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Yepez CE, Anderson CE, Frost E, Whaley SE, Koleilat M. Sleep Duration Is Associated with Household Food Insecurity and Sugar-Sweetened Beverage Intake Among Women, Infants and Children Participating Children Ages 0-5. Am J Health Promot 2024; 38:492-502. [PMID: 38155440 DOI: 10.1177/08901171231225289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
PURPOSE To determine associations between child and household characteristics and sleep duration among low-income children in Los Angeles County. DESIGN Cross-sectional study. SETTING Survey data collected in 2017 and 2020 in Los Angeles County, California. SAMPLE Special Supplemental Nutrition Program for Women, Infants and Children (WIC) households with children ages 4-60 months. MEASURES Sleep duration for children 4-60 months old (less than recommended (LTR), recommended range, more than recommended (MTR)), household food insecurity (HFI), sociodemographics, and daily servings of sugar-sweetened beverages (SSB). ANALYSIS Multinomial logistic regression, stratified by child age, was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between household/child characteristics and LTR or MTR sleep compared to recommended duration among WIC participating children 4-60 months old. RESULTS The final sample included 3512 children ages 4-23 months and 6035 children ages 24-60 months. In the study population, 32% (3-5 years old) to 44% (4-11months) of children under 5 did not meet the recommended hours of sleep per night. HFI was associated with higher odds of LTR (OR 1.27, CI 1.12-1.45) and MTR (OR 1.46, CI 1.15-1.87) sleep among 24-60 month-old children. Each additional daily SSB serving was associated with higher odds of LTR sleep (4-23 months: OR 1.10, CI 1.02-1.19; 24-59 months: OR 1.12, CI 1.08-1.17). CONCLUSIONS HFI and SSB intake are associated with not getting the recommended amount of sleep among low-income WIC participating children. Nutrition assistance program participants may benefit from receiving information about recommended sleep duration for young children and how to establish sleep routines to optimize sleep duration.
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Affiliation(s)
- Catherine E Yepez
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Christopher E Anderson
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Erin Frost
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, CA, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises (PHFE) WIC, a Program of Heluna Health, City of Industry, CA, USA
| | - Maria Koleilat
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, CA, USA
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Abdollahi AM, Li X, Merikanto I, Vepsäläinen H, Lehto R, Rahkola J, Nissinen K, Kanerva N, Roos E, Erkkola M. A tendency toward evening chronotype associates with less healthy diet among preschoolers: cross-sectional findings from the DAGIS study. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae026. [PMID: 38737796 PMCID: PMC11085840 DOI: 10.1093/sleepadvances/zpae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 04/12/2024] [Indexed: 05/14/2024]
Abstract
Study Objectives Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but little is known about these associations in younger children. The objective of the study was to (1) identify and compare individual chronotype tendencies among preschool-aged children and (2) investigate associations of sleep dimensions and chronotype with diet. Methods Participants were 636 3-6 years old (mean ± SD age: 4.74 ± 0.89 years, 49% girls) preschoolers from the cross-sectional Increased Health and Well-Being in Preschoolers (DAGIS) study in Finland. Sleep duration, sleep variability (in duration and midpoint), social jetlag, and midsleep on weekends adjusted for sleep debt (MSWEadj) were measured with 7-day actigraphy. Morning, intermediate, and evening chronotype tendencies were defined based on the lowest and highest 10th percentile cutoffs of MSWEadj. Food, energy, and macronutrient intake were assessed from 3-day records. Associations between sleep dimensions and diet were assessed with regression models. Results MSWEadj was 1:13 ± 14 minutes for morning (n = 64), 2:25 ± 28 minutes for intermediate (n = 560), and 3:38 ± 15 minutes for evening (n = 64) chronotype tendency. Children with an evening chronotype tendency had greater social jetlag and sleep variability. Having an evening chronotype tendency was associated with higher added sugar, higher sugary food consumption, and lower vegetable consumption compared to intermediate tendency types. A later chronotype (MSWEadj) was associated with higher sugary food consumption, as well as lower vegetable and fiber intake. Sleep duration, social jetlag, and sleep variability were not associated with diet. Conclusions Several less healthy sleep and diet behaviors were observed among children with later chronotypes. Future public health interventions aimed towards children would benefit from taking into account chronotype.
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Affiliation(s)
- Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Ilona Merikanto
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Reetta Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Folkhälsan, Helsinki, Finland
| | - Jenna Rahkola
- Folkhälsan Research Center, Folkhälsan, Helsinki, Finland
| | - Kaija Nissinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- School of Food and Agriculture, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Noora Kanerva
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Folkhälsan, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Kim M, Saade D, Dufourg MN, Charles MA, Plancoulaine S. Longitudinal sleep multi-trajectories from age 1 to 5.5 years and their early correlates: results from the Étude Longitudinale Française depuis l'Enfance birth cohort study. Sleep 2023; 46:zsad236. [PMID: 37682110 DOI: 10.1093/sleep/zsad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/28/2023] [Indexed: 09/09/2023] Open
Abstract
STUDY OBJECTIVES To identify sleep multi-trajectories in children from age 1 to 5.5 years and their early correlates. METHODS We collected early family, maternal, and child characteristics, including children's nighttime sleep duration (NSD) and daytime sleep duration (DSD), night waking (NW), and sleep-onset difficulties (SOD), by parental phone interviews at age 2 months and 1-, 2-, 3.5-, and 5.5 years. Group-based multi-trajectory modeling identified sleep multi-trajectory groups. Multinomial logistic regression assessed associations with early factors. RESULTS We identified five distinct sleep multi-trajectory groups for NSD, DSD, NW, and SOD in 9273 included children. The "Good sleepers" (31.6%) and "Long sleepers" (31.0%) groups had low NW and SOD prevalence and shorter NSD but longer DSD in "Good sleepers" than in "Long sleepers." The "Good sleepers but few SOD" group (10.3%) had long NSD and DSD but a SOD peak at age 3.5 years; the "Improving NW and SOD" group (9.6%) showed short but rapidly increasing NSD to a plateau and high but decreasing NW and SOD; the "Persistent NW and SOD" group (17.5%) had persistent high NW and SOD. Maternal depression during pregnancy and sleep habits at age 1 (e.g. parental presence or feeding to fall asleep, sleeping at least part of the night away from own bed) were common risk factors associated with the most disordered sleep multi-trajectory groups. CONCLUSIONS We identified distinct sleep multi-trajectory groups and early life-associated factors in preschoolers. Most of the factors associated with the most sleep-disordered multi-trajectory groups are likely modifiable and provide clues for early prevention interventions.
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Affiliation(s)
- Mihyeon Kim
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
| | - Danielle Saade
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
| | | | - Marie-Aline Charles
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
- Unité mixte Inserm-Ined-EFS Elfe, INED, Paris, France and
| | - Sabine Plancoulaine
- Centre de Recherche en Epidémiologie et StatistiqueS (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France
- Lyon Neuroscience Research Center (CRNL), Waking Team, Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
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Covington LB. Striving to improve sleep health disparities in racial/ethnic minority and socioeconomically disadvantaged families. J Clin Sleep Med 2023; 19:1577-1578. [PMID: 37401772 PMCID: PMC10476035 DOI: 10.5664/jcsm.10716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Lauren B. Covington
- School of Nursing, College of Health Sciences, University of Delaware, Newark, Delaware
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Lo BK, McTernan ML, Haines J, Savage JS, Kugler KC, Haneuse S, Redline S, Taveras EM, Davison KK. Development and Psychometric Properties of the Sleep Parenting Scale for Infants. Behav Med 2023; 49:151-161. [PMID: 34791992 PMCID: PMC9348862 DOI: 10.1080/08964289.2021.2002799] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 10/07/2021] [Accepted: 10/31/2021] [Indexed: 01/14/2023]
Abstract
Although infants' sleep behaviors are shaped by their interactions with parents at bedtime, few tools exist to capture parents' sleep parenting practices. This study developed a Sleep Parenting Scale for Infants (SPS-I) and aimed to (1) explore and validate its factorial structure, (2) examine its measurement invariance across mothers and fathers, and (3) investigate its reliability and concurrent and convergent validity. SPS-I was developed via a combination of items modified from existing scales and the development of novel items. Participants included 188 mothers and 152 mother-father dyads resulting in 340 mothers and 152 fathers; about half were non-Hispanic white. Mothers and fathers completed a 14-item SPS-I for their 12-month-old infant. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to explore and validate SPS-I's underlying structure. Multigroup CFA was used to examine measurement invariance across mothers and fathers. Reliability was examined using Cronbach's alpha. Concurrent validity was assessed using linear regressions examining associations between SPS-I factors and parent-reported infants nighttime sleep duration. Convergent validity was assessed using paired-sample t-tests to test whether the SPS-I subscale scores were similar between mothers and fathers in the same household. EFA and CFA confirmed a 3-factor, 12-item model: sleep routines, sleep autonomy, and screen media in the sleep environment. SPS-I was invariant across mothers and fathers and was reliable. Concurrent and convergent validity were established. SPS-I has good psychometric properties, supporting its use for characterizing sleep routines, sleep autonomy, and screen media in the sleep environment by mothers and fathers.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2002799 .
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Affiliation(s)
- Brian K. Lo
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | | | - Jess Haines
- Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Jennifer S. Savage
- Center for Childhood Obesity Research and Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Kari C. Kugler
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham & Women’s Hospital & Harvard Medical School, Boston, MA, USA
| | - Elsie M. Taveras
- Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
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Zhang L, Ma S, Dai F, Li Q, Wu L, Yu L, Xie T, Zhu DM, Zhu P. Anemia in pregnancy and sleep of 6-month-old infants: A prospective cohort study. Front Nutr 2023; 10:1049219. [PMID: 36969814 PMCID: PMC10036361 DOI: 10.3389/fnut.2023.1049219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
ObjectiveAnemia has been reported to adversely influence sleep in infants. However, the association between anemia in pregnancy and infant sleep remains unclear. We aimed to examine the association between maternal anemia in pregnancy and sleep parameters of 6-month-old infants.MethodsWe enrolled 2,410 mother-infant pairs between 2018 and 2021 in Hefei. Data on maternal hemoglobin concentration were collected at 24–28 gestational weeks from the electronic medical records of the hospitals. Nocturnal and daytime sleep duration, number of night awakenings, nocturnal wakefulness, and sleep latency of infants aged 6 months were measured using the Brief Infant Sleep Questionnaire with five items. A restricted cubic spline model was used to examine the relationship between maternal hemoglobin concentration and infant nocturnal sleep duration after adjusting for potential confounders.ResultsIn our study, 807 (33.5%) mothers had anemia during pregnancy. Compared to infants born to mothers without anemia, infants born to mothers with anemia in pregnancy had shorter nocturnal sleep duration [mean (SD), 560.29 (79.57) mins vs. 574.27 (75.36) mins] at the age of 6 months. Subgroup analysis showed consistent significant differences in nocturnal sleep duration between infant born to anemic and non-anemic mothers, except in case of stratification by preterm birth [mean difference (mins), 2.03 (95% CI, −20.01, −24.07)] and pre-pregnancy obesity [mean difference (mins), −0.85 (95% CI, −16.86, −15.16)]. A J-shaped nonlinear correlation curve was observed between maternal hemoglobin concentration and infant nocturnal sleep duration. Compared with mothers without daily iron supplementation, mothers who had daily iron supplementation had higher hemoglobin concentrations [mean (SD), 112.39 (11.33) g/L vs. 110.66 (10.65) g/L] at delivery and their infants had longer nocturnal sleep duration [mean (SD), 565.99 (82.46) mins vs. 553.66 (76.03) mins].ConclusionAnemia in pregnancy may have an adverse influence on the sleep of 6-mon-old infants, and the relationship between maternal hemoglobin concentration and nocturnal sleep duration is nonlinear.
