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Salomão LP, Magalhães GS, da Silva JFP, Dos Santos LM, Gomes Moura IC, Rezende BA, Rodrigues-Machado MG. Factors associated with arterial stiffness assessed by pulse pressure amplification in healthy children and adolescents: a cross-sectional study. BMC Pediatr 2023; 23:154. [PMID: 37009891 PMCID: PMC10069089 DOI: 10.1186/s12887-023-03942-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that reducing pulse pressure amplification (PPA) plays an important role in pathogenesis and progression of cardiovascular disease. This is a cross-sectional, observational, and analytical study in which we evaluated the associated factors with a greater chance of reducing PPA in 136 healthy children and adolescents aged 8 to 19 years old stratified by gender and age group. METHODS Arterial stiffness and vascular and hemodynamic parameters were non-invasively measured using Mobil-O-Graph® (IEM, Stolberg, Germany), a cuff-based oscillometric device. PPA was expressed as the peripheral-to-central pulse pressure ratio (PPp / PPc). Participants with PPA < 1.49 were considered as part of the arterial stiffness group. RESULTS In a univariate model, the increase in total vascular resistance, the reflection coefficient and the augmentation pressure were more likely to have arterial stiffness in all groups. The factors most likely to have arterial stiffness (as assessed by the reduction of the PPA) in the multivariate model were increasing age, the reflection coefficient and cardiac index in the total sample, male group and child and adolescent groups. In addition to age in the female group, cardiac output, stroke volume, and AIx@75 were the factors most likely to present arterial stiffness. CONCLUSIONS The results show for the first time in children and adolescents that the factors most likely to reduce PPA are related to the reflection wave, which determines aortic pressures and, therefore, left ventricular afterload.
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Affiliation(s)
- Leticia Pereira Salomão
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil
| | - Giselle Santos Magalhães
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil
| | - José Felippe Pinho da Silva
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil
| | - Luzia Maria Dos Santos
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil
| | - Isabel Cristina Gomes Moura
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil
| | - Bruno Almeida Rezende
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil
| | - Maria Glória Rodrigues-Machado
- Programa de Pós-Graduação em Ciências da Saúde - Faculdade Ciências Médicas-MG, Alameda: Ezequiel Dias, n 275. Bairro: Centro, CEP 30130-110, Belo Horizonte/MG, Brasil.
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A Cross-Sectional Investigation of Preadolescent Cardiometabolic Health: Associations with Fitness, Physical Activity, Sedentary Behavior, Nutrition, and Sleep. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020336. [PMID: 36832464 PMCID: PMC9955686 DOI: 10.3390/children10020336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Cardiometabolic disease (CMD) risk often begins early in life. Healthy lifestyle behaviors can mitigate risk, but the optimal combination of behaviors has not been determined. This cross-sectional study simultaneously examined the associations between lifestyle factors (fitness, activity behaviors, and dietary patterns) and CMD risk in preadolescent children. METHODS 1480 New Zealand children aged 8-10 years were recruited. Participants included 316 preadolescents (50% female, age: 9.5 ± 1.1 years, BMI: 17.9 ± 3.3 kg/m2). Fitness (cardiorespiratory fitness [CRF], muscular fitness), activity behaviors (physical activity, sedentary, sleep), and dietary patterns were measured. Factor analysis was used to derive a CMD risk score from 13 variables (adiposity, peripheral and central hemodynamics, glycemic control, and blood lipids). RESULTS Only CRF (β = -0.45, p < 0.001) and sedentary time (β = 0.12, p = 0.019) were associated with the CMD risk score in the adjusted multivariable analysis. CRF was found to be nonlinear (VO2 max ≤ ≈42 mL/kg/min associated with higher CMD risk score), and thus a CRF polynomial term was added, which was also associated (β = 0.19, p < 0.001) with the CMD risk score. Significant associations were not found with sleep or dietary variables. CONCLUSION The findings indicate that increasing CRF and decreasing sedentary behavior may be important public health targets in preadolescent children.
