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Chaput JP, Katzmarzyk PT, LeBlanc AG, Tremblay MS, Barreira TV, Broyles ST, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Rae DE, Maher C, Maia J, Matsudo V, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, Zhao P, Olds T. Associations between sleep patterns and lifestyle behaviors in children: an international comparison. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S59-65. [PMID: 27152187 DOI: 10.1038/ijosup.2015.21] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Although evidence is accumulating on the importance of a good night's sleep for healthy eating and activity behaviors, existing research has mainly been conducted in high-income, developed countries with limited sociocultural variability. This study is the first to examine the associations between sleep patterns and lifestyle behaviors in children from 12 countries in five major geographic regions of the world. METHODS This observational, multinational cross-sectional study included 5777 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom and the United States. Nocturnal sleep duration (hours per night), sleep efficiency (%) and bedtime (h:min) were monitored over 7 consecutive days using an accelerometer. Lifestyle behaviors included moderate-to-vigorous physical activity (MVPA), total sedentary time (SED), self-reported screen time (ST) and healthy/unhealthy diet patterns (HDP/UDP). Multilevel modeling analyses were used to account for the hierarchical nature of the data. RESULTS Overall, participants averaged 8.8 (s.d. 0.9) hours of sleep with 96.2% (s.d. 1.4) sleep efficiency and a mean bedtime of 2218 hours. After adjustment for age, sex, highest parental education and BMI z-score, results showed that (i) sleep duration was negatively associated with MVPA, SED and UDP score; (ii) sleep efficiency was negatively associated with MVPA and UDP score, and positively associated with SED; and (iii) later bedtime was positively associated with SED, ST and UDP score, and negatively associated with MVPA and HDP score. Results using categories of sleep patterns were consistent with the linear associations. Results also revealed that associations between sleep patterns and MVPA, SED and ST were significantly different between study sites, with stronger associations in high-income countries compared with low/middle-income countries. CONCLUSIONS Sleep characteristics are important correlates of lifestyle behaviors in children. Differences between countries suggest that interventions aimed at improving sleep and lifestyle behaviors should be culturally adapted.
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Affiliation(s)
- J-P Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - P T Katzmarzyk
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - A G LeBlanc
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada
| | - M S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - T V Barreira
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Exercise Science, University of Syracuse, Syracuse, NY, USA
| | - S T Broyles
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - M Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland
| | - G Hu
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - R Kuriyan
- St. Johns Research Institute , Bangalore, India
| | - A Kurpad
- St. Johns Research Institute , Bangalore, India
| | - E V Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa
| | - D E Rae
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa
| | - C Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal
| | - V Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo, Brazil
| | - V Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya
| | - O L Sarmiento
- School of Medicine Universidad de los Andes , Bogota, Colombia
| | - M Standage
- Department for Health, University of Bath , Bath, UK
| | - C Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - P Zhao
- Tianjin Women's and Children's Health Center , Tianjin, China
| | - T Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
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152
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Tudor-Locke C, Mire EF, Barreira TV, Schuna JM, Chaput JP, Fogelholm M, Hu G, Kurpad A, Kuriyan R, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Zhao P, Church TS, Katzmarzyk PT. Nocturnal sleep-related variables from 24-h free-living waist-worn accelerometry: International Study of Childhood Obesity, Lifestyle and the Environment. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S47-52. [PMID: 27152185 DOI: 10.1038/ijosup.2015.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We describe the process of identifying and defining nocturnal sleep-related variables (for example, movement/non-movement indicators of sleep efficiency, waking episodes, midpoint and so on) using the unique 24-h waist-worn free-living accelerometer data collected in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). METHODS Seven consecutive days of 24-h waist-worn accelerometer (GT3X+, ActiGraph LLC) data were collected from over 500 children at each site. An expert subgroup of the research team with accelerometry expertize, frontline data collectors and data managers met on several occasions to categorize and operationally define nocturnal accelerometer signal data patterns. The iterative process was informed by the raw data drawn from a sub set of the US data, and culminated in a refined and replicable delineated definition for each identified nocturnal sleep-related variable. Ultimately based on 6318 participants from all 12 ISCOLE sites with valid total sleep episode time (TSET), we report average clock times for nocturnal sleep onset, offset and midpoint in addition to sleep period time, TSET and restful sleep efficiency (among other derived variables). RESULTS Nocturnal sleep onset occurred at 2218 hours and nocturnal sleep offset at 0707 hours. The mean midpoint was 0243 hours. The sleep period time of 529.6 min (8.8 h) was typically accumulated in a single episode, making the average TSET very similar in duration (529.0 min). The mean restful sleep efficiency ranged from 86.8% (based on absolute non-movement of 0 counts per minute) to 96.0% (based on relative non-movement of <100 counts per minute). CONCLUSIONS These variables extend the potential of field-based 24-h waist-worn accelerometry to distinguish and categorize the underlying robust patterns of movement/non-movement signals conveying magnitude, duration, frequency and periodicity during the nocturnal sleep period.
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Affiliation(s)
- C Tudor-Locke
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA; Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - E F Mire
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - T V Barreira
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | - J M Schuna
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Oregon State University, Corvallis, USA
| | - J-P Chaput
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - M Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland
| | - G Hu
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - A Kurpad
- St Johns Research Institute , Bangalore, India
| | - R Kuriyan
- St Johns Research Institute , Bangalore, India
| | - E V Lambert
- Department of Human Biology, Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa
| | - C Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal
| | - V Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo, Brazil
| | - T Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - V Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya
| | - O L Sarmiento
- School of Medicine, Universidad de los Andes , Bogota, Colombia
| | - M Standage
- Department for Health, University of Bath , Bath, UK
| | - M S Tremblay
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - P Zhao
- Tianjin Women's and Children's Health Center , Tianjin, China
| | - T S Church
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - P T Katzmarzyk
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
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153
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Zakrzewski JK, Gillison FB, Cumming S, Church TS, Katzmarzyk PT, Broyles ST, Champagne CM, Chaput JP, Denstel KD, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Mire EF, Olds T, Onywera V, Sarmiento OL, Tremblay MS, Tudor-Locke C, Zhao P, Standage M. Associations between breakfast frequency and adiposity indicators in children from 12 countries. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S80-8. [PMID: 27152190 DOI: 10.1038/ijosup.2015.24] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Reports of inverse associations between breakfast frequency and indices of obesity are predominantly based on samples of children from high-income countries with limited socioeconomic diversity. Using data from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the present study examined associations between breakfast frequency and adiposity in a sample of 9-11-year-old children from 12 countries representing a wide range of geographic and socio-cultural variability. METHODS Multilevel statistical models were used to examine associations between breakfast frequency (independent variable) and adiposity indicators (dependent variables: body mass index (BMI) z-score and body fat percentage (BF%)), adjusting for age, sex, and parental education in 6941 children from 12 ISCOLE study sites. Associations were also adjusted for moderate-to-vigorous physical activity, healthy and unhealthy dietary patterns and sleep time in a sub-sample (n=5710). Where interactions with site were significant, results were stratified by site. RESULTS Adjusted mean BMI z-score and BF% for frequent breakfast consumers were 0.45 and 20.5%, respectively. Frequent breakfast consumption was associated with lower BMI z-scores compared with occasional (P<0.0001, 95% confidence intervals (CI): 0.10-0.29) and rare (P<0.0001, 95% CI: 0.18-0.46) consumption, as well as lower BF% compared with occasional (P<0.0001, 95% CI: 0.86-1.99) and rare (P<0.0001, 95% CI: 1.07-2.76). Associations with BMI z-score varied by site (breakfast by site interaction; P=0.033): associations were non-significant in three sites (Australia, Finland and Kenya), and occasional (not rare) consumption was associated with higher BMI z-scores compared with frequent consumption in three sites (Canada, Portugal and South Africa). Sub-sample analyses adjusting for additional covariates showed similar associations between breakfast and adiposity indicators, but lacked site interactions. CONCLUSIONS In a multinational sample of children, more frequent breakfast consumption was associated with lower BMI z-scores and BF% compared with occasional and rare consumption. Associations were not consistent across all 12 countries. Further research is required to understand global differences in the observed associations.