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Affiliation(s)
- Lei Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Shuangshuang Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
| | - Feicai Dai
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Qiong Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Lin Wu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Lijun Yu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Tianqin Xie
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
| | - Dao-min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Dao-min Zhu,
| | - Peng Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
- *Correspondence: Peng Zhu,
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Yisahak SF, Boone KM, Rausch J, Keim SA. The timing and quality of sleep was associated with dietary quality and anthropometry in toddlers born preterm. Acta Paediatr 2023. [PMID: 36905082 DOI: 10.1111/apa.16750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023]
Abstract
AIM The aim of the study was to examine prospective associations of sleep characteristics (duration, timing, quality) with dietary and anthropometric measures among toddlers born preterm (<35 weeks). METHODS Children participated in the Omega Tots trial at 10-17 months' corrected age (Ohio, USA; 26 April 2012 to 6 April 2017). Caregivers reported toddlers' sleep at baseline using the Brief Infant Sleep Questionnaire. After 180 days, caregivers reported toddlers' past month diet in a food frequency questionnaire, and anthropometry was measured using standardised protocols. The toddler diet quality index (TDQI: higher scores indicating better quality), and weight-for-length, triceps skinfold and subscapular skinfold z-scores were calculated. Linear and logistic regression assessed adjusted associations with dietary and anthropometric outcomes at 180-day follow-up (n = 284), and linear mixed models assessed changes in anthropometry. RESULTS Daytime sleep was associated with lower TDQI (βadj per hour = -1.62 (95% CI: -2.71, -0.52)) whereas night-time sleep was associated with higher TDQI (βadj = 1.01 (95% CI: 0.16, 1.85)). Night-time awakenings and caregiver-reported sleep problems were also associated with lower TDQI. Night awakening duration and sleep-onset latency were associated with higher triceps skinfold z-score. CONCLUSION Daytime and night-time caregiver-reported sleep showed opposite associations with diet quality, suggesting that sleep timing may be important.
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Affiliation(s)
- Samrawit F Yisahak
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Kelly M Boone
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Joseph Rausch
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sarah A Keim
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
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The association between sleeping behavior, obesity, psychological depression, and eating habits among adolescents in the emirate of Abu Dhabi–United Arab Emirates. PLoS One 2022; 17:e0269837. [PMID: 36040982 PMCID: PMC9426872 DOI: 10.1371/journal.pone.0269837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/28/2022] [Indexed: 11/21/2022] Open
Abstract
Objective The study aimed to investigate the association between sleeping behavior (specifically sleep duration), body mass index (BMI), eating habits, and psychological mood depression among adolescents in the Emirate of Abu Dhabi- UAE. Methods and materials A subsample of three hundred and ninety-five participants (209 females and 186 males) from middle and high schools (aged 12–18 years) in the emirate of Abu Dhabi completed the surveys in the presence of their parents and two research assistants. Measures of daytime sleepiness and other sleep parameters (sleep duration on weekdays and weekends), eating habits, and mood depression questionnaires were reported. Results Differences in BMI between males and females were statistically significant (26.12 ± 4.5 vs. 24.4 ± 4.3; p < 0.01). There was a negative linear association (p < 0.01) between the students’ BMI and the weekday/ weekend sleep duration. The average weekday and weekend sleep duration ranged from 5.7 hours (weekdays) to 9.3 hours(weekend). The study showed that an increase in BMI was correlated to mood depression (r = 0.396, p<0.01). In terms of eating habits, there was a significant association between eating unhealthy food and sleep duration; 72.6% of students who slept less than 6 hours reported unhealthy eating habits (p <0.05). Conclusion The study showed a clear association between short sleep duration and obesity among adolescents in the UAE. This relationship between sleep duration and obesity is less studied and less understandable. Future research about exploring how sleeping behaviors can affect obesity during adolescence can support understanding this association and create an effective intervention.
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Fauziah PY, Kusumawardani E, Nopembri S, Mulyawan R, Susilowati IH, Nugraha S, Alimoeso S, Hasiholan BP, Fauzi L, Cahyati WH, Rahayu T, Chua TBK, Chia MYH. Play-Sleep Nexus in Indonesian Preschool Children before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10695. [PMID: 36078411 PMCID: PMC9517845 DOI: 10.3390/ijerph191710695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has transformed Indonesians' behaviors and has had an impact on many facets of daily life. People's lives are becoming increasingly dependent on digital technologies, which is a phenomenon with conflicting effects on people's health and happiness. This cross-sectional study focused on one such influence, namely, how the shift from the period before to during COVID-19 has affected children's playtime and sleep duration. As part of a multicenter study, 618 adult caregivers (parents, family members, or babysitters) who visited the kindergarten in question on behalf of preschool children aged 2-5 years (4.04 ± 1.39) were surveyed on the children's play and sleep habits before and during the COVID-19 pandemic in Indonesia, particularly Java Island (before pandemic, N = 309; during pandemic, N = 309). ANOVA was used for a statistical analysis to describe the difference between groups and within time collections. Significant favorable relationships were found between pre-pandemic and post-pandemic playtime and sleeping time on weekdays, weekends, and averaged weekday-weekend (r = 0.437; 0.180 and 0.321, all p < 0.05) were detected. Before the pandemic, children's playtime (4.11 vs. 3.55 h) and sleep duration (10.92 vs. 10.70 h) were significantly greater on the weekend than on the weekday (p < 0.05) but not during the pandemic (playtime: 3.48 vs. 3.45 h and sleep duration: 10.83 vs. 10.80 h; all p > 0.05). The COVID-19 pandemic had no impact on sleep duration or playtime in Javanese preschool children. Efforts should be intensified to promote the value of playtime and sleep duration among children in this age range so that the future of Indonesian children's can be ensured.
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Affiliation(s)
- Puji Yanti Fauziah
- Nonformal Education Department, Faculty of Education Science, Universitas Negeri Yogyakarta, Sleman 55281, Indonesia
| | - Erma Kusumawardani
- Nonformal Education Department, Faculty of Education Science, Universitas Negeri Yogyakarta, Sleman 55281, Indonesia
| | - Soni Nopembri
- Department of Physical Education, Faculty of Sports Science, Universitas Negeri Yogyakarta, Sleman 55281, Indonesia
| | - Rizki Mulyawan
- Department of Sports Science, Faculty of Sports Science, Universitas Negeri Yogyakarta, Sleman 55281, Indonesia
| | - Indri Hapsari Susilowati
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia
| | - Susiana Nugraha
- Department of Public Health, Faculty of Health Science, Universitas Respati Indonesia, Yogyakarta 55281, Indonesia
| | | | - Bonardo Prayogo Hasiholan
- Directorate of Productive and Older Adult Ages Health, Ministry of Health, Republic of Indonesia, Jakarta 12950, Indonesia
| | - Lukman Fauzi
- Public Health Department, Faculty of Sports Science, Universitas Negeri Semarang, Semarang 50229, Indonesia
| | - Widya Hary Cahyati
- Public Health Department, Faculty of Sports Science, Universitas Negeri Semarang, Semarang 50229, Indonesia
| | - Tandiyo Rahayu
- Physical Education Department, Faculty of Sports Science, Universitas Negeri Semarang, Semarang 50229, Indonesia
| | - Terence Buan Kiong Chua
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 639798, Singapore
| | - Michael Yong Hwa Chia
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 639798, Singapore
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Lai JS, Blackwell CK, Tucker CA, Jensen SE, Cella D. Measuring PROMIS® Physical Activity and Sleep Problems in Early Childhood. J Pediatr Psychol 2022; 47:534-546. [PMID: 35552434 PMCID: PMC9113359 DOI: 10.1093/jpepsy/jsac028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 02/27/2022] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Physical activity (PA) and sleep are leading health indicators for individuals of all ages. Monitoring young children’s PA and sleep using psychometrically sound instruments could help facilitate timely interventions to promote healthy development. This article describes the development of the PROMIS® Early Childhood (EC) Parent Report Physical Activity (PA) and Sleep Problems (SP) measures for children aged 1–5 years.
Methods
Item pools were generated by interviewing parents, input from content experts, and literature review. Data from a U.S. general population sample were used to determine factor structures of item pools via factor analytic approaches, estimate item parameters via item response theory (IRT) models, and establish norms. Pearson correlations were used to evaluate across-domain associations. Analysis of variance was used and known-groups’ validity of PA and SP by comparing their scores to PROMIS EC Parent Report Global Health: child’s physical, emotional, and mental conditions.
Results
Initial item pools consisted of 19 and 26 items for PA and SP, respectively. Factor analyses’ results supported unidimensionality of 5 and 16 items measuring PA and SP, respectively, which were then calibrated using IRT. Norms were established by centering to a probability-based U.S. general population. Computerized adaptive testing algorithms were established. Some analyses supported initial measure validity.
Conclusions
The PROMIS EC PA calibrated scale and SP item banks are user-friendly and brief, yet produce precise scores. Both measures enable psychometrically sound assessment of PA behavior and sleep problems. Future studies to comprehensively evaluate the validity of these two measures are warranted.
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Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Carole A Tucker
- Department of Nutrition, Metabolic and Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, USA
| | - Sally E Jensen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
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11
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Lupini F, Leichman ES, Gould RA, Walters RM, Mindell JA, Williamson AA. Correlates of a caregiver-reported child sleep problem and variation by community disadvantage. Sleep Med 2022; 90:83-90. [PMID: 35123150 PMCID: PMC9206234 DOI: 10.1016/j.sleep.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/16/2021] [Accepted: 01/10/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Previous studies of sleep patterns and perceived problems in early childhood indicate variation by family socioeconomic status. The purpose of this study was to examine variation in correlates of a caregiver-perceived child sleep problem across and within levels of community disadvantage in a large US sample. METHODS Caregivers of 14,980 young children (ages 0-35.9 months) in the US completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R) on the freely and publicly available Johnson's® Bedtime® Baby Sleep App. Zip code was used to identify a Distressed Communities Index (DCI) score, which represents community disadvantage based on neighborhood indicators. RESULTS Across all levels of community disadvantage, caregivers who reported greater impact of child sleep on their own sleep, bedtime difficulty, more frequent and longer night wakings, and increased total nighttime sleep were more likely to endorse a child sleep problem. These associations varied by level of community disadvantage. For caregivers living in more disadvantaged communities, impact of child sleep on their own sleep and night wakings were the strongest correlates of endorsing a child sleep problem, whereas for those in more advantaged communities the impact of child sleep on their own sleep and night wakings as well as additional aspects of sleep health, such as short sleep duration, were associated with endorsement of a child sleep problem. CONCLUSIONS Findings suggest that families living in more distressed communities are most likely to identify the impact of child sleep on their own sleep and night wakings in reporting a child sleep problem, whereas those from more prosperous communities consider these factors as well as other sleep parameters, including sleep duration. Clinicians should consider expanding screening questions for child sleep problems to include the perceived impact on caregiver sleep.