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Castro N, Bates LC, Zieff G, Pagan Lassalle P, Faulkner J, Lark S, Hamlin M, Skidmore P, Signal TL, Williams MA, Higgins S, Stoner L. Adiposity in preadolescent children: Associations with cardiorespiratory fitness. PLoS One 2022; 17:e0275982. [PMID: 36288267 PMCID: PMC9605025 DOI: 10.1371/journal.pone.0275982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022] Open
Abstract
Lifestyle factors contribute to childhood obesity risk, however it is unclear which lifestyle factors are most strongly associated with childhood obesity. The purpose of this cross-sectional study was to simultaneously investigate the associations among dietary patterns, activity behaviors, and physical fitness with adiposity (body fat %, fat mass, body mass index [BMI], and waist to hip ratio) in preadolescent children. Preadolescent children (N = 392, 50% female, age: 9.5 ± 1.1year, BMI: 17.9 ± 3.3 kg/m2) were recruited. Body fat (%) and fat mass (kg) were measured with bioelectrical impedance analysis. Cardiorespiratory fitness (VO2 max), muscular strength (hand-grip strength), activity, sleep, and dietary pattern was assessed. Multivariable analysis revealed that cardiorespiratory fitness associated most strongly with all four indicators of adiposity (body fat (%) (β = -0.2; p < .001), fat mass (β = -0.2; p < .001), BMI (β = -0.1; p < .001) and waist to hip ratio (β = -0.2; p < .001). Additionally, fruit and vegetable consumption patterns were associated with body fat percentage, but the association was negligible (β = 0.1; p = 0.015). Therefore, future interventions should aim to promote the use of cardiorespiratory fitness as a means of reducing the obesity epidemic in children.
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Affiliation(s)
- Nicholas Castro
- School of Health and Applied Human Sciences, University of North Carolina at Wilmington, Wilmington, NC, United States of America
| | - Lauren C. Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | - Gabriel Zieff
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Patricia Pagan Lassalle
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - James Faulkner
- School of Sport, Health, and Community, University of Winchester, Winchester, United Kingdom
| | - Sally Lark
- School of Sport, Exercise, and Nutrition, Massey University, Wellington, New Zealand
| | - Michael Hamlin
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
| | - Paula Skidmore
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - T. Leigh Signal
- Sleep-Wake Research Centre, Massey University, Wellington, New Zealand
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States of America
| | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Higgins S, Stoner L, Black K, Wong JE, Quigg R, Meredith-Jones K, Skidmore PM. Social jetlag is associated with obesity-related outcomes in 9-11-year-old children, independent of other sleep characteristics. Sleep Med 2021; 84:294-302. [PMID: 34217919 DOI: 10.1016/j.sleep.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/24/2021] [Accepted: 06/10/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Social jetlag has been reported to predict obesity-related indices, independent of sleep duration, with associations in female adolescents but not males. However, such sex-specific relationships have not been investigated in pre-adolescents. OBJECTIVES To examine: (i) the relationships between sleep characteristics, including social jetlag, and obesity-related outcomes during childhood, and (ii) whether these relationships are moderated by sex. METHODS This cross-sectional study included 381 children aged 9-11 years (49.6% female). Average sleep duration, social jetlag, and physical activity were assessed via wrist-worn accelerometry. Sleep disturbances were quantified from the Children's Sleep Habits Questionnaire. Obesity-related outcomes included age-specific body mass index Z-scores (zBMI) and waist-to-height ratio. Additionally % fat, total fat mass, and fat mass index were assessed via bioelectrical impedance analysis. Linear mixed models that nested children within schools were used to identify relationships among sleep characteristics and obesity-related outcomes. RESULTS Positive associations between social jetlag with zBMI, % fat, and fat mass index were seen in univariable and unadjusted multivariable analyses. Following adjustments for known confounders, social jetlag remained significantly associated with zBMI (β = 0.12, p = 0.013). Simple slopes suggested a positive association in girls (β = 0.19, p = 0.006) but not in boys (β = 0.03, p = 0.703). CONCLUSIONS Obesity prevention efforts, particularly in girls, may benefit from targeted approaches to improving the consistency of sleep timing in youth.
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Affiliation(s)
- Simon Higgins
- Department of Exercise Science, Elon University, Elon, NC, USA.
