The Effect of Nutrition and Sleep Habits on Predisposition for Metabolic Syndrome in Greek Children

The Response of Antioxidant Enzymes and Antiapoptotic Markers to an Oral Glucose Tolerance Test (OGTT) in Children and Adolescents with Excess Body Weight

Oxidative stress and apoptosis are involved in the pathogenesis of obesity-related diseases. This observational study investigates the antioxidant and apoptotic markers response to an oral glucose tolerance test (OGTT) in a population of overweight children and adolescents, with normal (NGT) or impaired glucose tolerance (IGT). Glucose, insulin, and C-peptide concentrations, as well as oxidative stress (SOD, GPx3) and apoptotic markers (Apo1fas, cck18), were determined at T = 0, 30, 60, 90, 120, and 180 min after glucose intake during OGTT. The lipid profile, thyroid function, insulin-like growth factor1, leptin, ghrelin, and adiponectin were also measured at baseline. The 45 participants, with a mean age of 12.15 (±2.3) years old, were divided into two subcategories: those with NGΤ (n = 31) and those with IGT (n = 14). The area under the curve (AUC) of glucose, insulin, and C-peptide was greater in children with IGT; however, only glucose differences were statistically significant. SOD and GPx3 levels were higher at all time points in the IGT children. Apo1fas and cck18 levels were higher in the NGT children at most time points, whereas Adiponectin was lower in the IGT group. Glucose increased during an OGTT accompanied by a simultaneous increase in antioxidant factors, which may reflect a compensatory mechanism against the impending increase in oxidative stress in children with IGT.

Prevalence trends of hypertension and influence factors among children and adolescents aged 7-17 years in China, 2011-2015: A serial cross-sectional study

Hypertension has rapidly increased in the last decades throughout the world. It is an emerging disease. However, limited information is available on secular trends and factors of childhood and adolescents' hypertension in China. In this study, 5-year successive data were derived from a cross-sectional study of the China Health and Nutrition Survey (CHNS) in 2011 and 2015. We used systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) at least 95th percentile on the basis of age, sex, and height percentiles to define hypertension (HBP). A total of 2,827 children and adolescents aged 7-17 years were included. The age-standardized prevalence of hypertension was increased significantly across 5 years: the standardized prevalence of hypertension was increased from 8.08% (2011) to 11.46% (2015) in China (P < 0.01). The mean SBP of boys increased from 101.21 to 102.79 mmHg, while the mean SBP of girls increased from 98.96 to 100.04 mmHg. The mean DBP of boys increased from 61.20 to 67.40 mmHg, while the mean DBP of girls increased from 64.34 to 65.76 mmHg. The prevalence of hypertension grew continuously in both sexes, but the pace of change for boys was more rapid than that for girls. This study confirmed that the association between rural (odds ratio [OR] = 1.394, 95%CI 1.032-1.883), overweight/obesity (OR = 2.621, 95%CI 1.506-4.562), and BP levels was highly correlated (P < 0.05). The possible protecting factors associated with hypertension were being a girl (OR = 0.788, 95%CI 0.595-1.043). There was no association between weekly physical activity, daily sleep duration, and hypertension (P > 0.05). Further in-depth analysis of influencing factors and comprehensive interventions should be urgently implemented to combat the hypertension epidemic among children and adolescents in China.

Are adherence to the Mediterranean diet and siesta individually or jointly associated with blood pressure in Spanish adolescents? Results from the EHDLA study

Background

Both dietary and sleep patterns can influence both blood pressure levels and heart rate, but these associations have been understudied in adolescents. Furthermore, it is not known whether diet and sleep could exert a synergistic effect with respect to the maintenance of optimal BP levels in this population.

Objective

To investigate the relationship of blood pressure levels with the combination of higher adherence to the Mediterranean diet and the habit of siesta (daytime napping) in Spanish adolescents.

Methods

A cross-sectional study was conducted with data obtained through personal interviews and physical examination from a representative sample of 1,378 adolescents (12-17 years of age) from the Valle de Ricote (Region of Murcia, Spain) selected using a simple random sampling technique. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Quality Index in Children and Adolescents, and the frequency and duration of siesta were self-reported. Objective measurements of systolic and diastolic blood pressure were obtained under standardized conditions. Statistical procedures were performed with SPSS software (v.25) and included logistic and generalized regression models adjusted for sex, age, socioeconomic status, body mass index, total energy intake, nighttime sleep duration, and moderate-to-vigorous physical activity.

Results

Of the 698 adolescents finally studied (mean age 13.9 ± 1.5 years; 56.2% female), 37.1% (n = 259) had high adherence to the Mediterranean diet and 19.6% (n = 137) reported frequent siesta. In the completely adjusted models, compared to adolescents with low Mediterranean diet adherence and no or infrequent siesta, those with high Mediterranean diet adherence and frequent siesta were less likely to have high-normal blood pressure or hypertension (odds ratio = 0.47; 95% confidence interval: 0.26, 0.88) and showed slightly lower systolic blood pressure (ß-coef. = -2.60; 95% CI: -5.18, -0.02).