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Affiliation(s)
| | | | | | | | - Jodi A. Mindell
- Saint Joseph’s University, USA,Children’s Hospital of Philadelphia, USA,University of Pennsylvania, Perelman School of Medicine, USA,Corresponding author. Department of Psychology, Saint Joseph’s University, Philadelphia, PA 19131, USA. (J.A. Mindell)
| | - Ariel A. Williamson
- Children’s Hospital of Philadelphia, USA,University of Pennsylvania, Perelman School of Medicine, USA
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12
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Jin M, Kato M, Itakura S. Development of a classifier to screen for severe sleep disorders in children. Front Pediatr 2022; 10:902012. [PMID: 35935356 PMCID: PMC9354400 DOI: 10.3389/fped.2022.902012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to develop an automatic classifier for the identification of severe sleep disorders that require immediate intervention in children. Our study assessed 7,008 children (age: 0-83 months) in Japan, whose parents and nursery teachers recorded their 14-day sleep patterns. Sleep quality was assessed by pediatricians and scored as 1 (no severe sleep disorder) or 0 (severe sleep disorder). Discriminant analysis was performed for each age group using sleep quality (0 or 1) as the dependent variable and variables in the 14-day sleep log as independent variables. A stepwise method was used to select the independent variables to build the best model. The accuracy of the discriminant analysis for the age groups ranged from 71.3 to 97.3%. In summary, we developed an automatic classifier with sufficient application value to screen for severe sleep disorders in children. In the future, this classifier can be used to rapidly determine the presence or absence of severe sleep disorders in children based on their 14-day sleep logs, thus allowing immediate intervention.
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Affiliation(s)
- Mingwen Jin
- Center for Baby Science, Doshisha University, Kyoto, Japan
| | - Masaharu Kato
- Center for Baby Science, Doshisha University, Kyoto, Japan
| | - Shoji Itakura
- Center for Baby Science, Doshisha University, Kyoto, Japan
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13
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St Laurent CW, Rodheim K, Spencer RMC. A Systematic Review of the Relationships Between Physical Activity and Sleep in Early Childhood. KINESIOLOGY REVIEW (CHAMPAIGN, ILL.) 2021; 11:121-137. [PMID: 35873529 PMCID: PMC9302480 DOI: 10.1123/kr.2020-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this systematic review was to examine the associations between physical activity and sleep in children aged less than 6 years. Articles were included if participants were primarily aged less than 6 years and study designs were observational or experimental. Study characteristics were extracted, and the Grading Recommendations Assessment, Development and Evaluation framework was used to assess study quality. Thirty-six studies (16 sleep, 16 physical activity, and three fitness outcomes) from 18 countries reported in 29 articles were included. The majority of sleep and physical activity outcome studies reported mixed effects with very low to low quality of evidence. Fitness outcome studies were limited, and therefore, evidence was insufficient. The high prevalence of mixed and null results could be related to study limitations. Importantly, this review points to the critical need for higher quality studies of sleep and physical activity in young children, which would support health recommendations and intervention strategies for healthier child development.
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Affiliation(s)
- Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Katrina Rodheim
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rebecca M C Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Institute of Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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14
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Yu J, Jin H, Wen L, Zhang W, Saffery R, Tong C, Qi H, Kilby MD, Baker PN. Insufficient sleep during infancy is correlated with excessive weight gain in childhood: a longitudinal twin cohort study. J Clin Sleep Med 2021; 17:2147-2154. [PMID: 34666881 DOI: 10.5664/jcsm.9350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine total sleep duration in infancy and the associations of insufficient sleep duration with later weight gain and the risk of overweight in a longitudinal twin cohort study. METHODS The data for this study are from the Longitudinal Twin Study (LoTiS), a twin-pregnancy birth cohort study that was carried out in China (n = 186 pairs). The sleep data were collected at 6 months using the Brief Infant Sleep Questionnaire that was completed by parents with the assistance of a research assistant. Anthropometric data were obtained from the children's health clinic records at 6, 12, 18, and 24 months. RESULTS There were no significant differences between infants with insufficient sleep and those with sufficient sleep in terms of height, weight, body mass index, incidence of overweight, and body fat mass, while infants with insufficient sleep duration were predisposed to gain excessive weight from 6 to 12 and 6 to 18 months of age (all P < .05). After adjusting for confounding variables, insufficient sleep duration was found to be correlated with excessive weight gain from 6 to 18 months of age (odds ratio: 3.47; 95% confidence interval, 1.23-9.78). The relationship was more pronounced in monozygotic twins than in dizygotic twins. CONCLUSIONS Insufficient total sleep duration at the age of 6 months is correlated with the risk of excessive weight gain at 18 months of age in twins, particularly in monozygotic twins. CLINICAL TRIAL REGISTRATION Registry: Chinese Clinical Trial Register; Name: Unraveling the complex interplay between genes and environment in specifying early life determinants of illness in infancy: a longitudinal prenatal study of Chinese Twins. URL: http://www.chictr.org.cn/showproj.aspx?proj=13839; Identifier: ChiCTR-OOC-16008203. CITATION Yu J, Jin H, Wen L, et al. Insufficient sleep during infancy is correlated with excessive weight gain in childhood: a longitudinal twin cohort study. J Clin Sleep Med. 2021;17(11):2147-2154.
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Affiliation(s)
- Jiaxiao Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huili Jin
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjin Zhang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Richard Saffery
- Cancer, Disease, and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Mark D Kilby
- Centre for Women's and Newborn Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
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15
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Martinez SM, Blanco E, Tschann JM, Butte NF, Grandner MA, Pasch LA. Sleep duration, physical activity, and caloric intake are related to weight status in Mexican American children: a longitudinal analysis. Int J Behav Nutr Phys Act 2021; 18:93. [PMID: 34243777 PMCID: PMC8272387 DOI: 10.1186/s12966-021-01159-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/17/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Obesity is a serious issue, spanning all ages, and, in the U.S., disproportionately affects Latinos and African Americans. Understanding sleep, physical activity and dietary behaviors that may predict childhood obesity can help identify behavioral intervention targets. METHODS Data were drawn from a U.S. cohort study of 323 Mexican American 8-10-year-old children and their mothers, who participated in a longitudinal study over a 2-year period. Measures were collected at baseline (BL; child mean age = 8.87, SD = 0.83), year 1 (FU1) and year 2 (FU2). Mothers reported on household income and acculturation at BL. Child height and weight were collected and BMI z-scores (BMIz) were calculated for weight status at BL, FU1, and FU2. Accelerometer-estimated sleep duration (hours) and moderate-to-vigorous physical activity (MVPA; minutes) were collected across 3 days at BL, FU1, and FU2. Two 24-h dietary recalls were performed at each time point; from these, average energy intake (EI, kcals/day) was estimated. Cross-lagged panel analysis was used to examine behavioral predictors on BMIz at each time point and across time. RESULTS At BL and FU1, longer sleep duration (β = - 0.22, p < 0.001; β = - 0.17, p < 0.05, respectively) and greater MVPA (β = - 0.13, p < 0.05; β = - 0.20, p < 0.01, respectively) were concurrently related to lower BMIz. At FU2, longer sleep duration (β = - 0.18, p < 0.01) was concurrently related to lower BMIz, whereas greater EI (β = 0.16, p < 0.01) was related to higher BMIz. Longer sleep duration at BL predicted lower BMIz at FU1 (β = - 0.05, p < 0.01). CONCLUSIONS Longer sleep duration was concurrently related to lower weight status at each time point from ages 8-10 to 10-12. Higher MVPA was concurrently related to lower weight status in earlier childhood (ages 8-10 and 9-11) and higher EI was concurrently related to higher weight status toward the end of childhood (ages 10-12 years). Furthermore, longer sleep in earlier childhood was protective of children's lower weight status 1 year later. These findings suggest that sleep duration plays a consistent and protective role against childhood obesity; in addition, MVPA and healthy EI remain important independent factors for obtaining a healthy weight.
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Affiliation(s)
- S M Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco; 550 16th St., 2nd Floor, San Francisco, CA, 94158, USA.
| | - E Blanco
- Department of Pediatrics, Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA, USA
- Public Health PhD program, University of Chile, Santiago, Chile
| | - J M Tschann
- Department of Psychiatry and Behavioral Sciences, University of California at San Francisco, San Francisco, CA, 94143-0848, USA
| | - N F Butte
- Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, 1100 Bates Street, Houston, TX, 77030-2600, USA
| | - M A Grandner
- Department of Psychiatry, University of Arizona, 2800 E. Ajo Way, Tucson, AZ, 85713, USA
| | - L A Pasch
- Department of Psychiatry and Behavioral Sciences, University of California at San Francisco, San Francisco, CA, 94143-0848, USA
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16
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Zhang Z, Sousa-Sá E, Pereira JR, Okely AD, Feng X, Santos R. Correlates of Sleep Duration in Early Childhood: A Systematic Review. Behav Sleep Med 2021; 19:407-425. [PMID: 32496141 DOI: 10.1080/15402002.2020.1772264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This systematic review aimed to summarize correlates of sleep duration in children under 5 years of age. METHODS Six electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, SPORTDiscus, and Scopus) were searched from inception to May 2019. Observational studies and intervention studies reporting cross-sectional results from baseline data were considered. Data were extracted using a predesigned form and potential correlates were categorized following a sociological framework. RESULTS One-hundred and sixteen studies, representing 329,166 children, met the inclusion criteria, with a high risk of bias in 62 included studies. A total of 83 correlates of sleep duration were identified. Among the associations studied four or more times, correlates of nap duration were child's age and nighttime sleep onset/bedtime; correlates of nighttime sleep duration were household income, parent marital status, parental adiposity level, nighttime sleep duration at younger age, nighttime sleep onset/bedtime, nighttime sleep wakeup time, and frequency of current bedtime routine; correlate of total sleep duration was screen time. CONCLUSIONS Young children from low-income households, single families, or having overweight parents may be at risk for short sleep duration. Promoting healthy sleep duration from an early age appears essential. Effective practices may include encouraging an earlier bedtime, limiting screen time, and establishing a regular bedtime routine. The absence of consistent evidence in the psychological, cognitive, and emotional domain as well as the physical environmental domain warrants further research.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,CIDAF (Uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Illawarra Health and Medical Research Institute, Australia
| | - Xiaoqi Feng
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Australia.,Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona de Humanidades e Tecnologia, Lisboa, Portugal
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17
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Killian HJ, Pallotto IK, Sweeney BR, Dreyer Gillette ML. Weight Management Outcomes of Youth with Autism Spectrum Disorder Seeking Treatment from a Multidisciplinary Team. J Autism Dev Disord 2021; 52:791-799. [PMID: 33791886 PMCID: PMC8011772 DOI: 10.1007/s10803-021-04982-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 12/02/2022]
Abstract
Youth with Autism Spectrum Disorder (ASD) are at an increased risk for developing obesity when compared to their typically developing peers. Given higher prevalence of obesity in youth with ASD, understanding factors relating to success in obesity treatment provides insight into implementing efficacious treatments for youth. The current study examines age, sleep, and metabolic factors potentially affecting success in 74 youth (Mage = 11.66) attending a multidisciplinary weight management treatment program over a year. Multilevel modeling indicated that higher baseline BMI class category, medications at baseline, and absence of sleep difficulties predicted greater reduction in BMI after a year of treatment.