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Affiliation(s)
- J K Zakrzewski
- Department of Sport Science and Physical Activity, University of Bedfordshire , Bedford, UK
| | - F B Gillison
- Department for Health, University of Bath , Bath, UK
| | - S Cumming
- Department for Health, University of Bath , Bath, UK
| | - T S Church
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - P T Katzmarzyk
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - S T Broyles
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - C M Champagne
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - J-P Chaput
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - K D Denstel
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - M Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland
| | - G Hu
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - R Kuriyan
- St Johns Research Institute , Bangalore, India
| | - A Kurpad
- St Johns Research Institute , Bangalore, India
| | - E V Lambert
- Department of Human Biology, Faculty of Health Sciences, Division of Exercise Science and Sports Medicine, University of Cape Town , Cape Town, South Africa
| | - C Maher
- Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal
| | - V Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo, Brazil
| | - E F Mire
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - T Olds
- Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - V Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya
| | - O L Sarmiento
- School of Medicine Universidad de los Andes , Bogota, Colombia
| | - M S Tremblay
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - C Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - P Zhao
- Tianjin Women's and Children's Health Center , Tianjin, China
| | - M Standage
- Department for Health, University of Bath , Bath, UK
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154
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Tudor-Locke C, Barreira TV, Schuna JM, Katzmarzyk PT. Unique contributions of ISCOLE to the advancement of accelerometry in large studies. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S53-8. [PMID: 27152186 DOI: 10.1038/ijosup.2015.20] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Accelerometry has become a mainstay approach for objectively monitoring children's physical activity and sedentary time in epidemiological studies. The magnitude of effort underlying successful data collection, management and treatment is prodigious and its complexity has been associated with increasingly diverse methodological choices that, while defensible relative to specific research questions, conspire to undermine the ability to compare results between studies. Although respecting widespread calls for best practices, it is also important to openly share tools and resources supporting potential improvements to research practice and study design, thus allowing others to replicate, further improve, and/or otherwise build on this foundation. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is a large multinational study that included accelerometer-based measures of physical activity, sedentary time and sleep. This review summarizes the unique contributions of ISCOLE to the advancement of accelerometry in large studies of children's behavior, and in particular: (1) open-access publication of the ISCOLE accelerometry Manual of Operations; (2) 24-h waist-worn accelerometry protocol; (3) identification and extraction of nocturnal total sleep episode time (with open access to editable SAS syntax); (4) development of the first interpretive infrastructure for identifying and defining an evolved list of sleep-related variables from 24-h waist-worn accelerometry; (5) provision of a detailed model for reporting accelerometer paradata (administrative data related to accelerometry); and (6) cataloging the most detailed and defensible list of accelerometry-derived physical activity and sedentary time variables to date. The novel tools and resources associated with these innovations are shared openly in an effort to support methodological harmonization and overall advancement of accelerometry in large epidemiological studies.
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Affiliation(s)
- C Tudor-Locke
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA; Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - T V Barreira
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Syracuse University, Syracuse, NY, USA
| | - J M Schuna
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Oregon State University, Corvallis, OR, USA
| | - P T Katzmarzyk
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
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155
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Denstel KD, Broyles ST, Larouche R, Sarmiento OL, Barreira TV, Chaput JP, Church TS, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Standage M, Tremblay MS, Tudor-Locke C, Zhao P, Katzmarzyk PT. Active school transport and weekday physical activity in 9-11-year-old children from 12 countries. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S100-6. [PMID: 27152177 DOI: 10.1038/ijosup.2015.26] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Active school transport (AST) may increase the time that children spend in physical activity (PA). This study examined relationships between AST and weekday moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time (SED) and total activity during naturally organized time periods (daily, before school, during school and after school) in a sample of children from 12 countries. METHODS The sample included 6224 children aged 9-11 years. PA and sedentary time were objectively measured using Actigraph accelerometers. AST was self-reported by participants. Multilevel generalized linear and logistic regression statistical models were used to determine associations between PA, SED and AST across and within study sites. RESULTS After adjustment for age, highest parental educational attainment, BMI z-score and accelerometer wear time, children who engaged in AST accumulated significantly more weekday MVPA during all studied time periods and significantly less time in LPA before school compared with children who used motorized transport to school. AST was unrelated to time spent in sedentary behaviors. Across all study sites, AST was associated with 6.0 min (95% confidence interval (CI): 4.7-7.3; P<0.0001) more of weekday MVPA; however, there was some evidence that this differed across study sites (P for interaction=0.06). Significant positive associations were identified within 7 of 12 study sites, with differences ranging from 4.6 min (95% CI: 0.3-8.9; P=0.04, in Canada) to 10.2 min (95% CI: 5.9-14.4; P<0.0001, in Brazil) more of daily MVPA among children who engaged in AST compared with motorized transport. CONCLUSIONS The present study demonstrated that AST was associated with children spending more time engaged in MVPA throughout the day and less time in LPA before school. AST represents a good behavioral target to increase levels of PA in children.
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Affiliation(s)
- K D Denstel
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - S T Broyles
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - R Larouche
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - O L Sarmiento
- School of Medicine, Universidad de los Andes , Bogotá, Colombia
| | - T V Barreira
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Exercise Science, University of Syracuse, Syracuse, NY, USA
| | - J-P Chaput
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - T S Church
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - M Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland
| | - G Hu
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
| | - R Kuriyan
- St Johns Research Institute , Bangalore, India
| | - A Kurpad
- St Johns Research Institute , Bangalore, India
| | - E V Lambert
- Department of Human Biology, Faculty of Health Sciences, Division of Exercise Science and Sports Medicine, University of Cape Town , Cape Town, South Africa
| | - C Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal
| | - V Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , São Paulo, Brazil
| | - T Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia
| | - V Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya
| | - M Standage
- Department for Health, University of Bath , Bath, UK
| | - M S Tremblay
- Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada
| | - C Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - P Zhao
- Tianjin Women's and Children's Health Center , Tianjin, China
| | - P T Katzmarzyk
- Pennington Biomedical Research Center , Baton Rouge, LA, USA
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156
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Qiao Y, Ma J, Wang Y, Li W, Katzmarzyk PT, Chaput JP, Fogelholm M, Johnson WD, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Church TS, Zhao P, Hu G. Birth weight and childhood obesity: a 12-country study. INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2015; 5:S74-9. [PMID: 27152189 PMCID: PMC4850624 DOI: 10.1038/ijosup.2015.23] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Few studies have investigated the association between the full range of birth weight and the risk of childhood obesity in high-, middle- and low-income countries. The aim of the present study is to assess the association between different levels of birth weight and the risk of obesity among children aged 9-11 years in 12 countries. METHODS A multinational, cross-sectional study of 5141 children aged 9-11 years was conducted in 12 countries. Height and weight were obtained using standardized methods. Time spent in moderate-to-vigorous physical activity (MVPA), sedentary and sleeping were objectively measured using 24-h, waist-worn accelerometer (Actigraph GT3X+) monitored for 7 days. Birth weight and other factors (regions, parental education, maternal history of gestational diabetes, children age, gender, breast feeding, gestational age, unhealthy diet scores and healthy diet scores) were collected by parental and children's questionnaires. Multilevel modeling was used to account for the nested nature of the data. RESULTS The overall prevalence of obesity (BMI z-score>+2 s.d.) was 15.4% for boys and 10.0% for girls. There was a positive association between birth weight and BMI z-scores. The multivariable-adjusted odds ratios (ORs) of childhood obesity were significantly higher among children whose birth weights were 3500-3999 g (OR 1.45; 95% confidence interval (CI): 1.10-1.92), and >4000 g (OR 2.08; 95% CI: 1.47-2.93), compared with the reference group (2500-2999 g). The positive association between birth weight and the odds of childhood obesity was seen in girls, whereas a U-shaped association appeared in boys. CONCLUSIONS High levels of birth weight, defined as birth weight ⩾3500 g, were associated with increased odds of obesity among 9-11-year-old children in 12 countries. However, sex differences in the association between birth weight and the risk of obesity need to be considered when planning interventions to reduce childhood obesity.