Conclusion

Greater adherence to the Mediterranean diet and frequent siesta have a synergistic effect on maintaining lower blood pressure levels in adolescence. These findings reinforce that adherence to both Mediterranean lifestyle behaviors early in life may be an important strategy to prevent hypertension throughout adulthood.

Sleep, nutritional status and eating behavior in children: a review study

OBJECTIVE

To review the current literature on the relationship between sleep, nutritional status and eating behavior, as well as mechanisms associated with these elements in children.

DATA SOURCE

The literature research was conducted in the PubMed, LILACS and Scopus databases, using the following terms: "Child"; "Nutritional status"; "Sleep"; "Physical activity OR Physical activities OR Exercise". The articles included were those that met the research objective. Review articles, letters to authors, or guidelines were excluded.

DATA SYNTHESIS

402 articles were initially found in the literature search. After careful analyses of the title and abstract, and application of inclusion criteria, only 24 studies were included in the present review. Most studies (n=13) suggest that short sleep duration (<9-10 hours/night) is associated with overweight/obesity in children. Only three studies did not show associations between overweight/obesity and sleep variables. Short sleep duration is also associated with poor food quality, higher intake of soft drinks and stimulant beverages before bedtime, as well as micronutrient deficiency.

CONCLUSIONS

Sleep duration is related to overweight and obesity development in infants. Changes in dietary pattern are also related to sleep debt, being one of the mechanisms that contribute to excessive weight gain. It is necessary that health professionals understand the importance of sleep quality in the nutritional status maintenance in children.

Sono, estado nutricional e hábitos alimentares em crianças: um estudo de revisão

RESUMO Objetivo: Fazer uma revisão da literatura sobre a relação entre sono, estado nutricional e padrão alimentar, bem como mecanismos associados, na população infantil. Fontes de dados: Foram realizadas buscas bibliográficas nas bases PubMed, LILACS e Scopus, usando os seguintes descritores: “Child”; “Nutritional status”; “Sleep”; “Physical activity OR Physical activities OR Exercise”. Os artigos que atenderam ao objetivo da pesquisa foram incluídos. Excluíram-se estudos de revisão, cartas para autores ou diretrizes. Síntese dos dados: Inicialmente, 402 artigos foram encontrados na pesquisa. Após análise dos títulos e abstracts e a aplicação dos critérios de exclusão, 24 estudos foram selecionados para a revisão. A maioria dos estudos (n=13) sugere que sono de curta duração (<9-10 horas/noite) está associado com sobrepeso/obesidade na população infantil. Apenas três artigos não reportaram associações entre variáveis do sono e estado nutricional. Curta duração do sono também foi associada a hábitos alimentares ruins, maior consumo de refrigerantes e bebidas estimulantes antes de deitar, bem como deficiência de micronutrientes. Conclusões: A duração do sono tem relação com sobrepeso e obesidade na população infantil. Alterações no padrão alimentar também têm relação com débito de sono, sendo um dos mecanismos que contribuem para o ganho de peso excessivo. É necessário que os profissionais de saúde tomem conhecimento da importância da qualidade do sono para a manutenção do estado nutricional em crianças.

Association of the apoptotic marker APO1/Fas with children's predisposing factors for metabolic syndrome and with mean platelet volume

BACKGROUND

Apoptosis antigen 1/FAS receptor (APO1/Fas) signaling in endothelial cells plays a significant role in angiogenesis while increased mean platelet volume (MPV) is an important marker for platelet activation. We investigated the possible correlation between APO1/Fas and both metabolic parameters and platelet activity (indicated by the MPV) in a healthy pediatric population.

METHODS

One hundred and eighty-five children, aged 5-17 years old, were enrolled in the study. The participants were divided into subgroups according to their age and body mass index percentile (BMI%). APO1/Fas was measured by enzyme-linked immunosorbent assay (ELISA) and MPV by the MEK-6410K.

RESULTS

Eighty-one children (43.8%) had excess weight, which was more prevalent in children ≤9 years of age. Sixty-five children (35.1%) exhibited a predisposition for metabolic syndrome. A negative correlation was found between APO1/Fas and predisposing factors for metabolic syndrome: Glucose, cholesterol, uric acid, low-density lipoprotein (LDL), and triglycerides. In contrast, a positive correlation was found between APO1/Fas and C-reactive protein (CRP). Receiver operating characteristic (ROC) analysis showed a predisposition to metabolic syndrome when APO1/Fas was <78.46 pg/mL. A negative correlation was also observed between APO1/Fas and MPV. MPV was also positively correlated with predisposing factors for metabolic syndrome: BMI%, glucose, cholesterol, uric acid, LDL, and negatively with high-density lipoprotein.

