Can poor sleep, body fat mass, and low physical activity contribute mutually to an increase in childhood obesity?

Childhood obesity is a worldwide epidemic and a public health problem. Sleep is an important factor in this process, and its quality and duration are associated with metabolism, eating behavior, cognition, and psychology. Physical activity encompasses hormonal, thermoregulatory, fatiguing, and restorative processes, is a metabolic regulator of sleep, and modestly reduces body fat through elevated energy expenditure and metabolic regulation. The relationships among obesity, sleep, and physical activity in childhood need to be better understood. Physical activity regulates circadian rhythms and metabolic alterations that can improve sleep quality and minimally reduce adiposity and the incidence of obesity. Poor sleep quality is associated with higher body mass index and lower levels of physical activity, contributing to increased caloric intake through hormonal deregulation related to eating behavior. Thus, poor sleep contributes to higher energy intake and lower daily caloric expenditure through a sedentary lifestyle.