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Associations of weekday-to-weekend and day-to-day sleep differences with adiposity-related measures in children and adolescents: A systematic review and meta-analysis

Jiameng Zhou, Hengying Chen, Weixi Deng, Jinrui Xiong, Jianduan Zhang, Hongzhong Zhang

NMCD. Nutrition Metabolism and Cardiovascular Diseases, 2025

197,873 participants

Abstract

AIMS

Variability in sleep patterns between weekdays and weekends, along with day-to-day fluctuations, is prevalent among children and adolescents. These inconsistencies have been hypothesized to contribute to obesity within this demographic. However, a comprehensive synthesis of evidence remains lacking.

DATA SYNTHESIS

This systematic review and meta-analysis focused on observational studies investigating the associations between weekday-to-weekend and day-to-day sleep differences and adiposity-related measures. Five major databases were searched from their inception to April 2024. The effect sizes and corresponding 95 % confidence intervals were pooled using the profile likelihood model and the quality effect model. Thirty-seven studies, comprising 197873 participants, met the inclusion criteria for our meta-analysis. The profile likelihood model indicated that, compared to the lowest group, individuals in the highest group of social jetlag, defined as the difference in sleep-wake timing between weekdays and weekends, showed increased BMI (body mass index)-z score (β: 0.06, 95 % CI: 0.05, 0.07), percentage fat mass (β: 0.10, 95 % CI: 0.01, 0.39), and odds of overweight/obesity (odds ratio: 1.25, 95 % CI: 1.01, 1.53). However, after adjusting for study quality, these associations became non-significant. Additionally, weekday-to-weekend bedtime difference was significantly and positively associated with BMI-z (β: 0.07, 95 % CI: 0.01, 0.10). Elevated intradaily variability was…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 197,873 participants or records.

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