CONCLUSIONS

APO1/Fas expression is associated with a lower predisposition to metabolic syndrome may be through endothelial homeostasis, the induction of apoptosis of cells involved in atherosclerosis, and platelet activity. It may also enhance CRP-mediated noninflammatory clearance of apoptotic cells. Early monitoring of all the components of metabolic syndrome in overweight children is important in order to prevent metabolic and cardiovascular complications.

The roles of triglyceride/high-density lipoprotein cholesterol ratio and uric acid as predisposing factors for metabolic syndrome in healthy children

PURPOSE

To estimate the roles of triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio and uric acid in predisposition for metabolic syndrome (MetS) and its components in healthy children.

METHODS

Anthropometric and biochemical analyses were performed on 110 children, aged 5 to 12 years, from the Greek county of Laconia. The children were studied as a whole population and in separate groups according to age and predisposition to MetS after taking into consideration International Diabetes Federation criteria, body mass index, and lipid profile.

RESULTS

Seventeen percent of children exhibited predisposition to MetS, while 39.1% had TG/HDL ratio &gt;1, and 3.64% had high level of uric acid. According to a receiver operating characteristic curve analysis, the relative probability for MetS predisposition sextupled when TG/HDL ratio was ≥1 (odds ratio [OR], 5.986; 95% confidence interval [CI], 1.968-18.205). Children in the total population and those aged &lt; 9 years had a greater probability for increased low-density lipoprotein (LDL) cholesterol (OR, 3.614; 95% CI, 1.561-8.365) when TG/HDL ratio was ≥ 1. The TG/HDL ratio was positively correlated with body mass index (BMI) (P=0.035) in children without MetS, cholesterol in the total population (P=0.06) and children ≥9 years old (P=0.026), and with LDL in the total population and both age groups (P=0.001). The TG/HDL ratio was also positively correlated with alanine aminotransferase in the total population (P=0.033) and gamma-glutamyl transferase in most studied groups (P&lt;0.001). Uric acid was positively correlated with waist circumference in the total population (P=0.043) and in those without MetS (P=0.027). It was also positively correlated with BMI, TG, cholesterol, and TG/HDL ratio and negatively correlated with HDL in most studied groups (P&lt;0.005).

CONCLUSION

The studied parameters correlated with MetS components and could be characterized as effective indexes for childhood MetS, regardless of age and predisposition to MetS.

Low sleep time is associated with higher levels of blood pressure and fat mass in Amerindian schoolchildren

OBJECTIVES

While altered sleep patterns (ie, low sleep time) have been studied and reported in adults as a new cardiometabolic risk factor, less information is available on how sleep patterns impact children of different ethnicities. The aim of this study was to compare the levels of blood pressure and other cardiometabolic risk factors in relation to different levels of sleep time in schoolchildren of Amerindian Mapuche or European-ancestry of Southern Chile.

METHODS

In a cross-sectional study, 540 Chilean schoolchildren (6-13 years) were divided into two ethnic groups (n = 119 Mapuche Amerindians and n = 421 European-ancestry). Groups were analyzed according to sleep time per day as registered by parents' report and distributed into quartile categories of sleep time: Mapuche (quartile 1 [Q1] ≥10.0 h, n = 34; Q2 9.5-10.0 h, n = 29; Q3 8.5-9.0 h, n = 31; and Q4 ≤ 8.5 h, n = 25), and European (Q1, n = 99; Q2, n = 77; Q3, n = 144; Q4, n = 101). The main cardiovascular parameters (systolic [SBP] and diastolic blood pressure) were complemented with anthropometric/body composition (body mass, body mass index [BMI], waist circumference, fat mass, muscle mass, lean mass), cardiorespiratory (heart rate rest, oxygen saturation), and muscle strength (handgrip of dominant and non-dominant arm) outcomes.

RESULTS

From Q1 and across Q2, Q3, and Q4, there was an increase in delta mean SBP in both Mapuche (Δ +17.6 mm Hg) and European (Δ +7.3 mm Hg) schoolchildren with 30-90 min of decreased sleep time (using ≥10 h as reference in Q1). The tendency for worsening of other cardiometabolic risk factors was maintained for delta mean BMI (Δ +2.6 kg/m² ), waist circumference (Δ +12 cm), and fat mass (Δ +8.3%) in Mapuches, whereas European peers showed only worsened waist circumference (Δ +6 cm) across Q2, Q3, and Q4 in comparison with reference Q1. There was also a higher prevalence of hypertension in Mapuche (31.1%) compared to in European schoolchildren (17.6%).

CONCLUSIONS

Mapuche and European schoolchildren show higher levels of SBP with a decrease in sleep time of 30 min; however, there is a higher prevalence of hypertension and obesity in ethnic Mapuches than in European schoolchildren. These findings indicate that more studies should be applied at early school ages for preventing low sleep time and their related cardiometabolic risk factors for hypertension development in different ethnic groups.