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Affiliation(s)
- Y Qiao
- Tianjin Women's and Children's Health Center, Tianjin, China
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - J Ma
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Y Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - W Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - P T Katzmarzyk
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - J-P Chaput
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - M Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - W D Johnson
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - R Kuriyan
- St Johns Research Institute, Bangalore, India
| | - A Kurpad
- St Johns Research Institute, Bangalore, India
| | - E V Lambert
- Department of Human Biology, Faculty of Health Sciences, Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - C Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal
| | - V Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS), Sao Paulo, Brazil
| | - T Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - V Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya
| | - O L Sarmiento
- School of Medicine, Universidad de los Andes, Bogota, Colombia
| | | | - M S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - C Tudor-Locke
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - T S Church
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - P Zhao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - G Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - for the ISCOLE Research Group
- Tianjin Women's and Children's Health Center, Tianjin, China
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
- St Johns Research Institute, Bangalore, India
- Department of Human Biology, Faculty of Health Sciences, Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS), Sao Paulo, Brazil
- Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya
- School of Medicine, Universidad de los Andes, Bogota, Colombia
- University of Bath, Bath, UK
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
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157
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Criteria for nap identification in infants and young children using 24-h actigraphy and agreement with parental diary. Sleep Med 2015; 19:85-92. [PMID: 27198952 DOI: 10.1016/j.sleep.2015.10.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 10/30/2015] [Accepted: 10/31/2015] [Indexed: 11/21/2022]
Abstract
STUDY OBJECTIVES The study aimed to determine if an automated algorithm, capable of batch scoring, could extract naps and other 24-h sleep-wake variables from actigraphy without the need for parental sleep diaries, which rely heavily on parental awareness of child sleep. DESIGN A cross-sectional design was used for the study. SETTING The study examined healthy infants/children in their home setting. PARTICIPANTS A total of 160 infants/children in five age groups (6 months, and 1, 2, 3½ and 5 years) participated in the study. MEASUREMENTS AND RESULTS Participants wore actigraphs for 5-7 days, and parents completed sleep diaries over 2 consecutive days. Three criteria were applied to find the minimum sleep time (20, 30 and 40 min) yielding the best nap agreement between diaries and actigraphy for nap/no-nap identification. Best agreements were 72.1% (20 min minimum), 78.4% (20 min), 91.0% (30 min) and 93.3% (30 min) for ages 6 months, 1, 2 and 3½ years, respectively. Kappa statistics classified nap-nap agreement as 'slight' for 6-month data but 'moderate' or 'almost perfect' for older age groups. The number of daytime naps extracted at each age group yielded no significant discrepancies between the methods. Diaries generally returned significantly earlier sleep onset, later sleep offset, longer sleep duration and fewer night wakings at 6 months and 1 and 2 years, but this was not significant at 3½ or 5 years of age. CONCLUSIONS Minimum age-specific sleep time thresholds are recommended to improve nap identification in actigraphy across infant and toddler age groups. The findings strengthen our confidence in the ability to collect actigraphy data in the absence of parental diaries, in 3½- and 5-year-olds, at least.
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158
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Quante M, Kaplan ER, Rueschman M, Cailler M, Buxton OM, Redline S. Practical considerations in using accelerometers to assess physical activity, sedentary behavior, and sleep. Sleep Health 2015; 1:275-284. [PMID: 29073403 DOI: 10.1016/j.sleh.2015.09.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/03/2015] [Accepted: 09/03/2015] [Indexed: 12/11/2022]
Abstract
Increasingly, behavioral and epidemiological research uses activity-based measurements (accelerometry) to provide objective estimates of physical activity, sedentary behavior, and sleep in a variety of study designs. As interest in concurrently assessing these domains grows, there are key methodological considerations that influence the choice of monitoring instrument, analysis algorithm, and protocol for measuring these behaviors. The purpose of this review is to summarize evidence-guided information for 7 areas that are of importance in the design and interpretation of studies using actigraphy: (1) choice of cut-points; (2) impact of epoch length; (3) accelerometer placement; (4) duration of monitoring; (5) approaches for distinguishing sleep, nonwear times, and sedentary behavior; (6) role for a sleep and activity diary; and (7) epidemiological applications. Recommendations for future research are outlined and are intended to enhance the appropriate use of accelerometry for assessing physical activity, sedentary behavior, and sleep behaviors in research studies.
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Affiliation(s)
- Mirja Quante
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA 02115
| | - Emily R Kaplan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, Boston, MA 02115
| | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, Boston, MA 02115
| | - Michael Cailler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, Boston, MA 02115
| | - Orfeu M Buxton
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA 02115; Department of Biobehavioral Health, Pennsylvania State University, 221 Biobehavioral Health Building, University Park, PA 16802; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Kresge Building, Boston, MA 02115
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA 02115; Sleep Disorders Center, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115.
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KATZMARZYK PETERT, BARREIRA TIAGOV, BROYLES STEPHANIET, CHAMPAGNE CATHERINEM, CHAPUT JEANPHILIPPE, FOGELHOLM MIKAEL, HU GANG, JOHNSON WILLIAMD, KURIYAN REBECCA, KURPAD ANURA, LAMBERT ESTELLEV, MAHER CAROL, MAIA JOSE, MATSUDO VICTOR, OLDS TIMOTHY, ONYWERA VINCENT, SARMIENTO OLGAL, STANDAGE MARTYN, TREMBLAY MARKS, TUDOR-LOCKE CATRINE, ZHAO PEI, CHURCH TIMOTHYS. Physical Activity, Sedentary Time, and Obesity in an International Sample of Children. Med Sci Sports Exerc 2015; 47:2062-9. [DOI: 10.1249/mss.0000000000000649] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chu AHY, Ng SHX, Koh D, Müller-Riemenschneider F. Reliability and Validity of the Self- and Interviewer-Administered Versions of the Global Physical Activity Questionnaire (GPAQ). PLoS One 2015; 10:e0136944. [PMID: 26327457 PMCID: PMC4556683 DOI: 10.1371/journal.pone.0136944] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 08/11/2015] [Indexed: 12/17/2022] Open
Abstract
Objective The Global Physical Activity Questionnaire (GPAQ) was originally designed to be interviewer-administered by the World Health Organization in assessing physical activity. The main aim of this study was to compare the psychometric properties of a self-administered GPAQ with the original interviewer-administered approach. Additionally, this study explored whether using different accelerometry-based physical activity bout definitions might affect the questionnaire’s validity. Methods A total of 110 participants were recruited and randomly allocated to an interviewer- (n = 56) or a self-administered (n = 54) group for test-retest reliability, of which 108 participants who met the wear time criteria were included in the validity study. Reliability was assessed by administration of questionnaires twice with a one-week interval. Criterion validity was assessed by comparing against seven-day accelerometer measures. Two definitions for accelerometry-data scoring were employed: (1) total-min of activity, and (2) 10-min bout. Results Participants had similar baseline characteristics in both administration groups and no significant difference was found between the two formats in terms of validity (correlations between the GPAQ and accelerometer). For validity, the GPAQ demonstrated fair-to-moderate correlations for moderate-to-vigorous physical activity (MVPA) for self-administration (rs = 0.30) and interviewer-administration (rs = 0.46). Findings were similar when considering 10-min activity bouts in the accelerometer analysis for MVPA (rs = 0.29 vs. 0.42 for self vs. interviewer). Within each mode of administration, the strongest correlations were observed for vigorous-intensity activity. However, Bland-Altman plots illustrated bias toward overestimation for higher levels of MVPA, vigorous- and moderate-intensity activities, and underestimation for lower levels of these measures. Reliability for MVPA revealed moderate correlations (rs = 0.61 vs. 0.63 for self vs. interviewer). Conclusions Our findings showed comparability between both self- and interviewer-administration modes of the GPAQ. The GPAQ in general but especially the self-administered version may offer a relatively inexpensive method for measuring physical activity of various types and at different domains. However, there may be bias in the GPAQ measurements depending on the overall physical activity. It is advisable to incorporate accelerometers in future studies, particularly when measuring different intensities of physical activity.
