Association of nocturnal lifestyle with overweight and obesity: a cross-sectional study based on SHOOW (Shanghai Overweight/Obesity and Wellness Study) cohort
5 affiliations
- 1Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- 2Department of Endocrinology, Gansu Provincial Hospital
- 3Shanghai Health Development Research Center (Shanghai Medical Information Center)
- 4Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
- 5Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University
Abstract
Background This study aims to examine the associations between nocturnal lifestyle and overweight/obesity, especially central obesity. While most previous studies have examined individual nocturnal lifestyle factors separately, this study simultaneously evaluates three nocturnal lifestyle behaviors (weekly midnight snack frequency, bedtime, and sleep duration) in a clinical sample of overweight and obese adults, with a specific focus on central obesity indicators. Methods The study was based on clinical data of 1295 overweight and obese patients collected from a weight management outpatient clinic. We analyzed the associations between weekly midnight snack frequency, bedtime, sleep duration and obesity-related indicators. Results Female patients accounted for 69.19% (896 cases) and male patients accounted for 30.81% (399 cases). Young and middle-aged adults (18–49 years old) constituted the largest proportion, reaching 91.51%. In terms of weekly midnight snack frequency, 58.92% of patients (763 cases) did not consume midnight snacks, 29.96% (388 cases) consumed midnight snacks 1–3 times per week, and 11.12% (144 cases) consumed midnight snacks 4–7 times per week. The largest group of patients (786 cases, 60.70%) went to bed between 22:00 and 24:00, while 409 patients (31.58%) fell asleep between 24:00 and 2:00. Most patients (1111 cases, 85.79%) had a nocturnal sleep duration of 4–8 h. Univariate linear regression analysis showed that weekly midnight snack frequency (4–7 times/week) was significantly positively associated with body mass index (BMI, P = 0.017) and waist circumference (WC, P = 0.003); weekly midnight snack frequency (1–3 times/week) was significantly positively associated with waist-to-hip ratio (WHR, P = 0.009). Compared with the 22:00–24:00 bedtime group, the after 2:00 group was significantly associated with all obesity indicators. The 24:00–2:00 group was significantly associated with all obesity indicators except body fat percentage (BFP). Concerning sleep duration, compared with the 4–8 h group, the > 8 h group was significantly associated with higher BMI (P = 0.002), neck circumference (NC, P = 0.008), WC (P = 0.003), WHR (P = 0.046) and upper arm circumference (UAC, P = 0.008). Multivariate linear regression analysis further confirmed that WC and WHR was jointly associated with weekly midnight snack frequency, bedtime and sleep duration. Conclusion Nocturnal lifestyle was mainly associated with central obesity indicators, and adjustment of nocturnal lifestyle habits may be a consideration for central obesity prevention efforts.
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BibTeX
@article{li2026association,
title = {{Association of nocturnal lifestyle with overweight and obesity: a cross-sectional study based on SHOOW (Shanghai Overweight/Obesity and Wellness Study) cohort}},
author = {Huaifeng Li and Jing Feng and Wendi Cheng and Qiwen Feng and Wenjie Tian and Jiatian Cao and Wei Gong and Bo Li},
journal = {BMC Public Health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28640-2},
url = {https://doi.org/10.1186/s12889-026-28640-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of nocturnal lifestyle with overweight and obesity: a cross-sectional study based on SHOOW (Shanghai Overweight/Obesity and Wellness Study) cohort
AU - Huaifeng Li
AU - Jing Feng
AU - Wendi Cheng
AU - Qiwen Feng
AU - Wenjie Tian
AU - Jiatian Cao
AU - Wei Gong
AU - Bo Li
PY - 2026
DA - 2026/07/01
JO - BMC Public Health
DO - 10.1186/s12889-026-28640-2
UR - https://doi.org/10.1186/s12889-026-28640-2
AB - Background This study aims to examine the associations between nocturnal lifestyle and overweight/obesity, especially central obesity. While most previous studies have examined individual nocturnal lifestyle factors separately, this study simultaneously evaluates three nocturnal lifestyle behaviors (weekly midnight snack frequency, bedtime, and sleep duration) in a clinical sample of overweight and obese adults, with a specific focus on central obesity indicators. Methods The study was based on clinical data of 1295 overweight and obese patients collected from a weight management outpatient clinic. We analyzed the associations between weekly midnight snack frequency, bedtime, sleep duration and obesity-related indicators. Results Female patients accounted for 69.19% (896 cases) and male patients accounted for 30.81% (399 cases). Young and middle-aged adults (18–49 years old) constituted the largest proportion, reaching 91.51%. In terms of weekly midnight snack frequency, 58.92% of patients (763 cases) did not consume midnight snacks, 29.96% (388 cases) consumed midnight snacks 1–3 times per week, and 11.12% (144 cases) consumed midnight snacks 4–7 times per week. The largest group of patients (786 cases, 60.70%) went to bed between 22:00 and 24:00, while 409 patients (31.58%) fell asleep between 24:00 and 2:00. Most patients (1111 cases, 85.79%) had a nocturnal sleep duration of 4–8 h. Univariate linear regression analysis showed that weekly midnight snack frequency (4–7 times/week) was significantly positively associated with body mass index (BMI, P = 0.017) and waist circumference (WC, P = 0.003); weekly midnight snack frequency (1–3 times/week) was significantly positively associated with waist-to-hip ratio (WHR, P = 0.009). Compared with the 22:00–24:00 bedtime group, the after 2:00 group was significantly associated with all obesity indicators. The 24:00–2:00 group was significantly associated with all obesity indicators except body fat percentage (BFP). Concerning sleep duration, compared with the 4–8 h group, the > 8 h group was significantly associated with higher BMI (P = 0.002), neck circumference (NC, P = 0.008), WC (P = 0.003), WHR (P = 0.046) and upper arm circumference (UAC, P = 0.008). Multivariate linear regression analysis further confirmed that WC and WHR was jointly associated with weekly midnight snack frequency, bedtime and sleep duration. Conclusion Nocturnal lifestyle was mainly associated with central obesity indicators, and adjustment of nocturnal lifestyle habits may be a consideration for central obesity prevention efforts.
SN - 1471-2458
ER -