Effects of Midnight Eating Habits and Sleep Duration on the

Incidence of Overnutrition in Adolescents in Medan City

Yatty Destani Sandy

, Erni Rukmana

, Kanaya Yori Damanik

and Tyas Permatasari

Nutrition Study Program, Universitas Negeri Medan, Medan, Indonesia

Keywords: Midnight Eating, Sleep Duration, Overnutrition.

Abstract:

College students constitute a cohort of late adolescents undergoing a phase of rapid growth and development,

necessitating adequate food intake, sufficient sleep, and the cultivation of sound dietary practices. The purpose

of this study was to analyze the relationship between night eating patterns and sleep duration on the incidence

of overnutrition among college students in Medan City. The research adopts a cross-sectional design,

encompassing active students aged 18 to 25 years. Data collection involves interviews, anthropometric

measurements, and questionnaire completion. The research instrument used The Night Eating Diagnostic

Questionnaire (NEDQ) and The Pittsburgh Sleep Quality Index (PSQI). Overnutrition is determined by body

weight divided by height in meters squared. Data analysis used the chi-square test. The study encompasses

138 participants, wherein 64.5% exhibit a penchant for midnight eating and 69.6% report suboptimal sleep

durations. Outcomes manifest a discernible correlation between midnight eating habits (p = 0.017) and sleep

duration (p = 0.022) with the incidence of overnutrition. Students partaking in late-night eating rituals and

enduring inadequate sleep are predisposed to the risk of being overweight or obese.

1 INTRODUCTION

The state of being overweight and obese exerts a

considerable impact on the well-being of adolescents

in Indonesia, with direct repercussions on both health

and psychosocial development. Furthermore, this

condition elevates the risk of non-communicable

diseases (NCDs) (Unicef, 2020). Adolescence,

marked by significant changes in various life

domains, encompasses a period characterized by

rapid growth in both weight and height. College

students, comprising a late adolescent demographic

aged between 18 and 25 years, find themselves within

a crucial phase of growth and development. To

navigate this phase successfully, they necessitate

adequate nutrition, engagement in physical activity,

and sufficient sleep duration (Mufidah & Soeyono,

2021). The profound transformations inherent in late

adolescence are influenced by several factors

including customary values of culture, family,

friendship, and socio-economy. These dynamics

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render adolescents particularly vulnerable to health

issues associated with their nutritional status

(Laurson et al., 2015).

The prevalence of nutritional challenges escalates

consistently from late adolescence into adulthood.

The 2018 Riskesdas findings underscore this trend,

revealing an upswing in the prevalence of obesity

from 14.8% at 18 years to 21.8%. Concurrently,

central obesity has witnessed an increase from 26.6%

to 31% in 2018 (Riskesdas, 2018). Notably, research

conducted in Bosnia indicates that nutritional issues

extend to students, with 18.09% of adolescents

grappling with overnutrition (Delvarianzadeh et al.,

2016). Within the Indonesian context, nutrition-

related problems are also evident among final-year

students. In Medan City, 40.8% of adolescents are

classified as obese, while 56.9% fall within the

overweight category. Similarly, in Semarang, the

prevalence of obesity is reported at 41.3% (Irfan &

Ayu, 2022; Sandy et al., 2023; Wijayanti et al., 2019).

This collective evidence underscores a persistent

Sandy, Y. D., Rukmana, E., Damanik, K. Y. and Permatasari, T.

Effects of Midnight Eating Habits and Sleep Duration on the Incidence of Overnutrition in Adolescents in Medan City.

DOI: 10.5220/0012901100004564

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 5th International Conference on Social Determinants of Health (ICSDH 2023), pages 87-92

ISBN: 978-989-758-727-6; ISSN: 2975-8297

upward trajectory in the prevalence of obesity issues

among late adolescents.

Overnutrition status observed in adolescents is

attributable an imbalance between dietary

consumption and physical activity levels. The

primary contributors to overnutrition encompass the

selection of calorie-dense, low-fiber foods coupled

with insufficient physical activity. Research

conducted on college students or late adolescents

substantiates this phenomenon, revealing eating

behaviour characterized by diminished vegetable

consumption and heightened intake of energy-dense

foods (Roy et al., 2019).