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Affiliation(s)
- Anne H. Y. Chu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- * E-mail:
| | - Sheryl H. X. Ng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - David Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, Brunei Darussalam
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre Berlin, Berlin, Germany
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161
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Pereira S, Gomes TN, Borges A, Santos D, Souza M, dos Santos FK, Chaves RN, Katzmarzyk PT, Maia JAR. Variability and Stability in Daily Moderate-to-Vigorous Physical Activity among 10 Year Old Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:9248-63. [PMID: 26262632 PMCID: PMC4555277 DOI: 10.3390/ijerph120809248] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 07/10/2015] [Accepted: 08/03/2015] [Indexed: 11/17/2022]
Abstract
Day-to-day variability and stability of children's physical activity levels across days of the week are not well understood. Our aims were to examine the day-to-day variability of moderate-to-vigorous physical activity (MVPA), to determine factors influencing the day-to-day variability of MVPA and to estimate stability of MVPA in children. The sample comprises 686 Portuguese children (10 years of age). MVPA was assessed with an accelerometer, and BMI was computed from measured height and weight. Daily changes in MVPA and their correlates (gender, BMI, and maturity) were modeled with a multilevel approach, and tracking was calculated using Foulkes & Davies γ. A total of 51.3% of boys and 26.2% of girls achieved 60 min/day of MVPA on average. Daily MVPA was lower during the weekend (23.6% of boys and 13.6% of girls comply with the recommended 60 min/day of MVPA) compared to weekdays (60.8% and 35.4%, boys and girls, respectively). Normal weight children were more active than obese children and no effect was found for biological maturation. Tracking is low in both boys (γ = 0.59 ± 0.01) and girls (γ = 0.56 ± 0.01). Children's MVPA levels during a week are highly unstable. In summary, boys are more active than girls, maturation does not affect their MVPA, and obese children are less likely to meet 60 min/day of MVPA. These results highlight the importance of providing opportunities for increasing children's daily MVPA on all days of week, especially on the weekend.
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Affiliation(s)
- Sara Pereira
- CIFI2D, Faculty of Sport, University of Porto, Porto 4099-002, Portugal.
| | | | - Alessandra Borges
- CIFI2D, Faculty of Sport, University of Porto, Porto 4099-002, Portugal.
| | - Daniel Santos
- CIFI2D, Faculty of Sport, University of Porto, Porto 4099-002, Portugal.
| | - Michele Souza
- CIFI2D, Faculty of Sport, University of Porto, Porto 4099-002, Portugal.
| | - Fernanda K dos Santos
- Department of Physical Education and Sports Science, Academic Center of Vitoria, Federal University of Pernambuco, Recife 55608-680, Brazil.
| | - Raquel N Chaves
- Federal University of Technology-Paraná (UTFPR), Campus Curitiba, Curitiba 80230-901, Brazil.
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70220, USA.
| | - José A R Maia
- CIFI2D, Faculty of Sport, University of Porto, Porto 4099-002, Portugal.
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162
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Gomes TN, Hedeker D, dos Santos FK, Pereira S, Katzmarzyk PT, Maia JAR. Why Are Children Different in Their Daily Sedentariness? An Approach Based on the Mixed-Effects Location Scale Model. PLoS One 2015; 10:e0132192. [PMID: 26230652 PMCID: PMC4521850 DOI: 10.1371/journal.pone.0132192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/10/2015] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate the between- and within-individual variability in sedentary time over seven days, using a mixed-effects location scale model. The sample comprised 686 Portuguese children (381 girls) aged 9–11 years, from 23 schools. Sedentary time was estimated by the Actigraph GT3X+ accelerometer, which was used 24 hours/day for 7 consecutive days; height, sitting height, and weight were measured, BMI was computed (WHO cut-points were used to classify subjects as normal weight or overweight/obese), and maturity offset was estimated. Information regarding the home environment was obtained by questionnaire. Results revealed that (i) children were more sedentary on Friday, but less so on Saturday and Sunday (compared to Monday), with significant variation between- and within-subjects (between-subject variance=0.800, within-subject variance=1.793, intra-subject correlation=0.308); (ii) there is a sex effect on sedentariness, with boys being less sedentary than girls (p<0.001), and the between-subject variance was 1.48 times larger for boys than girls; (iii) in terms of the within-subject variance, or erraticism, Tuesday, Wednesday and Friday have similar erraticism levels as Monday (Thursday has less, while Saturday and Sunday have more); in addition, girls (variance ratio=0.632, p<0.001), overweight/obese children (variance ratio=0.861, p=0.019), and those later mature (variance ratio=0.849, p=0.013) have less erraticism than their counterparts; (iv) the within-subject variance varied significantly across subjects (scale std dev=0.342±0.037, p<0.001); and (v) in the fixed part of the model, only biological maturation was positively related to sedentariness. This study demonstrated that there is significant between- and within-subject variability in sedentariness across a whole week. This implies that a focus on intra-individual variability, instead of only on mean values, would provide relevant information towards a more complete map of children’s sedentary behaviour, which can be helpful when developing more efficient strategies to reduce sedentariness.
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Affiliation(s)
- Thayse Natacha Gomes
- Center of Research, Education, Innovation and Intervention in Sport (CIFID), Kinanthropometry Lab, Faculty of Sport, University of Porto, Porto, Portugal
- * E-mail:
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Fernanda Karina dos Santos
- Department of Physical Education and Sports Science, CAV, Federal University of Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | - Sara Pereira
- Center of Research, Education, Innovation and Intervention in Sport (CIFID), Kinanthropometry Lab, Faculty of Sport, University of Porto, Porto, Portugal
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - José A. R. Maia
- Center of Research, Education, Innovation and Intervention in Sport (CIFID), Kinanthropometry Lab, Faculty of Sport, University of Porto, Porto, Portugal
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163
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Meredith-Jones K, Williams S, Galland B, Kennedy G, Taylor R. 24 h Accelerometry: impact of sleep-screening methods on estimates of sedentary behaviour and physical activity while awake. J Sports Sci 2015; 34:679-85. [PMID: 26194337 DOI: 10.1080/02640414.2015.1068438] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although accelerometers can assess sleep and activity over 24 h, sleep data must be removed before physical activity and sedentary time can be examined appropriately. We compared the effect of 6 different sleep-scoring rules on physical activity and sedentary time. Activity and sleep were obtained by accelerometry (ActiGraph GT3X) over 7 days in 291 children (51.3% overweight or obese) aged 4-8.9 years. Three methods removed sleep using individualised time filters and two methods applied standard time filters to remove sleep each day (9 pm-6 am, 12 am-6 am). The final method did not remove sleep but simply defined non-wear as at least 60 min of consecutive zeros over the 24-h period. Different methods of removing sleep from 24-h data markedly affect estimates of sedentary time, yielding values ranging from 556 to 1145 min/day. Estimates of non-wear time (33-193 min), wear time (736-1337 min) and counts per minute (384-658) also showed considerable variation. By contrast, estimates of moderate-to-vigorous activity (MVPA) were similar, varying by less than 1 min/day. Different scoring methods to remove sleep from 24-h accelerometry data do not affect measures of MVPA, whereas estimates of counts per minute and sedentary time depend considerably on which technique is used.
