Title : The effect of prebiotic food on sleep patterns during complementary feeding – A study protocol
Abstract:
Sleep plays a critical role in promoting healthy brain development, including cognitive function, memory, and language development. Sleep deprivation and related issues have been associated with obesity and behavioural problems later in life. One of the most commonly reported infant sleep-related issues by parents is frequent night waking, with many parents believing hunger to be one of the main causes of their infants waking up at night. Prebiotic foods are a potential solution for hunger-induced night waking. Prebiotic foods contain complex carbohydrates such as resistant starches that are not digested in the upper digestive tract but are fermented by the gut microbiota in the colon, resulting in the production of short-chain fatty acids (SCFAs). Propionate, one of the SCFAs produced, is a primary substrate for gluconeogenesis in the liver - a metabolic pathway that allows the body to generate glucose from non-carbohydrate sources such as amino acids and fatty acids. The increased production of SCFAs and subsequent conversion to glucose in the liver may enhance satiety, thereby keeping infants fuller for longer periods, leading to longer uninterrupted sleep periods and fewer night wakings.
A double-blinded Randomised Controlled Trial (RCT) has been designed to determine the effects of a prebiotic food: a New Zealand-grown sweet potato locally known as k?mara, with or without the added effect of green banana resistant starch, on the development of the infant immune system. As a secondary objective, sleep data were collected to explore the relationship between prebiotic feeding and infant sleep patterns. The study aims to recruit three hundred infants around six months of age, prior to starting solids, from Auckland, New Zealand. The study design consists of three parallel arms, including two intervention groups: standard k?mara (K) and k?mara with added green banana resistant starch (K+), as well as a control group (complementary feeding as per New Zealand National Dietary Guidelines). Infant stool samples and sleep data were collected at three time points: when the infants were 6 months old (baseline), 8 months old, and 10 months old. To obtain a true reflection of infant sleep patterns, both subjective assessment tools (a parent-completed sleep diary and Brief Infant Sleep Questionnaire) and an objective assessment tool (5-day actigraphy) were used. Infant stool samples were analysed to assess gut microbiota diversity and Short-Chain Fatty Acid content.
This study is the first large-scale Randomised Control Trial to investigate the causal relationship between prebiotic feeding and infant sleep, providing a possible explanation of the mechanism behind the changes through the alteration in short-chain fatty acids and microbial diversity.
Audience Take Away:
- The feasibility of conducting a feeding trial in infants.
- Sleep assessment tools that could be used to capture a true reflection of infants' sleep patterns will be described. Novel ways to subjectively and objectively measure infant sleep through the use of sleep records and questionnaires, and the use of actigraphs attached to the calf with Neoprene bands.
- Building on previous research (Heath et al. 2020) to gain insights into the relationship between microbial metabolites (Short Chain Fatty Acid Production) and infant sleep patterns.