Student commonly find themselves immersed in

both academic and non-academic commitments,

contending with numerous demanding assignments,

stringent Grade Point Average (GPA) expectations,

and challenges within student organizations. The

exigencies of these multifaceted responsibilities can

influence their eating habits. Particularly, college

students in big cities usually engage in activities

extending late into the night, leading to delayed sleep

onset and, consequently, an extended period of

wakefulness. This prolonged wakefulness tends to

prompt increased food consumption. Notably, the

practice of consuming food in close proximity to

bedtime can have adverse health effects, including an

elevated susceptibility to degenerative diseases,

diabetes, obesity, and alterations in body composition

(Kinsey & Ormsbee, 2015). Research findings further

indicate a heightened risk of metabolic disorders,

such as Type 2 Diabetes Mellitus (DM), among

individuals with late meal times attributed to impaired

glucose tolerance linked to elevated melatonin

concentrations (Lopez-Minguez et al., 2018).

The imposition of deadlines for academic

assignments and external engagements within student

organizations is concomitant within reduced sleep

duration. This abbreviated period of rest is intricately

linked to heightened consumption of deleterious

foods, including sugary beverages, fast food, and

instant noodles, while concurrently contributing to

diminished intake of vegetables, fruits, and milk (Min

et al., 2018). According to data from the Sleep

Foundation in 2020, chronic sleep disorders afflict

15-30% of adults (Suni & Debanto, 2022). Another

study reported that inadequate sleep duration is

associated with unhealthy eating patterns. Prior

investigations have consistently demonstrated a

robust association between sleep duration and the

regulation of appetite-regulating hormones, thereby

influencing food choices (Anindiba et al., 2022;

Jansen et al., 2019).

2 METHOD

This study employed a cross sectional study design

and was conducted in June 2023. The research

targeted active students residing in Medan City, with

the subject selection method based on the average

estimation formula, resulting in a sample size of 138

students chosen through purposive sampling.

Inclusion criteria encompassed students who

willingly consented to participate, were illness free,

and fell within the age range of 18-25 years.

Conversely, exclusion criteria were applied to

subjects who declined participation or were currently

unwell.

Primary data served as the basis for data

collection, encompassing subject characteristics

(name, gender, date of birth, age, address, ethnic

origin) family socio-economic status (parental

education, parental income, and amount of pocket

money), body mass index (height and weight), night

eating habits, and sleep duration.

The acquisition of body weight data involved

measurements using a digital scale with an accuracy

of 0.1 kg, while body height data was obtained

through measurements using a microtoise with an

accuracy of 0.1 cm.

The nutritional status of subjects was assessed

based on the Body Mass Index (Kemenkes, 2020).

The assessment of eating habits questionnaire utilized

the night eating diagnostic questionnaire (NEDQ)

(Nolan & Geliebter, 2017), while sleep duration was

evaluated using the Pittsburgh Sleep Quality Index

(PSQI) questionnaire (Winer et al., 2021).

Data collected from the study underwent both

univariate and bivariate analyses. Univariate analysis

was employed to elucidate the data characteristics of

the subject, while bivariate analysis utilized the chi-

square test to examine the relationship between

midnight eating habits, sleep duration and Body Mass

Index.

This research obtained approval from the

Research Ethics Committee of the Faculty of

Medicine, University of Kristen Maranatha. The

approval was granted through Decision Letter No:

130/KEP/VI/2023 on June 7, 2023.

3 RESULT

The characteristic data shows that the study

encompassed a total of 138 people, as depicted in

Table 1. The female subjects predominated,

comprising 74.6% of the total cohort. All participants

ICSDH 2023 - The International Conference on Social Determinants of Health

were in their late teens, falling within the age range of

19-24 years old.

Table 1 further illustrates that the majority of the

subjects were in semesters IV and V, constituting

55.8% of the total. A notable proportion, accounting

for 60.1% of resided with their parents, as opposed to

those residing in boarding houses or with relatives.

Concerning family income, more than half of the

subjects (58.7%) fell within the category equal to or

greater than the Average Minimum Wage (UMR). In

terms of parental education, a significant portion of

parents had completed high school, representing a

range of 55-58%. Conversely, parents with a college

degree comprised a percentage ranging from 22-

25.4% of the total subjects.