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Affiliation(s)
| | - Sheila Williams
- b Department of Preventive and Social Medicine , University of Otago , Dunedin , New Zealand
| | - Barbara Galland
- c Department of Women's and Children's Health , University of Otago , Dunedin , New Zealand
| | - Gavin Kennedy
- d School of Physical Education, Sport and Exercise Sciences , University of Otago , Dunedin , New Zealand
| | - Rachael Taylor
- a Department of Medicine , University of Otago , Dunedin , New Zealand
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Are BMI and Sedentariness Correlated? A Multilevel Study in Children. Nutrients 2015; 7:5889-904. [PMID: 26193311 PMCID: PMC4517035 DOI: 10.3390/nu7075258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/23/2015] [Accepted: 07/03/2015] [Indexed: 11/16/2022] Open
Abstract
The purpose of this research was to investigate the relationship between body mass index (BMI) and sedentariness (Sed) in children and to examine the influence of child and school correlates on their variation. The sample comprises 580 children (337 girls, 9-11 years). Sedentariness was assessed with an accelerometer, and BMI was computed. Child- and school-level covariates were analyzed using multilevel models. No significant correlation between Sed and BMI was found. School context explains 5% and 1.5% of the total variance in Sed and BMI, respectively. At the child level, only moderate-to-vigorous physical activity was associated with both Sed (β = -0.02 ± 0.002) and BMI (β = -0.005 ± 0.002). Sleep time is related to Sed (β = -0.42 ± 0.04), while sex (β = 1.97 ± 0.13), biological maturity (β = 1.25 ± 0.07), media in the bedroom (β = 0.26 ± 0.08) and healthy (β = -0.09 ± 0.03) and unhealthy (β = -0.07 ± 0.04) diet scores were associated with BMI. None of the school-level covariates were related to BMI, but access to cafeteria (β = -0.97 ± 0.25), playground equipment (β = -0.67 ± 0.20) and restaurants (β = 0.16 ± 0.08) were related to Sed. In conclusion, Sed and BMI were not correlated. Further, they have different correlates, while children's traits seem to play more relevant roles in their differences in Sed and BMI than the school milieu. This information should be taken into account when strategies to reduce Sed and BMI are implemented.
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Profiling physical activity, diet, screen and sleep habits in Portuguese children. Nutrients 2015; 7:4345-62. [PMID: 26043034 PMCID: PMC4488788 DOI: 10.3390/nu7064345] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/08/2015] [Accepted: 05/20/2015] [Indexed: 11/18/2022] Open
Abstract
Obesity in children is partly due to unhealthy lifestyle behaviours, e.g., sedentary activity and poor dietary choices. This trend has been seen globally. To determine the extent of these behaviours in a Portuguese population of children, 686 children 9.5 to 10.5 years of age were studied. Our aims were to: (1) describe profiles of children’s lifestyle behaviours; (2) identify behaviour pattern classes; and (3) estimate combined effects of individual/socio-demographic characteristics in predicting class membership. Physical activity and sleep time were estimated by 24-h accelerometry. Nutritional habits, screen time and socio-demographics were obtained. Latent Class Analysis was used to determine unhealthy lifestyle behaviours. Logistic regression analysis predicted class membership. About 78% of children had three or more unhealthy lifestyle behaviours, while 0.2% presented no risk. Two classes were identified: Class 1-Sedentary, poorer diet quality; and Class 2-Insufficiently active, better diet quality, 35% and 65% of the population, respectively. More mature children (Odds Ratio (OR) = 6.75; 95%CI = 4.74–10.41), and boys (OR = 3.06; 95% CI = 1.98–4.72) were more likely to be overweight/obese. However, those belonging to Class 2 were less likely to be overweight/obese (OR = 0.60; 95% CI = 0.43–0.84). Maternal education level and household income did not significantly predict weight status (p ≥ 0.05).
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166
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Borghese MM, Tremblay MS, Katzmarzyk PT, Tudor-Locke C, Schuna JM, Leduc G, Boyer C, LeBlanc AG, Chaput JP. Mediating role of television time, diet patterns, physical activity and sleep duration in the association between television in the bedroom and adiposity in 10 year-old children. Int J Behav Nutr Phys Act 2015; 12:60. [PMID: 25967920 PMCID: PMC4434872 DOI: 10.1186/s12966-015-0221-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 05/01/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Having a TV in the bedroom is associated with adiposity in children. It is not known how lifestyle behaviours (television viewing time, diet patterns, physical activity, and sleep duration) mediate this association. The objective of this study was to examine the mediating role of these lifestyle behaviours in the association between TV in the bedroom and percent body fat (% BF). METHODS Cross-sectional data from 1 201 children (57.3% female; mean age = 9.8 years) from Ottawa, Canada and Baton Rouge, USA were examined. % BF was directly measured. Accelerometers were used to determine physical activity and sleep duration (24-h, 7-day protocol). Questionnaires were used to assess TV viewing time and healthy/unhealthy diet patterns (derived using factor analysis from food frequency questionnaire data). RESULTS Canadian boys and girls with a TV in their bedroom had a higher % BF, watched more TV and had unhealthier diets. American boys and girls with a TV in their bedroom watched more TV, while boys had a higher % BF and a more unhealthy diet, and girls had less MVPA. In Canadian girls, TV viewing time mediated the association between having a TV in the bedroom and adiposity, independent of diet patterns, MVPA, and sleep duration. Other lifestyle mediators were not significant in Canadian boys or in US children. CONCLUSION TV viewing is a mediating lifestyle behaviour in the association between TV in the bedroom and adiposity in Canadian girls. Future research is needed to identify lifestyle behaviours as intermediate mediators.
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Affiliation(s)
- Michael M Borghese
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Population Health, Faculty of Graduate and Postdoctoral Studies, University of Ottawa, Ottawa, ON, Canada.
| | | | | | - John M Schuna
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Geneviève Leduc
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
| | - Charles Boyer
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
| | - Allana G LeBlanc
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
- Population Health, Faculty of Graduate and Postdoctoral Studies, University of Ottawa, Ottawa, ON, Canada.
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, ON, Canada.
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Population Health, Faculty of Graduate and Postdoctoral Studies, University of Ottawa, Ottawa, ON, Canada.
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A model for presenting accelerometer paradata in large studies: ISCOLE. Int J Behav Nutr Phys Act 2015; 12:52. [PMID: 25927615 PMCID: PMC4409714 DOI: 10.1186/s12966-015-0213-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We present a model for reporting accelerometer paradata (process-related data produced from survey administration) collected in the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE), a multi-national investigation of >7000 children (averaging 10.5 years of age) sampled from 12 different developed and developing countries and five continents. METHODS ISCOLE employed a 24-hr waist worn 7-day protocol using the ActiGraph GT3X+. Checklists, flow charts, and systematic data queries documented accelerometer paradata from enrollment to data collection and treatment. Paradata included counts of consented and eligible participants, accelerometers distributed for initial and additional monitoring (site specific decisions in the face of initial monitoring failure), inadequate data (e.g., lost/malfunction, insufficient wear time), and averages for waking wear time, valid days of data, participants with valid data (≥4 valid days of data, including 1 weekend day), and minutes with implausibly high values (≥20,000 activity counts/min). RESULTS Of 7806 consented participants, 7372 were deemed eligible to participate, 7314 accelerometers were distributed for initial monitoring and another 106 for additional monitoring. 414 accelerometer data files were inadequate (primarily due to insufficient wear time). Only 29 accelerometers were lost during the implementation of ISCOLE worldwide. The final locked data file consisted of 6553 participant files (90.0% relative to number of participants who completed monitoring) with valid waking wear time, averaging 6.5 valid days and 888.4 minutes/day (14.8 hours). We documented 4762 minutes with implausibly high activity count values from 695 unique participants (9.4% of eligible participants and <0.01% of all minutes). CONCLUSIONS Detailed accelerometer paradata is useful for standardizing communication, facilitating study management, improving the representative qualities of surveys, tracking study endpoint attainment, comparing studies, and ultimately anticipating and controlling costs. TRIAL REGISTRATION ClinicalTrials.gov: NCT01722500.
