ArticleTranslational pediatrics2026
Association of a 'three meals and sleep routine' lifestyle intervention with weight and metabolic health in children with obesity: a prospective, single-arm pilot study.
Article in Translational pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intensive health behavior and lifestyle treatment is the foundation of pediatric obesity care, but sustained adherence and weight-loss maintenance remain difficult. Regular meal and sleep timing may complement standard care, although pediatric interventional evidence is limited. This prospective, single-arm pilot study aimed to evaluate longitudinal changes in weight, body composition, and metabolic markers during a 'three meals and sleep routine' (TMSR) intervention. Methods: This prospective, single-center, single-arm pilot study consecutively included 119 children with obesity aged 5-18 years [body mass index (BMI)-for-age Z-score (BAZ) >2] from January 2022 to December 2023. Families received nutritionist-led written guidance for three structured meals per day, no caloric intake between meals, age-based energy targets of 1,500-2,300 kcal/day, a protocol-defined minimum of 7.5 hours of nighttime sleep with lights off by 22:30, and maintenance of habitual physical activity. Follow-up was planned at approximately 2-month intervals but occurred according to clinical availability. Anthropometry, bioelectrical-impedance body composition, and fasting metabolic markers were assessed. Adherence, dietary intake, sleep, and physical activity were not objectively monitored. Generalized linear mixed models used available repeated measurements to estimate average within-cohort change over time. Results: The cohort had a mean age of 10.24±2.33 years; 82 participants (68.9%) were male and 37 (31.1%) were female. The fitted BMI trajectory decreased from approximately 26.0 kg/m Conclusions: In this uncontrolled cohort, several anthropometric and metabolic measures improved during the first 4-6 months, but BMI, BAZ, adiposity measures, insulin, and glucose later showed partial rebound. The findings are preliminary and hypothesis-generating; the absence of a comparator and objective adherence data precludes causal attribution to TMSR and limits assessment of durability and safety. Controlled, multicenter studies with age-appropriate sleep targets and objective behavioral monitoring are needed.
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