Table 1. Characteristics of Respondents.

Variable Category N (%)

Gende

Male 35 25.4

Female 103 74.6

e Middle adolescent 0 0

Late adolescent 138 100

Semeste

Early (II) 17 12.3

Middle

(

-VI

)

77 55.8

Last

(

≥VIII

)

44 31.9

Residence Boardin

house 47 34.1

With parents 83 60.1

With relatives 8 5.8

Family Income < UMR 57 41.3

≥ UMR 81 58.7

Father’s Last

Education

No school 3 2.2

Elementary School 9 6.5

Junior Hi

h School 15 10.9

Senior Hi

h School 80 58

College/Universit

31 22.5

Mother’s Last

Education

No school 1 7

Elementar

School 9 6.5

Junior High School 16 11.6

Senior High School 77 55.8

College/Universit

35 25.4

Midnight Eating

Habits

Not often 49 35.5

Often 89 64.5

Slee

Duration Normal 42 30.4

Abnormal 96 69.6

Overnutrition Not overnutrition 89 64.5

Overnutrition 49 35.5

The findings presented in Table 1 indicate that

64.5% of students frequently engage in the midnight

eating habits, encompassing the consumption of both

snacks and substantial meals. Moreover, 69,6% of

students exhibit abnormal nigh sleep hours,

comprising both insufficient and excessive sleep

durations, while only 30.4% maintain a normal night

sleep duration of 7-9 hours. Furthermore, 35.5% of

students experience overnutrition, encompassing

both overweight and obesity.

Examining the data in Table 2, it is evident that

27.5% of subjects frequently indulge in midnight

eating habits and concurrently experience excess

nutrition. Additionally, 29% of subjects with

abnormal night sleep durations exhibit a higher

prevalence of overnutrition. This prevalence

surpasses that observed in subjects who infrequently

engage in midnight eating and maintain normal night

sleep durations.

Table 2. Bivariate Test Results.

Midnight

Eating

Habits

Overnutrition Occurrences

Total

Not over

nutrition

Overnutrition

N % N % N %

Not

often

38 27.5 11 8 49 35.5

0.0

Often 51 37 38 27.5 89 64.5

Total 89 64.5 49 35.5 138 100

Sleep

Duration

Overnutrition Occurrences

Total

Not over

nutrition

Overnutrition

N % N % N %

Normal 33 23.9 9 6.5 42 30.4

0.0

Abnor

mal

56 40.6 40 29 96 69.6

Total 89 64.5 49 35.5 138 100

Table 2 presents the outcomes of the bivariate

analysis utilizing the chi-square test. The results of

the chi square test indicate a statistically significant

association between midnight eating habits and the

incidence of overnutrition among adolescents in the

city of Medan (p-value 0.017). Furthermore, the

results of the bivariate analysis reveal a significant

relationship between sleep duration and the incidence

of overnutrition in adolescents in Medan City (p-

value 0.002).

4 DISCUSSION

Contemporary research has extensively explored the

correlation between eating habits and obesity. The

body's metabolism at night tends to decelerate,

requiring less energy compared to the morning and

daytime. Therefore, individuals who frequently

consume substantial amounts of food at night may

experience an energy imbalance, particularly

considering the reduced physical activity during

night-time (Evan et al., 2017).

Effects of Midnight Eating Habits and Sleep Duration on the Incidence of Overnutrition in Adolescents in Medan City

The study findings indicate a discernible

association between the habit of eating late at night

and the incidence of overnutrition in adolescents. In

terms of proportion, the prevalence of overnutrition is

notably higher among adolescents who frequently

engage in midnight eating. Specifically, out of 49

adolescents with overnutrition, 38 exhibits a tendency

to consume food late at night, while the remaining 11

fall into the category of rare midnight eating. The

results of the bivariate analysis corroborate this

observation, revealing a statistically significant

relationship between midnight eating habits and. the

incidence of overnutrition in adolescents in the city of

Medan (p-value 0.017).

The consumption of meals during late-night hours

has been associated with diminished energy

expenditure, a consequence of reduced leptin levels,

heightened hunger, increased appetite, and

subsequent weight gain (Vujović et al., 2022).