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LeBlanc AG, Broyles ST, Chaput JP, Leduc G, Boyer C, Borghese MM, Tremblay MS. Correlates of objectively measured sedentary time and self-reported screen time in Canadian children. Int J Behav Nutr Phys Act 2015; 12:38. [PMID: 25889903 PMCID: PMC4381481 DOI: 10.1186/s12966-015-0197-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 03/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Demographic, family, and home characteristics play an important role in determining childhood sedentary behaviour. The objective of this paper was to identify correlates of total sedentary time (SED) and correlates of self-reported screen time (ST) in Canadian children. METHODS Child- and parent-reported household, socio-demographic, behavioural, and diet related data were collected; directly measured anthropometric and accelerometer data were also collected for each child. Participants with complete demographic, anthropometric, and either SED (n=524, 41% boys) or ST (n=567, 42% boys) data from the Canadian site of the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE) were included in analysis. Sixteen potential correlates of SED and ST were examined using multilevel general linear models, adjusting for sex, ethnicity, number of siblings, and socio-economic status. All explanatory variables moderately associated (p<0.10) with SED and/or ST in univariate analyses were included in the final, fully-adjusted models. Variables that remained significant in the final models (p<0.05) were considered correlates of SED and/or ST. RESULTS Children averaged 8.5 hours of daily SED; no differences in total SED, or total ST were seen between girls and boys, but boys reported significantly more video game/computer usage than girls. Boys also had higher waist circumference and BMI z-scores than girls. In the final models, waist circumference and number of TVs in the home were the only common correlates of both SED and ST. SED was also negatively associated with sleep duration. ST was also positively associated with mother's weight status, father's education, and unhealthy eating pattern score and negatively associated with healthy eating pattern score, and weekend breakfast consumption. Few common correlates existed between boys and girls. CONCLUSION Several factors were identified as correlates of SED and/or of ST in Canadian children; however, few correlates were common for both SED and ST, and for both boys and girls. This suggests that a single strategy to reduce SED and ST is unlikely to be effective. Future work should examine a variety of other, non-screen based sedentary behaviours and their potential correlates in the hopes of creating tailored public health messages to reduce SED and ST in both boys, and girls.
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Affiliation(s)
- Allana G LeBlanc
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada. .,Population Health, Faculty of Graduate and Postdoctoral Studies, University of Ottawa, Ottawa, Ontario, Canada.
| | | | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada. .,Population Health, Faculty of Graduate and Postdoctoral Studies, University of Ottawa, Ottawa, Ontario, Canada. .,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Geneviève Leduc
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada.
| | - Charles Boyer
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada.
| | - Michael M Borghese
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada. .,Population Health, Faculty of Graduate and Postdoctoral Studies, University of Ottawa, Ottawa, Ontario, Canada. .,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
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169
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Taylor RW, Williams SM, Farmer VL, Taylor BJ. The stability of sleep patterns in children 3 to 7 years of age. J Pediatr 2015; 166:697-702.e1. [PMID: 25524316 DOI: 10.1016/j.jpeds.2014.11.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 09/25/2014] [Accepted: 11/05/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the reliability and stability of sleep (duration and quality) over time in young children using repeated accelerometer estimates of sleep. STUDY DESIGN One hundred ninety-four children wore Actical accelerometers for 5-day periods (24-hour monitoring) at 3, 4, 5, 5.5, 6.5, and 7 years of age. Sleep variables of interest (duration, onset, offset, latency, efficiency, and wake after sleep onset) were estimated using the Sadeh algorithm within a commercial data reduction program (ActiLife). Children were divided into various groups according to sleep stability, and demographic and behavioral differences were compared across groups by ANOVA. RESULTS All measures of sleep quantity and quality required 4-7 days of accelerometry to obtain acceptable reliability estimates, except morning wake time (2-4 days), and sleep latency (11-21 days). Average year-to-year correlations were only moderate for most measures (r = 0.41-0.51), but considerably higher than those observed for sleep latency, efficiency, and wake after onset (r = 0.15-0.24). Only 29 children were classified as sleep-stable over the 4 years. These children were less likely to be from ethnic minority groups (P = .017) and had higher levels of day-time physical activity (P = .032). CONCLUSIONS Sleep patterns in children are not particularly stable, showing considerable variation both within a week and across the years. Few children exhibit stable sleep patterns over time, yet characterization of these children might provide further information regarding how sleep benefits health.
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Affiliation(s)
- Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Sheila M Williams
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Barry J Taylor
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
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170
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Borges A, Gomes TN, Santos D, Pereira S, dos Santos FK, Chaves R, Katzmarzyk PT, Maia J. A count model to study the correlates of 60 min of daily physical activity in Portuguese children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2557-73. [PMID: 25730296 PMCID: PMC4377918 DOI: 10.3390/ijerph120302557] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/08/2015] [Accepted: 02/23/2015] [Indexed: 11/16/2022]
Abstract
This study aimed to present data on Portuguese children (aged 9-11 years) complying with moderate-to-vigorous physical activity (MVPA) guidelines, and to identify the importance of correlates from multiple domains associated with meeting the guidelines. Physical activity (PA) was objectively assessed by accelerometry throughout seven days on 777 children. A count model using Poisson regression was used to identify the best set of correlates that predicts the variability in meeting the guidelines. Only 3.1% of children met the recommended daily 60 min of MVPA for all seven days of the week. Further, the Cochrane-Armitage chi-square test indicated a linear and negative trend (p<0.001) from none to all seven days of children complying with the guidelines. The count model explained 22% of the variance in meeting MVPA guidelines daily. Being a girl, having a higher BMI, belonging to families with higher income, sleeping more and taking greater time walking from home to a sporting venue significantly reduced the probability of meeting daily recommended MVPA across the seven days. Furthermore, compared to girls, increasing sleep time in boys increased their chances of compliance with the MVPA recommendations. These results reinforce the relevance of considering different covariates' roles on PA compliance when designing efficient intervention strategies to promote healthy and active lifestyles in children.
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Affiliation(s)
- Alessandra Borges
- CIFI2D, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4250-Porto, Portugal.
| | - Thayse Natacha Gomes
- CIFI2D, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4250-Porto, Portugal.
| | - Daniel Santos
- CIFI2D, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4250-Porto, Portugal.
| | - Sara Pereira
- CIFI2D, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4250-Porto, Portugal.
| | - Fernanda K dos Santos
- CIFI2D, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4250-Porto, Portugal.
- Department of Physical Education and Sports Science, CAV, Federal University of Pernambuco, 55608-680 Vitória de Santo Antão, PE, Brazil.
| | - Raquel Chaves
- Physical Education Department, Federal University of Technology-Parana, Campus Curitiba, Curitiba/PR, 3165-Rebouças CEP 80230-901, Brazil.
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
| | - José Maia
- CIFI2D, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4250-Porto, Portugal.
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171
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Tudor-Locke C, Barreira TV, Schuna JM, Mire EF, Chaput JP, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Zhao P, Church TS, Katzmarzyk PT. Improving wear time compliance with a 24-hour waist-worn accelerometer protocol in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Int J Behav Nutr Phys Act 2015; 12:11. [PMID: 25881074 PMCID: PMC4328595 DOI: 10.1186/s12966-015-0172-x] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/26/2015] [Indexed: 11/18/2022] Open
Abstract
Background We compared 24-hour waist-worn accelerometer wear time characteristics of 9–11 year old children in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) to similarly aged U.S. children providing waking-hours waist-worn accelerometer data in the 2003–2006 National Health and Nutrition Examination Survey (NHANES). Methods Valid cases were defined as having ≥4 days with ≥10 hours of waking wear time in a 24-hour period, including one weekend day. Previously published algorithms for extracting total sleep episode time from 24-hour accelerometer data and for identifying wear time (in both the 24-hour and waking-hours protocols) were applied. The number of valid days obtained and a ratio (percent) of valid cases to the number of participants originally wearing an accelerometer were computed for both ISCOLE and NHANES. Given the two surveys’ discrepant sampling designs, wear time (minutes/day, hours/day) from U.S. ISCOLE was compared to NHANES using a meta-analytic approach. Wear time for the 11 additional countries participating in ISCOLE were graphically compared with NHANES. Results 491 U.S. ISCOLE children (9.92±0.03 years of age [M±SE]) and 586 NHANES children (10.43 ± 0.04 years of age) were deemed valid cases. The ratio of valid cases to the number of participants originally wearing an accelerometer was 76.7% in U.S. ISCOLE and 62.6% in NHANES. Wear time averaged 1357.0 ± 4.2 minutes per 24-hour day in ISCOLE. Waking wear time was 884.4 ± 2.2 minutes/day for U.S. ISCOLE children and 822.6 ± 4.3 minutes/day in NHANES children (difference = 61.8 minutes/day, p < 0.001). Wear time characteristics were consistently higher in all ISCOLE study sites compared to the NHANES protocol. Conclusions A 24-hour waist-worn accelerometry protocol implemented in U.S. children produced 22.6 out of 24 hours of possible wear time, and 61.8 more minutes/day of waking wear time than a similarly implemented and processed waking wear time waist-worn accelerometry protocol. Consistent results were obtained internationally. The 24-hour protocol may produce an important increase in wear time compliance that also provides an opportunity to study the total sleep episode time separate and distinct from physical activity and sedentary time detected during waking-hours. Trial registration ClinicalTrials.gov NCT01722500. Electronic supplementary material The online version of this article (doi:10.1186/s12966-015-0172-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catrine Tudor-Locke
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | - Tiago V Barreira
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA. .,Syracuse University, Syracuse, USA.
