age, mother's education level, economic status, academic performance, smoking, alcohol use, diet habits, exercises habits, using internet, stress, and health status.