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Affiliation(s)
- Haley J Killian
- Department of Psychology, The University of Missouri - Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA
| | - Isabella K Pallotto
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC, 27599, USA
| | - Brooke R Sweeney
- Department of Pediatrics, Weight Management and Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City/University of Missouri Kansas City School of Medicine, 2401 Gillham Rd., Kansas City, MO, 64108, USA
| | - Meredith L Dreyer Gillette
- Department of Pediatrics, Developmental and Behavioral Health and Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City/University of Missouri Kansas City School of Medicine, 2401 Gillham Rd., Kansas City, MO, 64108, USA.
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18
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Kracht CL, Redman LM, Casey PH, Krukowski RA, Andres A. Association between Home Environment in Infancy and Child Movement Behaviors. Child Obes 2021; 17:100-109. [PMID: 33471594 PMCID: PMC7984654 DOI: 10.1089/chi.2020.0319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: An adequate balance of movement behaviors, including physical activity (PA), sleep, and screen time, is important for preventing excess weight gain in children. This study examined the relationship between the infant home environment and movement behaviors later in life. Methods: Pregnant women were recruited for a cohort study related to maternal and child development. The home environment was assessed for developmental stimulation, organization, and toys by the Pediatric Review of Children's Environmental Support and Stimulation (PROCESS) questionnaire when the child was 6 months of age. At 2 years of age, mother-reported child screen time, and child PA and sleep duration were estimated by accelerometry. Child behaviors were compared with the 24-hour Movement Guidelines (≥180 minutes/day of total PA, 11-14 hours/day of sleep, and ≤1 hour/day of screen time). Logistic regression was used to assess the relationship between the home environment and movement behaviors, adjusting for maternal and child covariates. Results: Mother/child dyads (n = 141) were mainly white (84.4%), and middle (32.8%) or low income (48.9%). All children (100%) met the PA guideline, some met the sleep guideline (71.6%), fewer met the screen-time guideline (44.7%), and only one-third (34.0%) met all three guidelines. Children who met the screen-time guideline lived in homes with more developmental stimulation and toys (p < 0.05). Children who met all 3 guidelines lived in homes with more organization and toys (p < 0.05). Conclusion: The infant home environment was associated with appropriate amounts of movement behaviors at 2 years. Promoting organization (i.e., routines) and toys in infancy may help facilitate nonscreen-based habits and healthy development. The clinical trial registration number is NCT01131117.
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Affiliation(s)
| | | | - Patrick H. Casey
- Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Nutrition Center, Little Rock, AR, USA
| | - Rebecca A. Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Aline Andres
- Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Nutrition Center, Little Rock, AR, USA
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19
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Covington LB, Patterson F, Hale LE, Teti DM, Cordova A, Mayberry S, Hauenstein EJ. The contributory role of the family context in early childhood sleep health: A systematic review. Sleep Health 2021; 7:254-265. [PMID: 33436342 DOI: 10.1016/j.sleh.2020.11.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 01/25/2023]
Abstract
Sleep-wake regulation is established during early childhood and contributes to life-long health. The family context is critical to the development of child sleep-wake regulation. The primary aim of this systematic review was to elucidate family-level constructs (outside of bedtime parenting) that contribute to early childhood (age 0-5 years) sleep health. We identified empirical research articles that investigate these relationships through systematically searching PubMed, Web of Science, and PsycINFO databases. The transactional model of sleep-wake regulation guided the selection of family-level search terms, including socioeconomic status (SES), family structure, household chaos, marital, co-parenting, and social relationships. Sleep search terms included sleep problems, duration, timing, and variability. We searched sleep and family terms in combination with infant, toddler, or preschool developmental age. Sixteen studies satisfied criteria for inclusion. Results indicated that the presence of household chaos and poor quality marital relationships were directly associated with early childhood sleep problems and variable sleep timing. Higher marital satisfaction and the presence of household routines were positively associated with sleep duration. Several, but not all, studies showed an association between lower SES and poor child sleep health. There were no significant direct associations for family structure and limited findings for the role of perceived social support and co-parenting relationship quality. Overall, operationalization and measurement of family and sleep constructs varied across studies, decreasing our ability to make comparisons and draw robust conclusions. Future research should identify modifiable family-level factors that can be targeted, in addition to bedtime parenting, to improve sleep-wake regulation development.
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Affiliation(s)
- Lauren B Covington
- School of Nursing, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA.
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA
| | - Lauren E Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Health Sciences Center, Renaissance School of Medicine, Stony Brook University, 101 Nicolls Road, Stony Brook, NY 11794-8338, USA
| | - Douglas M Teti
- Department of Human Development & Family Studies, The Pennsylvania State University, 105 Health and Human Development Building, University Park, PA 16802, USA
| | - Angeni Cordova
- Epidemiology Program, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA
| | - Shannon Mayberry
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA
| | - Emily J Hauenstein
- School of Nursing, College of Health Sciences, University of Delaware, 100 Discovery Boulevard, Newark, DE 19713, USA
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20
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Covington L, Armstrong B, Trude ACB, Black MM. Longitudinal Associations Among Diet Quality, Physical Activity and Sleep Onset Consistency With Body Mass Index z-Score Among Toddlers in Low-income Families. Ann Behav Med 2020; 55:653-664. [PMID: 33196078 DOI: 10.1093/abm/kaaa100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Habits surrounding health behaviors (i.e., sleep, physical activity, diet) are developed in toddlerhood. Lack of consistent health habits may increase obesity risk among toddlers in low-income families. PURPOSE To compare the role of sleep onset consistency, physical activity and diet quality as mediators between household poverty and toddler weight. METHODS Two hundred and seven toddlers (mean age = 20.2 months, 46% female, 68.1% Black) participating in an obesity prevention trial were assessed at three time points over 12 months. Using Actical accelerometers, we assessed sleep and physical activity at each time point for up to 1 week. We defined sleep onset consistency as the standard deviation of sleep onset across all days. We calculated the Healthy Eating Index-2015 from a 24-hr dietary recall. We used WHO standards to calculate BMI-for-age z-scores from toddlers' weight/length, and calculated poverty ratio from parent-reported income and family size. Multilevel mediation models tested toddler sleep onset consistency, physical activity, and diet quality as mediators between household poverty and toddler BMI z-score. RESULTS Toddlers from households with higher poverty ratios had more inconsistent sleep onset times. Toddlers with more inconsistent sleep onset times had higher BMI z-scores across all timepoints, even when accounting for physical activity and diet quality. Sleep onset consistency indirectly explained the association between household poverty and BMI z-score. CONCLUSIONS Inconsistent sleep schedules could help explain the association between poverty and BMI. Future research should examine strategies to support low-income families to develop and maintain routines as a mechanism to prevent obesity and reduce disparities. TRIAL REGISTRATION NUMBER NCT02615158.
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Affiliation(s)
| | - Bridget Armstrong
- Arnold School of Public Health, Department of Exercise Science, Columbia, SC, USA
| | - Angela C B Trude
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, Baltimore, MD, USA
| | - Maureen M Black
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, Baltimore, MD, USA.,RTI International, Research Triangle Park, NC, USA
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21
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St. Laurent CW, Burkart S, Rodheim K, Marcotte R, Spencer RMC. Cross-Sectional Associations of 24-Hour Sedentary Time, Physical Activity, and Sleep Duration Compositions with Sleep Quality and Habits in Preschoolers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7148. [PMID: 33003598 PMCID: PMC7579350 DOI: 10.3390/ijerph17197148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
Although some studies indicate physical activity and sleep quality are positively associated in children, most reports examined physical activity independent of other 24-h behaviors and focused on older children. The aim of this cross-sectional study was to examine the predicted changes in sleep efficiency and habits when reallocating time between movement behaviors using compositional isotemporal substitution in preschool-aged children. Accelerometers were worn by 288 participants (51.6 ± 9.5 months) for up to 16 days. Sleep outcomes included sleep efficiency, nap frequency, sleep disturbances, and bedtime resistance. Compositional isotemporal substitution analyses demonstrated that the combined effect of 24-h movement behaviors was associated with sleep efficiency (p < 0.001) and nap frequency (p < 0.003). When sleep increased by 30 min at the expense of stationary time or light physical activity, estimates of sleep efficiency and bedtime resistance decreased while nap frequency increased. When stationary time increased by 30 min from moderate to vigorous physical activity, estimated sleep efficiency increased and sleep disturbances decreased. Although this study presents preliminary evidence that 24-h movement behavior compositions in early childhood are associated with sleep quality and nap frequency, estimated effects from theoretical time reallocations across sleep outcomes were mixed.
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Affiliation(s)
- Christine W. St. Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA;
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA;
| | - Katrina Rodheim
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA;
| | - Robert Marcotte
- Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA;
| | - Rebecca M. C. Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA;
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22
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Body Mass Index, Physical Activity, Sedentary Behavior, Sleep, and Gross Motor Skill Proficiency in Preschool Children From a Low- to Middle-Income Urban Setting. J Phys Act Health 2020; 16:525-532. [PMID: 31154894 DOI: 10.1123/jpah.2018-0133] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 12/27/2018] [Accepted: 02/24/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Limited research reports on the relationship between body mass index (BMI) and physical activity (PA), sedentary behavior (SB), sleep, and gross motor skills (GMS) in low- and middle-income countries. The aim of this study was to (1) describe BMI, PA, SB, sleep duration, and GMS proficiency in South African preschool children and (2) identify relationships between variables. METHODS BMI, including z scores for height, weight, and BMI were determined. Seven-day PA, SB, and sleep were measured using accelerometry. GMS were assessed using the Test of Gross Motor Development (second edition). Associations were explored by comparing sleep, PA, SB, and GMS between BMI tertiles using the Kruskal-Wallis test. RESULTS Most (86%) children (n = 78, 50% boys) had a healthy BMI (15.7 [1.3] kg/m2). Children spent 560.5 (52.9) minutes per day in light- to vigorous-intensity PA and 90.9 (30.0) minutes per day in moderate- to vigorous-intensity PA; most (83%) met the current PA guideline. Nocturnal sleep duration was low (9.28 [0.80] h/d). Although daytime naps increased 24-hour sleep duration (10.17 [0.71] h/d), 38% were classified as short sleepers. Around half (54.9%) of participants complied with both PA and sleep guidelines. No associations between variables were found. CONCLUSION Despite being lean, sufficiently active, and having adequate GMS, many children were short sleepers, highlighting a possible area for intervention.
