Association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents: A global perspective from 64 countries
Asaduzzaman Khan, Clare Dix, Nicola W. Burton, Shanchita R. Khan and Riaz Uddin
Background
Poor quality sleep adversely impacts on adolescent wellbeing. More multinational research is needed to understand modifiable risk factors, such as dietary behaviours. This study aimed to examine the association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents across 64 countries.
Methods
We analysed the Global School-based Student Health Survey data from 175,261 adolescents (mean age 13.8 [0.98]; 48.5% females). Adolescents reported frequency of stress-related sleep disturbance and consumption of carbonated soft drinks and fast foods. Country-level estimates were obtained by using multivariable logistic regression and meta-analysis to obtain pooled estimates.
Findings
Overall, 7.5% of adolescents reported sleep disturbance during the past 12 months (males: 6.6%; females: 8.4%). Meta-analysis showed that adolescents having carbonated soft drinks ≥3 times/day had over 50% higher odds of reporting sleep disturbance than <once/day (OR=1.55, 95% CI 1.42–1.70 for males; 1.51, 1.37–1.68 for females). Adolescent males who had fast foods ≥4 days/week had 55% higher odds of reporting sleep disturbance than ≤1 day/week (1.55, 1.39–1.73), while the odds was 50% higher in females (1.50, 1.32–1.70). Carbonated soft drinks ≥3 times/day and fast foods ≥ 4 days/week were significantly associated with sleep disturbance in all but low-income countries for both genders; while the associations were significant in males and mixed in females across WHO regions.
Interpretation
Our findings suggest strong positive associations between carbonated soft drink and fast food intake with stress-related sleep disturbance. Prospective studies are needed to understand the directionality of the relationship.
Details
Title
Association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents: A global perspective from 64 countries
Authors
Asaduzzaman Khan - The University of Queensland
Clare Dix - The University of Queensland
Nicola W. Burton - Griffith University
Shanchita R. Khan - Queensland University of Technology
Riaz Uddin (Corresponding Author) - The University of Queensland
The data for the current study are publicly available at the World Health Organization NCD Microdata Repository (URL: https://extranet.who.int/ncdsmicrodata/index.php/catalog).
Grant note
RU is supported by Alfred Deakin Postdoctoral Research Fellowship.