Association between sleep quality indicators and consumption of ultra-processed foods in adolescents

Cassemiro, Juliana Maria Batista Ferreira Medeiros; Vicente, Cynthia Dantas; Resende, Cristina Maria Mendes; Santos, Marcos André Moura dos

doi:10.1590/1678-9865202437e230168

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ORIGINAL | Clinical Nutrition • Rev Nutr 37 • 2024 • https://doi.org/10.1590/1678-9865202437e230168 linkcopy

Association between sleep quality indicators and consumption of ultra-processed foods in adolescents

Associação entre indicadores da qualidade do sono e consumo de alimentos ultraprocessados em adolescentes

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective To investigate the association between sleep quality indicators and the consumption of ultra-processed foods in adolescents. Methods An integrative review was carried out, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The search strategy was carried out using the descriptors “adolescent”, “ultra-processed foods” and “sleep” in the MedLine, SciELO, Scopus, Lilacs and PubMed databases, considering original studies on the investigation topic published in English, Portuguese and Spanish, without any date restriction. Methodological quality was assessed using the Checklist for Analytical Cross-Sectional Studies of the Joanna Briggs Institute. Initially, 79 articles were found. After reviewing the titles and abstracts, 17 papers were selected. Following a complete review the exclusion criteria were applied. Only 09 articles met the eligibility criteria.

Results Three studies described associations between greater consumption of ultra-processed foods and shorter sleep duration in adolescents; one study showed an association between the consumption of ultra-processed foods and poor sleep quality in adolescents; one study described the association of greater chances of insomnia with greater consumption of ultra-processed foods. Four studies did not report significant results regarding the main question of our survey.

Conclusion An association was identified between the consumption of ultra-processed foods and adolescent changes in the quality and duration of sleep, as well as in the ability to fall asleep and maintain continuous sleep.

Keywords
Adolescent; Food processed; Sleep

Author (year)	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Yes (%)	Risk1
Werneck et al. (2018) [²¹]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Sousa et al. (2020) [¹⁶]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Costa et al. (2021) [²²]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Santos et al. (2021) [²⁰]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Knébel et al. (2022) [¹⁵]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Lane et al. (2022) [¹⁴]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Silva et al. (2022) [¹²]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low
Oliveira et al. (2023) [²³]	Y	Y	Y	Y	U	U	Y	Y	75.0	Low

Author, year	Study design	Sample	Sleep analysis method	Food consumption analysis method	Sleep outcomes	UPF consumed
Werneck et al. (2018) [²¹]	Cross-sectional	100.839 teenagers from public and private schools in Brazil	Insomnia assessed by the question: “Over the past 12 months, how often did you have insomnia due to a worry? (A) Never; (B) Rarely; (C) Sometimes; (D) Often; (E) Very often.” Insomnia rating for reports of often and very often	UPF consumption assessed by intake in the last week (0 times, 1 to 3 times and more than 4 times)	No association between UPF consumption and sleep variables ↑ Total time watching television and total sitting time associated with insomnia	NA
Sousa et al. (2020) [¹⁶]	Cross-sectional	2.499 teenagers aged 18 to 19, from São Luís, Maranhão, Brazil	Sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI), which investigates subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances and use of sleeping medications (scores from 0 to 4 = good sleep quality; scores above 4 = poor sleep quality)	FFQ	UPF consumption associated with poor sleep quality	NR
Costa et al. (2021) [²²]	Cross-sectional	1.010 teenagers from schools in Florianópolis, São José and Palhoça (municipalities in the Greater Florianópolis mesoregion) in Santa Catarina, Brazil	Usual sleep duration calculated by weighting weekend sleep duration by 2 and weekday sleep duration by 5 and dividing the resulting value by 7	R24h	No association between UPF consumption and sleep variables ↑ UPF consumption associated with total sedentary behavior and inversely associated with total physical activity	Salty fried foods, sweets, soft drinks, sausages and fast food
Santos et al. (2021) [²⁰]	Cross-sectional	1.384 teenagers aged 10 to 14, from public schools in João Pessoa, Paraíba, Brazil	Sleep restriction analyzed by bedtime and wake-up times on days with and without classes (short sleep duration = less than 9 hours/night) Sleep quality assessed by subjective analysis of participants (poor and regular - negative quality; good, very good, excellent and positive - positive quality)	Multiple Source Method (MSM) program that uses R24h, food records and FFQ	UPF consumption associated with short sleep duration in adolescents under 12 years of age	Packaged snacks, fried snacks, baked snacks and pizzas, instant noodles, candies, lollipops, chewing gum, caramel, gelatin
Duraccio et al. (2022) [¹⁹]	Experimental	93 teenagers aged 14-17; 63% female	Sleep duration assessed by actigraphy and nighttime diaries (short sleep - about 6.5 hours/ healthy sleep - about 9.5 hours)	R24h	↓ Sleep duration associated with greater consumption of UPF, carbohydrate grams, foods with higher glycemic load, and lower consumption of fruits and vegetables	Sugary drinks
Knébel et al. (2022) [¹⁵]	Cross-sectional	750 teenagers, 52.8% female, aged 10-16 from Florianópolis, Santa Catarina, Brazil	Sleep duration assessed by the question “On average, how many hours do you sleep per day during the week and on weekends?” Answers between: <6, 6, 7, 8, 9, 10 and >10 h	Consumption assessed by the intake in the last seven days of five types of food (fruits, vegetables, salty snacks, sweets and sugary drinks)	↑ UPF consumption associated with shorter sleep duration	Chips, sweets and sugary drinks
Lane et al. (2022) [¹⁴]	Cross-sectional	733 female adolescents aged 12-18 from schools in Mashhad and Sabzevar, northeastern Iran	Insomnia assessed by the Insomnia Severity Index (ISI) questionnaire, stratified into four categories (0 – None, 1-mild, 2-moderate, 3-severe and 4-Very Severe). Individuals are considered to have insomnia when their score is >7 Daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS-IR) – classification of sleepiness in eight daily situations from 0 to 3, with 0 indicating no daytime sleepiness and 24 indicating more excessive daytime sleepiness	FFQ	↑ UPF consumption associated with increased chances of insomnia	Packaged industrialized breads, sausages and other reconstituted meat products, confectionery, ice cream, among others
Silva et al. (2022) [¹²]	Cross-sectional	964 teenagers aged 18 to 19 from São Luís, Maranhão, Brazil	Sleep duration verified by accelerometry in hours	FFQ	No association between the degree of food processing and sleep duration in adolescents	NA
Oliveira et al. (2023) [²³]	Cross-sectional	432 teenagers aged 14 to 19, from public and private schools in Minas Gerais, Brazil.	Sleep duration analyzed by hours of sleep in 24 hours (adequate sleep duration = 8 to 10 hours/day)	FFQ and subsequent classification of foods into three groups, according to the degree of processing: natural or minimally processed foods, industrialized foods used as ingredients in culinary preparations and ultra-processed foods	No association between UPF consumption and sleep variables ↓ Intake of natural or minimally processed foods associated with inadequate sleep duration ↑ UPF consumption was associated with high screen time	Breads, cookies, ice cream, chocolates, candies/sweets, snacks, soft drinks, nuggets, hot dogs, hamburgers and sausages

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[1] Note:

[TFN01] ¹
The Risk of bias was ranked as “high” when they reached less than 50% of positive answers, “moderate” when the study reached 50 to 69% of positive answers, and “low” when the study reached 70% or more of positive answers.

[3] Q: Question; Y: Yes; N: No, U: Unclear.