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23
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Ordway MR, Sadler LS, Jeon S, O'Connell M, Banasiak N, Fenick AM, Crowley AA, Canapari C, Redeker NS. Sleep health in young children living with socioeconomic adversity. Res Nurs Health 2020; 43:329-340. [PMID: 32306413 DOI: 10.1002/nur.22023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/22/2020] [Accepted: 03/29/2020] [Indexed: 12/19/2022]
Abstract
Racially and ethnically diverse young children who live with socioeconomic adversity are at high risk for sleep deficiency, but few behavioral sleep interventions (BSIs) are tailored to their needs. To support the future development of a feasible, acceptable, and culturally relevant sleep intervention, we conducted a community-engaged, mixed-methods study with 40 low-income, racially, and ethnically diverse parents to describe sleep characteristics, sleep habits, and parental sleep knowledge of their 6-36-month-old children and to examine the associations between children's sleep characteristics and sleep habits. This report presents quantitative data from this mixed-methods study. We measured objective (actigraphy) and parent-reported sleep (Brief Infant Sleep Questionnaire) characteristics, sleep habits at bedtime, sleep onset, and during night awakenings, parental sleep knowledge, psychological function (Brief Symptom Inventory), and parenting stress (Parenting Stress Index). Children had low sleep duration (537.2 ± 54.7 nighttime and 111.2 ± 29.8 nap minutes), late bedtimes (22:36 ± 1.5 hr), and high bedtime variability (mean squared successive difference = 3.68 ± 4.31 hr) based on actigraphy. Parental knowledge about sleep recommendations was limited. Sleep habits before bedtime, at sleep onset, and during night awakenings were varied. Sixty-five percent of parents reported co-sleeping. Feeding near bedtime or during the night was associated with later bedtimes, more fragmented sleep, and increased bedtime variability. These findings suggest the need for BSIs to support earlier bedtimes and improve sleep duration and continuity by addressing modifiable behaviors. Tailored BSIs that consider socioecological influences on the development of sleep habits are needed.
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Affiliation(s)
| | - Lois S Sadler
- Yale Child Study Center, Yale University School of Nursing, West Haven, Connecticut
| | | | | | | | - Ada M Fenick
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | | | - Craig Canapari
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
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24
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Armstrong B, Covington LB, Unick GJ, Black MM. Featured Article: Bidirectional Effects of Sleep and Sedentary Behavior Among Toddlers: A Dynamic Multilevel Modeling Approach. J Pediatr Psychol 2020; 44:275-285. [PMID: 30476202 DOI: 10.1093/jpepsy/jsy089] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine the bidirectional effects of objectively measured nighttime sleep and sedentary activity among toddlers. METHOD Actical accelerometer data were analyzed for 195 toddlers participating in an obesity prevention trial (mean age = 27 months). Toddlers wore the accelerometers for up to 7 consecutive days. Nighttime sleep was defined as the number of minutes asleep between the hours of 8 pm and 8 am the following morning. Sedentary behavior (in minutes) was defined using previously established Actical cut points for toddlers. Variables were lagged and parsed into latent within- and between-person components, using dynamic structural equation modeling (DSEM). RESULTS Toddlers spent an average of 172 min (∼3 hr) in sedentary activity and slept an average of 460 min (∼8 hr) per night. An autoregressive cross-lagged multilevel model revealed significant autoregression for both sleep and sedentary activity. Cross-lagged values revealed that decreased sleep predicted increased next-day sedentary activity, and sedentary activity predicted that night's sleep. For 89% of the sample, the within-person standardized cross-lagged effects of sleep on sedentary were larger than the cross-lagged effects of sedentary on sleep. CONCLUSIONS Results suggest that, on average, nighttime sleep is a stronger predictor of subsequent sedentary behavior (compared with the reverse), and this is the case for the majority of toddlers. Findings highlight the importance of interindividual associations between sleep and sedentary activity. The present study is an example of how DSEM methods can be used to ask questions about Granger-causal cross-lagged relations between variables, both within and between individuals.
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Affiliation(s)
| | | | | | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine.,RTI International
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25
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Ward AL, Reynolds AN, Kuroko S, Fangupo LJ, Galland BC, Taylor RW. Bidirectional associations between sleep and dietary intake in 0–5 year old children: A systematic review with evidence mapping. Sleep Med Rev 2020; 49:101231. [DOI: 10.1016/j.smrv.2019.101231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 01/11/2023]
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26
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Janssen X, Martin A, Hughes AR, Hill CM, Kotronoulas G, Hesketh KR. Associations of screen time, sedentary time and physical activity with sleep in under 5s: A systematic review and meta-analysis. Sleep Med Rev 2020; 49:101226. [PMID: 31778942 PMCID: PMC7034412 DOI: 10.1016/j.smrv.2019.101226] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 01/23/2023]
Abstract
Sleep is crucial to children's health and development. Reduced physical activity and increased screen time adversely impact older children's sleep, but little is known about these associations in children under 5 y. This systematic review examined the association between screen time/movement behaviors (sedentary behavior, physical activity) and sleep outcomes in infants (0-1 y); toddlers (1-2 y); and preschoolers (3-4 y). Evidence was selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and synthesized using vote counting based on the direction of association. Quality assessment and a Grading of Recommendations, Assessment, Development and Evaluation was performed, stratified according to child age, exposure and outcome measure. Thirty-one papers were included. Results indicate that screen time is associated with poorer sleep outcomes in infants, toddlers and preschoolers. Meta-analysis confirmed these unfavorable associations in infants and toddlers but not preschoolers. For movement behaviors results were mixed, though physical activity and outdoor play in particular were favorably associated with most sleep outcomes in toddlers and preschoolers. Overall, quality of evidence was very low, with strongest evidence for daily/evening screen time use in toddlers and preschoolers. Although high-quality experimental evidence is required, our findings should prompt parents, clinicians and educators to encourage sleep-promoting behaviors (e.g., less evening screen time) in the under 5s.
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Affiliation(s)
- Xanne Janssen
- University of Strathclyde, School of Psychological Science and Health, Glasgow, UK.
| | - Anne Martin
- University of Glasgow, MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
| | - Adrienne R Hughes
- University of Strathclyde, School of Psychological Science and Health, Glasgow, UK
| | - Catherine M Hill
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, UK; Institute of Education, University College London, UK; Southampton Children's Hospital, UK
| | | | - Kathryn R Hesketh
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, UK
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27
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Grant VM, Tomayko EJ, Kingfisher RD. Sleep and Physical Activity Patterns in Urban American Indian Children. Am J Health Behav 2020; 44:67-75. [PMID: 31783933 PMCID: PMC7373171 DOI: 10.5993/ajhb.44.1.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: In this study, we examined patterns of obesity, physical activity (PA), sleep, and screen time in urban American Indian (AI) youth in the 6th-8th grade. Methods: A youth sample (N = 36) from 3 middle schools was recruited to participate in this observational sample of convenience. Youth completed a demographic and screen time survey, measurements of height and weight, and wore a wrist accelerometer continuously for 7 days to assess PA and sleep. Results: Approximately 42% of participants were overweight or obese. Average weekday screen time was 254.7±98.1 minutes. Compared to weekdays, weekend sedentary activity increased (weekday, 159.2±81.1 minutes vs weekend, 204.3±91.7 minutes; p = .03) and vigorous PA (weekday, 20.9±19.1 minutes vs weekend, 5.7±8.1 minutes; p = .0001) and moderate-to-vigorous PA (weekday, 192.65±62.3 minutes vs weekend, 141±71.7 minutes; p = .002) decreased. Compared to weekdays, weekend total sleep time (weekday, 512.8±48.6 minutes vs weekend, 555.3±84.3 minutes; p = .007) and time in bed (weekday, 487.3±49.6 minutes vs weekend, 528.6±71.2 minutes; p = .01) increased. Conclusions: Weekday to weekend shifts in PA and sleep must be considered when designing targeted obesity prevention interventions.
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Affiliation(s)
- Vernon M Grant
- Center for American Indian and Rural Health Equity, Bozeman, MT;,
| | - Emily J Tomayko
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
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28
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Duh-Leong C, Jo Messito M, Katzow MW, Tomopoulos S, Nagpal N, Fierman AH, Gross RS. Material Hardships and Infant and Toddler Sleep Duration in Low-Income Hispanic Families. Acad Pediatr 2020; 20:1184-1191. [PMID: 32650047 PMCID: PMC9286002 DOI: 10.1016/j.acap.2020.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess relationships between material hardships, shortened sleep duration, and suboptimal sleep practices across infancy and toddlerhood in low-income Hispanic families. METHODS We analyzed longitudinal data of 451 low-income Hispanic mother-child pairs from a child obesity prevention trial. During infancy and toddlerhood, we used adjusted linear regression to assess associations between material hardship (financial difficulty, food insecurity, housing disrepair, and multiple hardships), sleep duration (24-hour, night), and the number of suboptimal sleep practices (eg, later bedtime, co-sleeping). We used adjusted linear regression to assess the longitudinal association between the number of suboptimal sleep practices in infancy and toddlerhood, and tested whether specific or multiple hardships moderated this association. RESULTS In infants, financial difficulty and multiple hardships were associated with decreased night sleep (B = -0.59 hours, 95% confidence interval [CI]: -1.04, -0.14; and B = -0.54 hours, 95% CI: -1.00, -0.08). Housing disrepair was associated with decreased 24-hour sleep (B = -0.64 hours, 95% CI: -1.29, -0.01). In toddlers, each additional suboptimal sleep practice was associated with a decrease in night sleep (B = -0.19 hours, 95% CI: -0.29, -0.09). Each additional suboptimal sleep practice in infancy was associated with a 0.30 increase in the number of suboptimal sleep practices in toddlerhood (P < .001), with greater increases for those with food insecurity or multiple hardships. CONCLUSION Specific and multiple hardships shortened sleep duration during infancy, and moderated the increase of suboptimal sleep behaviors between infancy and toddlerhood. Future studies should consider these early critically sensitive periods for interventions to mitigate material hardships and establish healthy sleep practices.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine (C Duh-Leong, MJ Messito, S Tomopoulos, N Nagpal, AH Fierman, and RS Gross).
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Michelle W. Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at, Hofstra/Northwell, 269-01 76th Ave, New Hyde Park, NY 11040 USA
| | - Suzy Tomopoulos
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Nikita Nagpal
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Arthur H. Fierman
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
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29
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Sleep duration associates with moderate-to-vigorous intensity physical activity and body fat in 1- to 3-year-old children. Infant Behav Dev 2019; 58:101392. [PMID: 31778860 DOI: 10.1016/j.infbeh.2019.101392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 11/22/2022]
Abstract
Sleep during early childhood is important for many developmental outcomes and shows promise as an important correlate of both obesity risk and physical activity behaviors. This was a cross-sectional study concerning the relationships between sleep and moderate- to - vigorous intensity physical activity and body fat percentage in a sample of 1- to 3-year-old children (N = 50; ages 27.512 ± 10.363 months). Sleep was measured with a caregiver questionnaire. Sedentary time, light, moderate, vigorous, and moderate- to - vigorous intensity physical activity were measured with Actigraph wT3x-BT accelerometers. Body fat was measured using Air Displacement Plethysmography with the BodPod Pediatric Option. Moderate- to - vigorous intensity physical activity and body fat percentage both associated with sleep duration, controlling for age and accelerometer wear time. These factors combined explained 54.3 % of the variance in sleep duration present in the sample. These results suggest the presence of relationships between sleep and physical activity and body composition constructs in this sample. Sleep may be an important variable in efforts to both promote early childhood physical activity and healthy body composition.