Additionally, eating at night has been found to

significantly elevate glucose, insulin, and triglyceride

levels, resulting in diminished insulin sensitivity

(Kessler & Pivovarova-Ramich, 2019). Further

studies, such as the one conducted by Firmanurochim

et al., (2021) have reinforced the existence of a

significant relationship between dinner habits and the

incidence of obesity in young women.

Obese individuals classified under the Metabolic

Unhealthy Obese type often exhibit night eating

syndrome, a pattern characterized by the omission of

breakfast, the consumption of large dinner portions

after 7 pm, and compromised sleep patterns. To

mitigate the risk of metabolic disorder, Leksono et al.,

(2022) propose reduction in the frequency and

duration of dinner.

The results of the bivariate analysis further reveal

a statistically significant relationship between sleep

duration and the incidence of overnutrition (p=0.022).

A noteworthy 81.6% adolescents with overnutrition

exhibit abnormal sleep duration. According to age-

based recommendations, adolescents typically

require approximately 7-8 hours of sleep per day, as

stipulated by the Ministry of Health guidelines

(Kemenkes, 2021). Insufficient sleep can lead to

various disorders, including disruption in the

regulation of hormones such as leptin and ghrelin,

which play crucial roles in appetite regulation and

food intake (Leksono et al., 2022).

Sleep duration has been identified as a factor

contributing to overweight and obesity. Over the past

century, a reduction in sleep duration by 1.5 hours per

day has been observed, attributed to factors such as

work schedules, insufficient sleep, and exposure to

artificial light at night. This reduction in sleep

duration has been associated with an increased

prevalence of obesity, correlating with a weight gain

of approximately 5 kg and a 10% or more rise in

Body Mass Index (Y.-M. M. Park et al., 2019).

Numerous studies conducted in Korea affirm the

elevated risk of obesity in individuals with a sleep

duration of less than 7 hours per day. Additional

research indicates that adolescents with lower BMI

tend to have prolonged sleep duration (>9 hours/day),

while those with higher BMI have shorter sleep

duration (<9 hours/day) (Grandner et al., 2015; S. K.

Park et al., 2018).

Insufficient sleep duration has been identified as a

contributing factor to the incidence of obesity,

influencing weight-related behaviours. Specifically,

inadequate sleep is associated with diminished

vegetable consumption, reduced frequency of

breakfast consumption, decreased physical activity,

and elevated sugar-sweetened beverages (Widome et

al., 2019). The physiological mechanism underlying

increased food intake at night involve heightened

levels of the ghrelin hormone and diminished levels

of the leptin hormone, culminating in heightened

appetite and hunger, particularly for foods rich in

calories, carbohydrates and fat (Dashti et al., 2015;

Silva et al., 2018; Sutanto et al., 2020).

Additional investigations have highlighted the

relationship between inadequate sleep duration and

obesity through food intake, with statistically

significant correlation (p = 0.000). Rachmawati et al.,

(2021) observed that students with short sleep

duration were more likely to fall into the obese

category and exhibited increased energy intake.

Conversely, a study by Vania (2022) reported no

discernible relationship between sleep duration and

students’ nutritional status (p=0.600). Despite

relatively short sleep durations, the distribution of

nutritional status in Vania's study remained

predominantly normal (Vania & Kumala, 2022).

It is essential to acknowledge a limitation of this

study, namely, the omission of an examination of

macronutrient intake in adolescents.

5 CONCLUSION

The study findings showed a noteworthy association

between midnight eating habits, sleep duration, and

the prevalence of overnutrition among adolescents in

Medan city. Students who frequently engage

midnight eating habits coupled with aberrant sleep

durations are more susceptible to experience

overnutrition compared to their counterparts who

ICSDH 2023 - The International Conference on Social Determinants of Health

infrequently indulge in midnight and maintain normal

sleep durations.

ACKNOWLEDGMENTS

The research team expresses gratitude to all

respondents who willingly participated in this study.

Special appreciation is extended to LPPM UNIMED

for generously providing the necessary funds, thereby

facilitating the smooth and systematic execution of

the research in accordance with the planned

objectives. Sincere thanks are conveyed to all

individuals who contributed to the successful

implementation of this research.

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