| | - John M Schuna
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA. .,Oregon State University, Corvallis, USA.
| | - Emily F Mire
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | | | | | - Gang Hu
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | | | | | | | - Carol Maher
- University of South Australia, Adelaide, Australia.
| | - José Maia
- CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal.
| | - Victor Matsudo
- Center of Studies of the Physical Fitness Research Laboratory from Sao Caetano do Sul (CELAFISCS), Sao Paulo, Brazil.
| | - Tim Olds
- University of South Australia, Adelaide, Australia.
| | | | | | | | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
| | - Pei Zhao
- Tianjin Women's and Children's Health Center, Tianjin, China.
| | - Timothy S Church
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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172
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Gomes TN, Katzmarzyk PT, dos Santos FK, Souza M, Pereira S, Maia JAR. Overweight and obesity in Portuguese children: prevalence and correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11398-417. [PMID: 25372884 PMCID: PMC4245619 DOI: 10.3390/ijerph111111398] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/22/2014] [Accepted: 10/27/2014] [Indexed: 12/18/2022]
Abstract
There are widespread differences in overweight/obesity prevalence in children, and understanding the reasons for this is very important. The present study aims: (I) to conduct a meta-analysis on overweight/obesity prevalence in Portuguese children; (II) to identify differences in biological and behavioural characteristics between normal-weight and overweight/obese children; and (III) to investigate the importance of individual- and school-level correlates of variation in children's BMI using multilevel modelling. A search was done for all published papers including Portuguese children during the last decade; further, 686 Portuguese children (9-11 years old) were sampled and their BMI, family income, maturity offset, nutritional habits, physical activity, sedentariness, sleep time, and school environment information were collected. Results showed a stabilization of overweight/obesity during the last decade, 30.6% (95%CI: 0.287-0.34) for boys, 28.4% (95%CI: 0.23-0.35) for girls, and 30.3% (95%CI: 0.27-0.34) for boys and girls together. Differences between weight groups were only found in individual-level biological traits. The multilevel analysis did not identify significant contributions of school-level variables to children's BMI variation. In conclusion, no increase was found in the prevalence of overweight/obesity among Portuguese children since 2000. Normal-weight and overweight/obese children only differ in individual-level characteristics, and school context variables were not related to variation in BMI.
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Affiliation(s)
- Thayse Natacha Gomes
- CIFID, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - Fernanda K dos Santos
- CIFID, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Michele Souza
- CIFID, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Sara Pereira
- CIFID, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - José A R Maia
- CIFID, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
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173
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Mcneil J, Tremblay MS, Leduc G, Boyer C, Bélanger P, Leblanc AG, Borghese MM, Chaput JP. Objectively-measured sleep and its association with adiposity and physical activity in a sample of Canadian children. J Sleep Res 2014; 24:131-9. [PMID: 25266575 DOI: 10.1111/jsr.12241] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/10/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Jessica Mcneil
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
- School of Human Kinetics; Faculty of Health Sciences; University of Ottawa; Ottawa ON Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
- School of Human Kinetics; Faculty of Health Sciences; University of Ottawa; Ottawa ON Canada
- Department of Pediatrics; Faculty of Medicine; University of Ottawa; Ottawa ON Canada
- Population Health; Faculty of Graduate and Postdoctoral Studies; University of Ottawa; Ottawa ON Canada
| | - Geneviève Leduc
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
| | - Charles Boyer
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
| | - Priscilla Bélanger
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
| | - Allana G. Leblanc
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
- Population Health; Faculty of Graduate and Postdoctoral Studies; University of Ottawa; Ottawa ON Canada
| | - Michael M. Borghese
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
- School of Human Kinetics; Faculty of Health Sciences; University of Ottawa; Ottawa ON Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group; Children's Hospital of Eastern Ontario Research Institute; Ottawa ON Canada
- School of Human Kinetics; Faculty of Health Sciences; University of Ottawa; Ottawa ON Canada
- Department of Pediatrics; Faculty of Medicine; University of Ottawa; Ottawa ON Canada
- Population Health; Faculty of Graduate and Postdoctoral Studies; University of Ottawa; Ottawa ON Canada
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174
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Gomes TN, dos Santos FK, Santos D, Pereira S, Chaves R, Katzmarzyk PT, Maia J. Correlates of sedentary time in children: a multilevel modelling approach. BMC Public Health 2014; 14:890. [PMID: 25174736 PMCID: PMC4159552 DOI: 10.1186/1471-2458-14-890] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 08/26/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) has been implicated as a potential risk factor for chronic disease. Since children spend most of their awake time in schools, this study aimed to identify individual- and school-level correlates of sedentary time using a multilevel approach, and to determine if these correlates have a similar effect in normal weight (NW) and overweight/obese (O/O) children. METHODS Sample comprised 686 Portuguese children aged 9-10 years from 23 schools that took part in the ISCOLE project. Actigraph GT3X + accelerometers were used 24 hours/day for 7 days to assess sedentary time (daily minutes <100 counts/min); BMI was computed and WHO cut-points were used to classify subjects as NW or O/O. Sex, BMI, number of siblings, family income, computer use on school days, and sleep time on school days were used as individual-level correlates. At the school level, school size (number of students), percentage of students involved in sports or physical activity (PA) clubs, school promotion of active transportation, and students' access to equipment outside school hours were used. All multilevel modelling analysis was done in SPSS, WINPEPI, and HLM. RESULTS School-level correlates explain ≈ 6.0% of the total variance in sedentary time. Results (β ± SE) showed that boys (-30.85 ± 5.23), children with more siblings (-8.56 ± 2.71) and those who sleep more (-17.78 ± 3.06) were less sedentary, while children with higher family income were more sedentary (4.32 ± 1.68). At the school level, no variable was significantly correlated with sedentary time. Among weight groups, variables related to sedentary time in NW were sex, sleep time and family income, while in O/O sex, number of siblings and sleep time were significant correlates. No school-level predictors were significantly associated in either of the weight groups. CONCLUSION Notwithstanding the relevance of the school environment in the reduction of children's sedentary time, individual and family characteristics played a more relevant role than the school context in this study.
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Affiliation(s)
| | | | | | | | | | | | - José Maia
- CIFI2D, Faculty of Sport, University of Porto, Rua Dr Plácido Costa, 91, Porto 4200-450, Portugal.
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175
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Galland B, Meredith-Jones K, Terrill P, Taylor R. Challenges and Emerging Technologies within the Field of Pediatric Actigraphy. Front Psychiatry 2014; 5:99. [PMID: 25191278 PMCID: PMC4139737 DOI: 10.3389/fpsyt.2014.00099] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 07/22/2014] [Indexed: 12/30/2022] Open
Abstract
Actigraphy as an objective measure of sleep and wakefulness in infants and children has gained popularity over the last 20 years. However, the field lacks published guidelines for sleep-wake identification within pediatric age groups. The scoring rules vary greatly and although sensitivity (sleep agreement with polysomnography) is usually high, a significant limitation remains in relation to specificity (wake agreement). Furthermore, accurate algorithm output and sleep-wake summaries usually require prior entry from daily logs of sleep-wake periods and artifact-related information (e.g., non-wear time), involving significant parent co-operation. Scoring criteria for daytime naps remains an unexplored area. Many of the problems facing accuracy of measurement are inherent within the field of actigraphy itself, particularly where sleep periods containing significant movements are erroneously classified as wake, and within quiet wakefulness when no movements are detected, erroneously classified as sleep. We discuss the challenges of actigraphy for pediatric sleep, briefly describe the technical basis and consider a number of technological approaches that may facilitate improved classification of errors in sleep-wake discrimination.