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30
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Simon SL, Goetz AR, Meier M, Brinton J, Zion C, Stark LJ. Sleep duration and bedtime in preschool-age children with obesity: Relation to BMI and diet following a weight management intervention. Pediatr Obes 2019; 14:e12555. [PMID: 31215768 PMCID: PMC6812590 DOI: 10.1111/ijpo.12555] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/13/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sleep duration is associated with obesity in preschoolers. Weight-management interventions may be an opportunity to incorporate sleep health recommendations. OBJECTIVES To examine changes in sleep in preschool-age children with obesity following a family-based weight-management intervention (Learning about Activity and Understanding Nutrition for Child Health [LAUNCH]) compared with motivational interviewing and standard care conditions. Additionally, we examined associations between sleep with body mass index (BMI) z score (BMIz) and diet. METHODS One hundred fifty-one children (4.6 ± 0.93 y) completed baseline (pretreatment) and posttreatment (week 24) assessments, including anthropometrics, 24-hour dietary recalls, and a 7-day sleep diary. Analysis of variance (ANOVA) and chi-squared tests compared sleep variables between groups; linear regression models examined effects of sleep on BMIz and dietary intake at posttreatment, controlling for baseline values. RESULTS Bedtime and sleep duration were not significantly different between treatment groups from baseline to posttreatment. After adjusting for baseline sleep, earlier bedtime was associated with lower BMIz (95% CI, 0.00-0.04; .03), intake of added sugars (95% CI, 0.70-4.32; .007), and sweet/dessert food servings (95% CI, 0.00-0.19; .04) at posttreatment. Longer night-time sleep duration was associated with fewer added sugars at posttreatment, adjusting for baseline sleep (95% CI, -3.79 to -0.35; .02). CONCLUSIONS More comprehensive sleep intervention incorporated into weight-management intervention may be necessary to promote positive changes for preschoolers with obesity. A focus on earlier bedtime and longer sleep duration appears to be important given associations between sleep duration and bedtime with BMIz and dietary intake.
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Affiliation(s)
- Stacey L. Simon
- Division of Pulmonary & Sleep Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - Amy R. Goetz
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Maxene Meier
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - John Brinton
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - Cynthia Zion
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Lori J. Stark
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
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31
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Zhang Z, Pereira JR, Sousa-Sá E, Okely AD, Feng X, Santos R. The cross-sectional and prospective associations between sleep characteristics and adiposity in toddlers: Results from the GET UP! Study. Pediatr Obes 2019; 14:e12557. [PMID: 31270962 DOI: 10.1111/ijpo.12557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/13/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The associations between sleep characteristics and adiposity in children under three years are not fully understood yet. OBJECTIVE The objective of the study is to examine the cross-sectional and prospective associations between sleep characteristics and adiposity in toddlers over a 12-month period. METHODS Participants were 202 toddlers from the GET-UP! STUDY Sleep duration, sleep timing, and sleep variability were assessed using 24-hour accelerometry for seven consecutive days. Height and weight were measured, and BMI z scores were calculated. Linear mixed models were performed to examine the cross-sectional and prospective associations between sleep characteristics and adiposity, with adjustments for clustering effects and demographic factors. RESULTS Total sleep duration was negatively associated with higher adiposity cross-sectionally (B = -0.12; 95% CI: -0.23, -0.01; .033) but not prospectively (B = 0.01; 95% CI: -0.13, 0.10; .843). Nap duration was prospectively associated with higher levels of adiposity (B = 0.41; 95% CI: 0.14, 0.68; .003). Sleep variability and sleep timing were not associated with concurrent or subsequent adiposity. CONCLUSION Although sleep duration is an important factor associated with obesity in toddlerhood, the potential effects of different types of sleep duration may vary. While longer total sleep duration may protect children from increasing adiposity, longer nap duration seems to be risk factor. As evidence in this age group is scarce, more research is needed to confirm this finding.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,CIDAF (UID/DTP/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Keiraville, Australia
| | - Xiaoqi Feng
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Keiraville, Australia.,Population Wellbeing and Environment Research Lab, Faculty of Social Science, University of Wollongong, Wollongong, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.,Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Universidade Lusófona de Humanidades e Tecnologia, Lisbon, Portugal
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32
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Derks IPM, Gillespie AN, Kerr JA, Wake M, Jansen PW. Associations of Infant Sleep Duration with Body Composition and Cardiovascular Health to Mid-Adolescence: The PEAS Kids Growth Study. Child Obes 2019; 15:379-386. [PMID: 31219339 DOI: 10.1089/chi.2018.0310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Short sleep duration in childhood has often been linked with obesity in later childhood or adolescence. However, whether infant sleep duration affects body composition trajectories and cardiovascular health through to mid-adolescence remains unknown. Methods: Participants were 336 adolescents from a community-based prospective birth cohort in Melbourne, Australia. Mothers completed 24-hour time diaries, including infant sleep in 5-minute intervals at ages 2, 4, and 12 months. BMI and body composition outcomes were measured 6-monthly between 4 and 6.5 years and at 10 and 14 years. Cardiovascular outcomes at 14 years comprised blood pressure, pulse wave velocity, retinal arteriole-to-venule ratio, and carotid intima-media thickness. We used multivariable linear regression and multinomial logistic regression analyses adjusted for sex, age, BMI at birth, gestational age, ethnicity, maternal education, maternal BMI, and neighborhood socioeconomic position. Results: At 2 months, infants slept on average 14.1 hours [standard deviation (SD) 1.9], decreasing to 13.4 hours (SD 2.0) by 12 months. We observed no associations between the different sleep duration time points in infancy and later BMI or body composition. Moreover, a shorter sleep duration did not increase the odds of being on a high body composition trajectory compared with longer sleep (e.g., odds ratio per hour of sleep at 4 months is 0.85, 95% confidence interval 0.65-1.11). Infant sleep duration was also not associated with cardiovascular function or large or small artery structure at 14 years of age. Conclusions: We found no evidence that sleep duration very early in life affects adolescent body composition or cardiovascular health.
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Affiliation(s)
- Ivonne P M Derks
- 1Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,2The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Alanna N Gillespie
- 3Centre for Community Child Health, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Australia.,4Department of Pediatrics, The University of Melbourne, Parkville, Australia
| | - Jessica A Kerr
- 3Centre for Community Child Health, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Australia.,4Department of Pediatrics, The University of Melbourne, Parkville, Australia
| | - Melissa Wake
- 3Centre for Community Child Health, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Australia.,4Department of Pediatrics, The University of Melbourne, Parkville, Australia.,5Department of Pediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Pauline W Jansen
- 1Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.,6Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
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33
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Sleep and weight-related factors in youth: A systematic review of recent studies. Sleep Med Rev 2019; 46:87-96. [DOI: 10.1016/j.smrv.2019.04.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/11/2019] [Accepted: 04/18/2019] [Indexed: 12/28/2022]
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34
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The Combined Impact of Sleep and Diet on Adiposity in Infants, Toddlers, and Young Children: A Systematic Review. J Dev Behav Pediatr 2019; 40:224-236. [PMID: 30741778 DOI: 10.1097/dbp.0000000000000636] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Short sleep duration and poor dietary habits may contribute to increased adiposity; however, the impact of the interaction between these variables on adiposity is less understood. To evaluate research investigating the combined effects of sleep and diet on adiposity in infants, toddlers, and young children. METHODS Systematic searches of electronic databases (PubMed, CINAHL, and Web of Science) from inception through April 2017 were conducted. All studies published in English that had at least 1 sleep (e.g., sleep duration and night awakenings), diet (e.g., 24-hour diet recall and breastfeeding duration), and adiposity (e.g., body mass index z-score and weight-for-length) measure were eligible for inclusion. Abstract and full-text article reviews were conducted by 2 independent reviewers. Data were extracted into a standardized spreadsheet. RESULTS Of the 17 full-text articles reviewed, 14 studies were included. Mediation (n = 2) and moderation (n = 2) were seldom used. Investigation of the combined effects of sleep and diet on adiposity demonstrated a substantial lack of evidence. Synthesis of articles suggests that the relationship between sleep and diet may be interactive and their effects additive in their impact when targeted simultaneously within interventions. CONCLUSION Without consideration of interaction effects among variables of interest, a substantial gap in the literature persists. Both diet and sleep need to be assessed simultaneously and repetitively in future longitudinal research.
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Jansen EC, Peterson KE, Lumeng JC, Kaciroti N, LeBourgeois MK, Chen K, Miller AL. Associations between Sleep and Dietary Patterns among Low-Income Children Attending Preschool. J Acad Nutr Diet 2019; 119:1176-1187. [PMID: 30878402 DOI: 10.1016/j.jand.2019.01.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/09/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Sleep disturbances and low-quality diets are prevalent among children in low-income settings, yet the nature of their relationship remains unclear. In particular, whether aspects other than sleep duration, including timing and quality, are associated with dietary patterns has rarely been examined, especially among preschool-aged children. OBJECTIVE To evaluate whether nightly and total sleep duration, sleep timing, differences in timing and duration from weekdays to weekends, and sleep quality were related to dietary patterns. DESIGN A cross-sectional analysis of children attending preschool. Parents completed questionnaires about children's sleep habits as well as a semiquantitative food frequency questionnaire. PARTICIPANTS/SETTING Three hundred fifty-four English-speaking children (49.9% boys) with no serious medical conditions aged 3 to 5 years who were enrolled in Head Start in Michigan (2009-2011) with complete information on sleep and diet. MAIN OUTCOME MEASURES Dietary pattern scores derived from food frequency questionnaire. STATISTICAL ANALYSES PERFORMED Principal component analysis was used to identify dietary patterns. Separate linear regression models with dietary pattern scores as the dependent variable and continuous sleep measures as independent variables were used to evaluate associations between sleep and diet, adjusting for sex, age, parent education level, and sleep hygiene. RESULTS Three dietary patterns were identified: Vegetables, Healthy Proteins, and Sides; Breads and Spreads; and Processed and Fried. Longer average weekend sleep duration and a greater difference in weekend-to-weekday sleep duration was related to lower Vegetables, Healthy Proteins, and Sides pattern scores. Later sleep midpoint during weekdays was related to lower Vegetables, Healthy Proteins, and Sides pattern scores, whereas later sleep midpoint on the weekend was associated with higher Processed and Fried pattern scores. Similarly, a larger weekend-weekday midpoint difference was associated with higher Processed and Fried pattern scores. CONCLUSIONS Later sleep timing and differences in sleep duration and timing from weekends to weekdays were related to less-optimal dietary pattern scores in young children.
