Karen Bonuck, Albert Einstein College of Medicine – Sleep & Childhood Obesity Risk Factors

Karen BonuckA holistic approach to wellness examines all influencing factors.

Karen Bonuck, a professor at Albert Einstein College of Medicine, is studying the relationship shared by sleep and childhood obesity.

Dr. Karen Bonuck is an epidemiologist who conducts research on pediatric sleep and parent-child interventions.

Dr. Bonuck has published extensively on the impact sleep-disordered breathing and/or short sleep duration has on children, including their behavioral difficulties (Pediatrics, March 2012), special education (Pediatrics, Sept. 2012), and obesity (The Journal of Pediatrics, Dec. 2014).
She also has experience in clinical trials of anticipatory guidance- breastfeeding, bottle-weaning, oral health and sleep. Her research has been featured in The New York Times, CBS Evening News, The Huffington Post and many more major media outlets and influenced clinical and parental guidelines issued by major pediatric organizations.

Dr. Bonuck joined Montefiore Medical Center/Albert Einstein College of Medicine while working on her doctoral dissertation in social work. After her Ph.D. on the unmet needs of persons with HIV/AIDS, she conducted assessments of the housing and nutritional needs of persons with HIV/AIDS for New York State and New York City.

After a major shift in focus, Dr. Bonuck received funding from the National Institutes of Health in 2007 for two new breastfeeding promotion clinical trials. Dr. Bonuck also works with a WIC nutritionist on the pernicious effects (i.e., obesity, iron deficiency) of prolonged/excessive bottle-feeding in children.

Sleep & Childhood Obesity Risk Factors


Childhood obesity begins early, and tracks with age, bringing with it increased risks of cardiovascular, diabetes, stigma and other effects. Treatments are resource intensive, and not very effective. Our recent study looked at two potentially modifiable risk factors for childhood obesity– short sleep duration and SDB which includes snoring and sleep apnea.  Both share many common pathways to obesity, e.g., insulin resistance and hormonal disturbances, but no study had yet tracked their independent effects, over time, upon weight gain throughout childhood.

We analyzed data collected on nearly 2,000 children by the Avon Longitudinal Study of Parents and Children (ALSPAC) based in Avon, England. ALSPAC collected parent questionnaire data on both child sleep duration and SDB symptoms from birth through 6.75 years, as well as data on child weight through 15 years of age.

We found that children with the most severe SDB were at greatest risk for obesity. These children with the “worst case” of SDB were twice as likely to become obese by 7, 10 and 15 years of age, compared to an asymptomatic group. Children whose SDB peaked later, around 5 to 6 years old, fared better but still had a 60 to 80 percent increased risk of becoming obese.

Turning to sleep duration, children with the shortest sleep time at approximately 5 and 6 years of age had a 60 to 100 percent increased risk of being obese at 15 years. Associations between short sleep time and obesity  at other ages bordered on statistical significance.

Thus, we found that SDB and lack of sleep were both equally strong risk factors for obesity, but their effects were independent of each other.

Our findings affirm the concept of healthy sleep, broadly conceived, as a foundation for healthy weight throughout childhood and into adulthood. A common cause of  SDB is enlarged tonsils or adenoids, which can be removed through surgery. As for lack of sufficient sleep, which affects 25 to 50 percent of preschoolers, learning and practicing good sleep habits can promote healthy sleep and longer sleep duration.  As the old saying goes “an ounce of prevention is worth a pound of cure.”

 Read More: Einstein News: Kids’ Snoring Linked to Hyperactivity: Kids’ Abnormal Breathing During Sleep Linked to Increased Risk for Behavioral Difficulties


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