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Affiliation(s)
- Barbara Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | | | - Philip Terrill
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD, Australia
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
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176
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Chaput JP, Leduc G, Boyer C, Bélanger P, LeBlanc AG, Borghese MM, Tremblay MS. Electronic screens in children's bedrooms and adiposity, physical activity and sleep: do the number and type of electronic devices matter? Canadian Journal of Public Health 2014; 105:e273-9. [PMID: 25166130 DOI: 10.17269/cjph.105.4511] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 07/18/2014] [Accepted: 06/19/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether the number and type of electronic screens available in children's bedrooms matter in their relationship to adiposity, physical activity and sleep. METHODS A cross-sectional study was conducted involving 502 children aged 9-11 years from Ottawa, Ontario. The presence (yes/no) of a television (TV), computer or video game system in the child's bedroom was reported by the parents. Percentage body fat was measured using bioelectrical impedance. An accelerometer was worn over seven days to assess moderate-to-vigorous physical activity (MVPA), total sedentary time, sleep duration and sleep efficiency. Screen time was self-reported by the child. RESULTS After adjustment for age, sex, ethnicity, annual household income and highest level of parental education, children with 2-3 screens in their bedroom had a significantly higher percentage of body fat than children with no screen in their bedroom. However, while children with 2-3 screens in their bedroom engaged in more screen time overall than those with no screen, total sedentary time and MVPA were not significantly different. Sleep duration was not related to the number of screens in the bedroom, but sleep efficiency was significantly lower in children with at least 2 screens in the bedroom. Finally, children having only a TV in their bedroom had significantly higher adiposity than those having no screen at all. In contrast, the presence of a computer in children's bedrooms was not associated with higher adiposity than that of children with no screen. CONCLUSIONS A higher number of screens in a child's bedroom was associated with higher adiposity, more total screen time and lower sleep efficiency. Having a TV in the bedroom appears to be the type of screen presence associated with higher levels of adiposity. Given the popularity of screens among children, these findings are increasingly relevant to health promotion strategies.
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177
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Objectively measured physical activity, sedentary time and sleep duration: independent and combined associations with adiposity in canadian children. Nutr Diabetes 2014; 4:e117. [PMID: 24911633 PMCID: PMC4079924 DOI: 10.1038/nutd.2014.14] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 04/29/2014] [Indexed: 11/19/2022] Open
Abstract
Objective: To examine independent and combined associations among objectively measured movement/non-movement behaviors (moderate-to-vigorous-intensity physical activity (MVPA), total sedentary time and sleep duration) and adiposity indicators in a sample of Canadian children. Methods: A cross-sectional study was conducted on 507 children aged 9–11 years from Ottawa, Canada. Movement/non-movement behaviors were assessed using an Actigraph GT3X+ accelerometer over 7 days (24-h protocol). Outcomes included percentage body fat (bioelectrical impedance) and waist-to-height ratio. Results: After adjustment for age, sex, ethnicity, maturity offset, fast food consumption, annual household income and highest level of parental education, MVPA was inversely and sedentary time positively associated with adiposity indicators, whereas sleep duration was not. However, only MVPA remained significantly associated with adiposity indicators after additional adjustment for the other movement/non-movement behaviors. Combined associations using tertiles of the three movement/non-movement behaviors showed that higher levels of MVPA were associated with lower adiposity indicators, irrespective of total sedentary time and sleep duration. Conclusions: Higher levels of MVPA were associated with lower adiposity in this sample of children regardless of sedentary time and sleep duration. Although correlational in nature, these findings suggest that future efforts of obesity reduction should focus more on increasing MVPA than on reducing sedentary time or increasing sleep duration to maximize the effectiveness of interventions.
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178
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Tracy DJ, Xu Z, Choi L, Acra S, Chen KY, Buchowski MS. Separating bedtime rest from activity using waist or wrist-worn accelerometers in youth. PLoS One 2014; 9:e92512. [PMID: 24727999 PMCID: PMC3984076 DOI: 10.1371/journal.pone.0092512] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 02/23/2014] [Indexed: 11/18/2022] Open
Abstract
Recent interest in sedentary behavior and technological advances expanded use of watch-size accelerometers for continuous monitoring of physical activity (PA) over extended periods (e.g., 24 h/day for 1 week) in studies conducted in natural living environment. This approach necessitates the development of new methods separating bedtime rest and activity periods from the accelerometer recordings. The goal of this study was to develop a decision tree with acceptable accuracy for separating bedtime rest from activity in youth using accelerometer placed on waist or wrist. Minute-by-minute accelerometry data were collected from 81 youth (10-18 years old, 47 females) during a monitored 24-h stay in a whole-room indirect calorimeter equipped with a force platform covering the floor to detect movement. Receiver Operating Characteristic (ROC) curve analysis was used to determine the accelerometer cut points for rest and activity. To examine the classification differences, the accelerometer bedtime rest and activity classified by the algorithm in the development group (n = 41) were compared with actual bedtime rest and activity classification obtained from the room calorimeter-measured metabolic rate and movement data. The selected optimal bedtime rest cut points were 20 and 250 counts/min for the waist- and the wrist-worn accelerometer, respectively. The selected optimal activity cut points were 500 and 3,000 counts/min for waist and wrist-worn accelerometers, respectively. Bedtime rest and activity were correctly classified by the algorithm in the validation group (n = 40) by both waist- (sensitivity: 0.983, specificity: 0.946, area under ROC curve: 0. 872) and wrist-worn (0.999, 0.980 and 0.943) accelerometers. The decision tree classified bedtime rest correctly with higher accuracy than commonly used automated algorithm for both waist- and wrist-warn accelerometer (all p<0.001). We concluded that cut points developed and validated for waist- and wrist-worn uniaxial accelerometer have a good power for accurate separation of time spent in bedtime rest from activity in youth.
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Affiliation(s)
- Dustin J. Tracy
- Energy Balance Laboratory, Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Zhiyi Xu
- Energy Balance Laboratory, Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Leena Choi
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Sari Acra
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Kong Y. Chen
- National Institute of Diabetes and Digestive and Kidney Disease, Diabetes, Endocrinology, and Obesity Branch, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Maciej S. Buchowski
- Energy Balance Laboratory, Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
- * E-mail:
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Borghese MM, Tremblay MS, Leduc G, Boyer C, Bélanger P, LeBlanc AG, Francis C, Chaput JP. Independent and combined associations of total sedentary time and television viewing time with food intake patterns of 9- to 11-year-old Canadian children. Appl Physiol Nutr Metab 2014; 39:937-43. [PMID: 24892903 DOI: 10.1139/apnm-2013-0551] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The relationships among sedentary time, television viewing time, and dietary patterns in children are not fully understood. The aim of this paper was to determine which of self-reported television viewing time or objectively measured sedentary time is a better correlate of the frequency of consumption of healthy and unhealthy foods. A cross-sectional study was conducted of 9- to 11-year-old children (n = 523; 57.1% female) from Ottawa, Ontario, Canada. Accelerometers were used to determine total sedentary time, and questionnaires were used to determine the number of hours of television watching and the frequency of consumption of foods per week. Television viewing was negatively associated with the frequency of consumption of fruits, vegetables, and green vegetables, and positively associated with the frequency of consumption of sweets, soft drinks, diet soft drinks, pastries, potato chips, French fries, fruit juices, ice cream, fried foods, and fast food. Except for diet soft drinks and fruit juices, these associations were independent of covariates, including sedentary time. Total sedentary time was negatively associated with the frequency of consumption of sports drinks, independent of covariates, including television viewing. In combined sedentary time and television viewing analyses, children watching >2 h of television per day consumed several unhealthy food items more frequently than did children watching ≤2 h of television, regardless of sedentary time. In conclusion, this paper provides evidence to suggest that television viewing time is more strongly associated with unhealthy dietary patterns than is total sedentary time. Future research should focus on reducing television viewing time, as a means of improving dietary patterns and potentially reducing childhood obesity.
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Affiliation(s)
- Michael M Borghese
- a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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