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Goetz AR, Beebe DW, Peugh JL, Mara CA, Lanphear BP, Braun JM, Yolton K, Stark LJ. Longer sleep duration during infancy and toddlerhood predicts weight normalization among high birth weight infants. Sleep 2019; 42:5167948. [PMID: 30412240 PMCID: PMC6369726 DOI: 10.1093/sleep/zsy214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/18/2018] [Indexed: 11/13/2022] Open
Abstract
Study Objectives High birth weight (HBW; ≥ 4000 g) is strongly associated with later overweight, yet little is known about how to disrupt this trajectory. The current study examined sleep practices during infancy and toddlerhood among children born HBW or normal birth weight (NBW; 2500-3999 g). Methods Latent growth curve models were used to examine sleep during infancy and toddlerhood among 270 mother-child dyads enrolled in the Health Outcomes and Measures of the Environment Study. Total sleep duration in 24 hr, sleep maintenance, and restlessness/vocalizations were collected at 6 month intervals between ages 6 and 24 months. Height and weight were obtained at ages 24 or 36 months, and normal and overweight BMI were derived. Sleep was examined among children with a normal BMI during the preschool years who were either HBW (HBW-Normal, n = 36) or NBW (NBW-Normal, n = 184) compared with overweight preschoolers (Overweight, n = 50). It was predicted that the Overweight group would have poorer sleep across infancy and toddlerhood compared with HBW-Normal and NBW-Normal. Results HBW-Normal had the longest and Overweight had the shortest mean 24 hr sleep duration across all time points with NBW-Normal falling in-between the two groups. Compared with Overweight, HBW-Normal exhibited longer 24 hr sleep duration at age 6 months with this group difference maintained over infancy and toddlerhood. No group difference was found for NBW-Normal. Conclusions A longer sleep duration in the first several years of life is associated with development of normal BMI among HBW children. These findings suggest that longer sleep duration may protect HBW children from becoming overweight.
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Affiliation(s)
- Amy R Goetz
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - James L Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Bruce P Lanphear
- Child and Family Research Institute, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Kimberly Yolton
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
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Miller AL, Miller SE, LeBourgeois MK, Sturza J, Rosenblum KL, Lumeng JC. Sleep duration and quality are associated with eating behavior in low-income toddlers. Appetite 2019; 135:100-107. [PMID: 30634008 DOI: 10.1016/j.appet.2019.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The present study examined whether different sleep health parameters (duration, timing, and quality) are associated with obesity-related eating behaviors including emotional overeating, food responsiveness, enjoyment of food, satiety responsiveness, and eating in the absence of hunger (EAH), during toddlerhood. DESIGN Among 134 low-income 33-month-old children, parents reported on child sleep parameters, including sleep quality (Children's Sleep Wake Scale; CSWS) and usual bedtimes and wake times on weekdays and weekends (weeknight sleep duration, weekday-to-weekend bedtime delay). Child eating behaviors were assessed using both observed and parent-report measures. Child Emotional Overeating, Food Responsiveness, Enjoyment of Food, and Satiety Responsiveness were measured by parent report using the Child Eating Behavior Questionnaire-Toddler. Observed child EAH was evaluated by measuring kilocalories of palatable foods consumed following a meal. Multivariable linear regression was used to examine the associations between sleep parameters and eating behaviors. RESULTS Poorer child sleep quality was associated with greater Emotional Overeating (standardized β = -0.20 (SE 0.09), p < .05) and greater Food Responsiveness (β = -0.18 (SE 0.09), p < .05). Shorter child nighttime sleep duration was associated with greater EAH kcal consumed (standardized β = -0.22 (SE 0.09), p < .05). Child bedtime delay was not associated with any of the eating behaviors, and no child sleep variables were associated with either Enjoyment of Food or Satiety Responsiveness. CONCLUSIONS Shorter nocturnal sleep duration and poorer sleep quality during toddlerhood were associated with some, but not all, of the obesity-related eating behaviors. Poor sleep health may promote childhood obesity risk through different eating behavior pathways. As children growing up in poverty may experience greater sleep decrements, sleep duration and sleep quality may be important targets for intervention among low-income families with young children.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States; Center for Human Growth and Development, University of Michigan, United States.
| | - Sara E Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, United States
| | | | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, United States
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, United States; Department of Psychiatry, University of Michigan Medical School, United States
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, United States; Department of Pediatrics, University of Michigan Medical School, United States; Department of Nutritional Sciences, University of Michigan School of Public Health, United States
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Parsons AA, Ollberding NJ, Smith L, Copeland KA. Sleep matters: The association of race, bedtime, outdoor time, and physical activity with preschoolers' sleep. Prev Med Rep 2018; 12:54-59. [PMID: 30181946 PMCID: PMC6120424 DOI: 10.1016/j.pmedr.2018.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 08/16/2018] [Accepted: 08/21/2018] [Indexed: 11/29/2022] Open
Abstract
Sleep is necessary for optimal functioning. Little is known about the extent to which race and opportunities to be active influence sleep in preschool-aged children attending full-day child care. Participants (n = 359) in this cross-sectional study attended 30 randomly selected, childcare centers in Cincinnati, OH. Data collection occurred from November 2009 to January 2011. Hierarchical linear regression and generalized estimating equations tested for associations between nighttime sleep duration and race, outdoor/indoor active time, actual physical activity (PA), screen time, daytime nap, and bedtime after 9 pm. Participants slept a mean ± SD of 1.5 ± 0.8 h at childcare and 9.7 ± 1.0 h at bedtime. White children (β = 0.57 ± 0.14, p < 0.01) and children identifying as Other race (β = 0.40 ± 0.15, p < 0.01) slept more hours than Black children at nighttime. White children were less likely to nap at childcare than Black children. Inside PA time provided was associated with increased nighttime sleep duration (β = 0.092 ± 0.04 h per 30 min PA, p < 0.03). There was no association between outdoor time or moderate to vigorous PA and nighttime sleep. Black children slept less at night on average, but were more likely to engage in nap sleep at childcare resulting in similar overall sleep duration. Additional studies in diverse populations that explore the effects of nighttime versus nap time sleep on child health and well-being are needed.
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Affiliation(s)
- Allison A. Parsons
- Division of Critical Care, Cincinnati Children's Hospital Medical Center (CCHMC), 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
| | - Nicholas J. Ollberding
- Division of Biostatistics and Epidemiology, CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, United States of America
| | - Laurie Smith
- Division of Biostatistics and Epidemiology, CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
| | - Kristen A. Copeland
- Division of General and Community Pediatrics, CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, United States of America
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Zhang Z, Sousa-Sá E, Pereira J, Chaput JP, Okely A, Feng X, Santos R. Correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in toddlers: results from the GET UP! Study. Sleep Med 2018; 53:124-132. [PMID: 30508780 DOI: 10.1016/j.sleep.2018.08.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in a sample of Australian toddlers. METHODS Participants were 173 toddlers (average age 19.7 ± 4.1 months) from the GET UP! STUDY Nocturnal sleep duration, nocturnal sleep variability, nap(s) and physical activity were measured using 24-h accelerometry (Actigraph GT3X+) over seven consecutive days. Nocturnal sleep problems were assessed using the Tayside Children's Sleep Questionnaire. Screen time was reported by the parents. Logistic regression models were used to examine the associations between potential correlates (ie, age, sex, socio-economic status, weight status, physical activity, screen time, nap(s), bedtimes, and wake-up times) and nocturnal sleep characteristics. RESULTS Older children were more likely to have greater sleep variability (OR: 1.97; 95% CI: 1.08-3.61). Less physical activity (OR: 2.38; 95% CI: 1.27-4.45), shorter nap(s) (OR: 2.42, 95% CI: 1.29-4.55), and later wake-up times (OR: 4.42; 95% CI: 2.32-8.42) were associated with higher odds of having longer nocturnal sleep duration. Late bedtimes were associated with shorter nocturnal sleep duration (OR: 0.09; 95% CI: 0.04-0.18) and with greater nocturnal sleep variability (OR: 1.97; 95% CI: 1.06-3.68). None of the potential correlates were associated with nocturnal sleep problems. CONCLUSION The present study identifies several correlates of nocturnal sleep duration (total physical activity, nap(s), bedtime, and wake-up time) and nocturnal sleep variability (age and bedtime), whereas no correlates were identified for nocturnal sleep problems. The association between late bedtimes and shorter nocturnal sleep duration and greater nocturnal variability suggests that these may be modifiable targets for future sleep interventions in early childhood. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12616000471482, 11/04/2016, retrospectively registered.
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Affiliation(s)
- Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - João Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; CIDAF (uid/dtp/04213/2016), University of Coimbra, Coimbra, Portugal
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Anthony Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia
| | - Xiaoqi Feng
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia; Population Wellbeing and Environment Research Lab, Faculty of Social Science, University of Wollongong, NSW, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Australia; Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
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Kaar JL, Schmiege SJ, Vadiveloo M, Simon SL, Tovar A. Sleep duration mediates the relationship between health behavior patterns and obesity. Sleep Health 2018; 4:442-447. [DOI: 10.1016/j.sleh.2018.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 11/16/2022]
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Cassanello P, Díez-Izquierdo A, Gorina N, Matilla-Santander N, Martínez-Sanchez JM, Balaguer A. Adaptation and study of the measurement properties of a sleep questionnaire for infants and pre-school children. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lindsay AC, Moura Arruda CA, Tavares Machado MM, De Andrade GP, Greaney ML. Exploring Brazilian Immigrant Mothers' Beliefs, Attitudes, and Practices Related to Their Preschool-Age Children's Sleep and Bedtime Routines: A Qualitative Study Conducted in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1923. [PMID: 30181465 PMCID: PMC6165127 DOI: 10.3390/ijerph15091923] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/23/2018] [Accepted: 09/01/2018] [Indexed: 12/26/2022]
Abstract
In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at increased risk of childhood obesity. Mounting evidence documents that sleep duration and sleep quality are important modifiable factors associated with increased risk of obesity among preschool-aged children. The number of Brazilian immigrants in the US is increasing, yet no existing research, to our knowledge, has examined factors affecting sleep and bedtime routines of children of Brazilian immigrant families. Therefore, the purpose of this qualitative study was to explore Brazilian immigrant mothers' beliefs, attitudes, and practices related to sleep and bedtime routines among preschool-aged children. Seven focus group discussions (FGDs) were conducted with 37 Brazilian immigrant mothers of preschool-age children living in the US. The audio-recordings of the FGDs were transcribed verbatim in Portuguese without identifiers and analyzed using thematic analyses. Mothers also completed a brief questionnaire assessing socio-demographic and acculturation. Analyses revealed that most mothers were aware of the importance of sleep and sleep duration for their children's healthy growth and development. Mothers also spoke of children needing consistent bedtime routines. Nevertheless, many mothers reported inconsistent and suboptimal bedtime routines (e.g., lack of predictable and orderly bedtime activities such as bath, reading, etc. and use of electronics in bed). These suboptimal routines appeared to be influenced by day-to-day social contextual and environmental factors that are part of Brazilian immigrant families' lives such as parents' work schedule, living with extended family, living in multi-family housing, neighborhood noise, etc. Analyses identified several modifiable parenting practices related to young children's sleep and bedtime routines (e.g., irregular bedtime, late bedtime, inconsistent bedtime routines, use of electronics in bed, etc.) that can be addressed in parenting- and family-based obesity prevention interventions. Interventions should consider the social context of the home/family (e.g., parents' work schedules) and the environment (e.g., multi-family housing; neighborhood noise, etc.) faced by Brazilian immigrant families when developing health promotion messages and parenting interventions tailored to this ethnic group.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | | | - Márcia M Tavares Machado
- Department of Community Health, Federal University of Ceará, Fortaleza, Ceará 62010-560, Brazil.
| | - Gabriela P De Andrade
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
| | - Mary L Greaney
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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Cassanello P, Díez-Izquierdo A, Gorina N, Matilla-Santander N, Martínez-Sanchez JM, Balaguer A. [Adaptation and study of the measurement properties of a sleep questionnaire for infants and pre-school children]. An Pediatr (Barc) 2018; 89:230-237. [PMID: 29317179 DOI: 10.1016/j.anpedi.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/02/2017] [Accepted: 12/07/2017] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Although sleep disturbances in infants and toddlers are common, there is no suitable validated tool in Spanish to evaluate sleep disorders. The Brief Infant Sleep Questionnaire (BISQ) is a well-established multidimensional questionnaire widely used internationally. OBJECTIVES To adapt the BISQ questionnaire to Spanish and analyse its reliability and validity. To explore its feasibility, both in the clinical context, and in epidemiological research. METHODS Participants were parents of children between 3 and 30 months of age. The adaptation to Spanish (BISQ-E) was achieved by using both back translation and consensus, following the international guidelines.Reliability was determined by means of test-retest and measurement of agreement (Kappa value) between 2forms of administration of the questionnaire (self-administration and clinical interview). Construct validity was established by analysing its correlation with a sleep diary. RESULTS A total of 87 families/children participated. The test-retest reliability undertaken in 60 subjects was excellent; r = 0.848 (P<0.001). The kappa value was 0.939 (95% CI: 0.858-1.00, P<0.001).The agreement between BISQ-E and the sleep diary was analysed in 27 families/children, with statistically significant values being obtained for the following variables: bedtime (r = 0.731), hours of night sleep (r = 0.726), hours of daytime sleep (r = 0.867), and number of nocturnal awakenings (r = 0.888) (P < 0.001). CONCLUSIONS The Spanish adaptation of the BISQ shows overall adequate validity and reliability for the evaluation of sleep in infants and pre-school children. Its use as a clinical tool, or for clinical-epidemiological research studies, is feasible.
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Affiliation(s)
- Pia Cassanello
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Ana Díez-Izquierdo
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Nuria Gorina
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Nuria Matilla-Santander
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Jose M Martínez-Sanchez
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España
| | - Albert Balaguer
- Hospital Universitari General de Catalunya, Sant Cugat del Vallès (Barcelona), España; Universitat Internacional de Catalunya, Sant Cugat del Vallès (Barcelona), España.
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Zhang Z, Pereira JR, Sousa-Sá E, Okely AD, Feng X, Santos R. Environmental characteristics of early childhood education and care centres and young children's weight status: A systematic review. Prev Med 2018; 106:13-25. [PMID: 29038034 DOI: 10.1016/j.ypmed.2017.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/07/2017] [Accepted: 10/02/2017] [Indexed: 02/04/2023]
Abstract
The aim of this systematic review was to summarize ECEC environmental correlates of weight status in children under the age of 6years. Six databases (PubMed, PsycINFO, CINAHL, SPORTDiscus, Scopus, and Web of Science) were searched until March 2017. Observational studies examining the relationship between ECEC environmental characteristics and weight status in children aged 0-6years were included. Data was extracted using a predesigned form. Eight studies, representing 4862 children, met the inclusion criteria. Twenty-two environmental characteristics were identified and classified into four domains (physical, political, economic, and sociocultural); of these, six correlates were found. 'Active environment' 'sedentary opportunities', 'active play time', 'high sugar and high fat served', 'educators' weight' and 'educators' habitual physical activity level' were associated with weight status in young children. However, for most environmental characteristics examined, strong evidence is not available yet, due to variations across studies on the measures of environmental characteristics and analytical methodologies. Stronger empirical evidence in greater quantity is needed. Future studies in this area are recommended to investigate the environmental influence using an ecological approach and to examine the potential mediators, with a focus on the settings of family-based centres and samples representing toddlers and/or infants.
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Affiliation(s)
- Zhiguang Zhang
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia.
| | - João R Pereira
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Research Unit for Sport and Physical Activity, University of Coimbra, Coimbra, Portugal
| | - Eduarda Sousa-Sá
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Anthony D Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - Xiaoqi Feng
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab, University of Wollongong, NSW, Australia
| | - Rute Santos
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia; Research Centre in Physical Activity, Health and Leisure; University of Porto, Porto, Portugal
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Gohil A, Hannon TS. Poor Sleep and Obesity: Concurrent Epidemics in Adolescent Youth. Front Endocrinol (Lausanne) 2018; 9:364. [PMID: 30042730 PMCID: PMC6048236 DOI: 10.3389/fendo.2018.00364] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/18/2018] [Indexed: 12/11/2022] Open
Abstract
Poor sleep and obesity are both extraordinarily common in the US adolescent population and often occur simultaneously. This review explores the links between obesity and sleep, outlining what is known about the relationships between sleep characteristics, obesity, and cardiometabolic risk factors in youth. Sleep duration is less than optimal in teens, and decreases as age increases. This is detrimental to overall well-being and is associated with obesity in children, adolescents, and young adults. Accordingly, inadequate sleep duration is associated with poor diet quality, decreased insulin sensitivity, hyperglycemia, and prevalent cardiometabolic risk factors. Evidence suggests that poor sleep quality and altered circadian timing characterized by a preferred later sleep onset, known as "adolescent chronotype," contributes to shortened sleep duration. Obstructive sleep apnea (OSA) occurs more frequently among youth with obesity, and is associated with autonomic nervous system activity promoting higher blood pressure, increased markers of cardiovascular disease risk, and insulin resistance. While there is a clear association between OSA and type 2 diabetes in adults, whether or not this association is prevalent in youth is unclear at this time. Interventions to improve both sleep duration and quality, and obesity in adolescents are scarce and more evidence is needed to determine if such interventions can improve obesity-related health outcomes.
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Affiliation(s)
- Anisha Gohil
- Pediatric Endocrinology Fellow, Section of Pediatric Endocrinology/Diabetology, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, IN, United States
- *Correspondence: Anisha Gohil
| | - Tamara S. Hannon
- Section of Pediatric Endocrinology/Diabetology, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, IN, United States
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Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Birken CS, MacLean JE, Aubert S, Sampson M, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:855. [PMID: 29219078 PMCID: PMC5773910 DOI: 10.1186/s12889-017-4850-2] [Citation(s) in RCA: 217] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The objective of this systematic review was to examine for the first time the associations between sleep duration and a broad range of health indicators in children aged 0 to 4 years. Methods Electronic databases were searched with no limits on date or study design. Included studies (published in English or French) were peer-reviewed and met the a priori determined population (apparently healthy children aged 1 month to 4.99 years), intervention/exposure/comparator (various sleep durations), and outcome criteria (adiposity, emotional regulation, cognitive development, motor development, growth, cardiometabolic health, sedentary behaviour, physical activity, quality of life/well-being, and risks/injuries). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Due to high levels of heterogeneity across studies, narrative syntheses were employed. Results A total of 69 articles/studies (62 unique samples) met inclusion criteria. Data across studies included 148,524 unique participants from 23 countries. The study designs were randomized trials (n = 3), non-randomized interventions (n = 1), longitudinal studies (n = 16), cross-sectional studies (n = 42), or longitudinal studies that also reported cross-sectional analyses (n = 7). Sleep duration was assessed by parental report in 70% of studies (n = 48) and was measured objectively (or both objectively and subjectively) in 30% of studies (n = 21). Overall, shorter sleep duration was associated with higher adiposity (20/31 studies), poorer emotional regulation (13/25 studies), impaired growth (2/2 studies), more screen time (5/5 studies), and higher risk of injuries (2/3 studies). The evidence related to cognitive development, motor development, physical activity, and quality of life/well-being was less clear, with no indicator showing consistent associations. No studies examined the association between sleep duration and cardiometabolic biomarkers in children aged 0 to 4 years. The quality of evidence ranged from “very low” to “high” across study designs and health indicators. Conclusions Despite important limitations in the available evidence, longer sleep duration was generally associated with better body composition, emotional regulation, and growth in children aged 0 to 4 years. Shorter sleep duration was also associated with longer screen time use and more injuries. Better-quality studies with stronger research designs that can provide information on dose-response relationships are needed to inform contemporary sleep duration recommendations. Electronic supplementary material The online version of this article (10.1186/s12889-017-4850-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
| | - Casey E Gray
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Veronica J Poitras
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Reut Gruber
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, H3A 1A1, Canada
| | - Catherine S Birken
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - Joanna E MacLean
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
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Rangan A, Zheng M, Olsen NJ, Rohde JF, Heitmann BL. Shorter sleep duration is associated with higher energy intake and an increase in BMI z-score in young children predisposed to overweight. Int J Obes (Lond) 2017; 42:59-64. [PMID: 28883538 DOI: 10.1038/ijo.2017.216] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 08/14/2017] [Accepted: 08/20/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Inadequate sleep has been shown to be a contributor to obesity in both children and adults. Less evidence is available for toddlers and among those with higher obesity risk. The objective of this study was to examine the relationship between sleep patterns and body weight development in a group of young obesity-predisposed children, and to assess whether intakes of energy or macronutrients mediate this relationship. METHODS Participants included 368 Danish children aged 2-6 years from the Healthy Start Study, a 1.3 year randomised controlled intervention trial. Sleep habits were measured using a 7-day sleep diary. Multivariate linear regression with adjustment for confounders was used to assess the association of sleep duration and sleep variability with 1.3 year changes (Δ) in body mass index (BMI) z-score from baseline to follow-up. RESULTS The average nighttime sleep duration was 10.7 h (range 8.8-12.5 h). After controlling for potential confounders, a significant inverse association between nighttime sleep duration and ΔBMI z-score (β=-0.090, P=0.046) was observed. This relationship was mediated by energy intake, with all macronutrients contributing to this mediation effect. No associations were found for sleep variability and ΔBMI z-score but baseline intake of added sugars and sugary beverages were positively associated with sleep variability. CONCLUSION Shorter sleep duration, mediated by energy intake in early in life, seems a risk factor for weight gain among young obesity-predisposed children.
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Affiliation(s)
- A Rangan
- Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - M Zheng
- Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - N J Olsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark
| | - J F Rohde
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - B L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospitals, the Capital Region, Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Boden Institute of Obesity, Nutrition, Exercise & Eating disorders, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Institute of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark
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48
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Infant sleep problems and interventions: A review. Infant Behav Dev 2017; 47:40-53. [DOI: 10.1016/j.infbeh.2017.02.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/18/2017] [Accepted: 02/21/2017] [Indexed: 01/04/2023]
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