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine Black
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Jyh Eiin Wong
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Robin Quigg
- Department of Preventative and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Paula Ml Skidmore
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Short Sleep Duration is Associated with Central Arterial Stiffness in Children Independent of Other Lifestyle Behaviors. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42978-020-00062-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Stoner L, Pontzer H, Barone Gibbs B, Moore JB, Castro N, Skidmore P, Lark S, Williams MA, Hamlin MJ, Faulkner J. Fitness and Fatness Are Both Associated with Cardiometabolic Risk in Preadolescents. J Pediatr 2020; 217:39-45.e1. [PMID: 31759583 DOI: 10.1016/j.jpeds.2019.09.076] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/27/2019] [Accepted: 09/26/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the associations between cardiorespiratory fitness (CRF) and fatness (overweight-obesity) with cardiometabolic disease risk among preadolescent children. STUDY DESIGN This cross-sectional study recruited 392 children (50% female, 8-10 years of age). Overweight-obesity was classified according to 2007 World Health Organization criteria for body mass index. High CRF was categorized as a maximum oxygen uptake, determined using a shuttle run test, exceeding 35 mL·kg-1·minute-1 in girls and 42 mL·kg-1·minute-1 in boys. Eleven traditional and novel cardiometabolic risk factors were measured including lipids, glucose, glycated hemoglobin, peripheral and central blood pressure, and arterial wave reflection. Factor analysis identified underlying cardiometabolic disease risk factors and a cardiometabolic disease risk summary score. Two-way analysis of covariance determined the associations between CRF and fatness with cardiometabolic disease risk factors. RESULTS Factor analysis revealed four underlying factors: blood pressure, cholesterol, vascular health, and carbohydrate-metabolism. Only CRF was significantly (P = .001) associated with the blood pressure factor. Only fatness associated with vascular health (P = .010) and carbohydrate metabolism (P = .005) factors. For the cardiometabolic disease risk summary score, there was an interaction effect. High CRF was associated with decreased cardiometabolic disease risk in overweight-obese but not normal weight children (P = .006). Conversely, high fatness was associated with increased cardiometabolic disease risk in low fit but not high fit children (P < .001). CONCLUSIONS In preadolescent children, CRF and fatness explain different components of cardiometabolic disease risk. However, high CRF may moderate the relationship between fatness and cardiometabolic disease risk. TRIAL REGISTRATION ACTRN 12614000433606.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Herman Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, NC; Duke Global Health Institute, Duke University, Durham, NC
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - Justin B Moore
- Department of Family & Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas Castro
- School of Sport & Exercise, Massey University, Wellington, NZ; School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS
| | - Paula Skidmore
- Department of Medicine, University of Otago, Christhcurch, NZ
| | - Sally Lark
- School of Sport & Exercise, Massey University, Wellington, NZ
| | - Michelle A Williams
- Depepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michael J Hamlin
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, NZ
| | - James Faulkner
- Sport & Exercise, University of Winchester, Winchester, United Kingdom
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Food Consumption Patterns and Body Composition in Children: Moderating Effects of Prop Taster Status. Nutrients 2019; 11:nu11092037. [PMID: 31480416 PMCID: PMC6770641 DOI: 10.3390/nu11092037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 12/31/2022] Open
Abstract
This cross-sectional study determined whether 6-n-propylthiouracil (PROP) taster status moderates the relationship between food consumption patterns and body composition in children. Children were recruited (n = 342, 50% female, 8-10 y) from across New Zealand. Using a food frequency questionnaire, these food consumption patterns were derived: Processed Foods, Fruit and Vegetables, and Breakfast Foods. Body composition variables included: body fat (%), fat mass (kg), fat mass index (FMI, kg/m2), body mass index (kg/m2) and waist to height ratio (W:Ht). Following adjustment for confounders, Processed Foods were positively associated with %fat (p = 0.015), fat mass (p = 0.004) and FMI (p = 0.016). Taste test strips determined PROP status. For Breakfast Foods, there were small negative associations with all body composition variables (p ≤ 0.001 to 0.037). The population sample was also stratified by PROP taster status. For the non-tasters, there were small to moderate negative associations between Breakfast Foods and each body composition variable (p = 0.003-0.045) except W:Ht (p = 0.112), and these relationships were stronger for girls compared to boys. For the tasters, there were small to moderate positive associations between Processed Foods with %fat (p = 0.030), fat mass (p ≤ 0.001) and FMI (p = 0.014). In conclusion, sensitivity to bitterness may moderate the relationship between food consumption patterns and body composition in children.
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Stoner L, Rowlands D, Morrison A, Credeur D, Hamlin M, Gaffney K, Lambrick D, Matheson A. Efficacy of Exercise Intervention for Weight Loss in Overweight and Obese Adolescents: Meta-Analysis and Implications. Sports Med 2018; 46:1737-1751. [PMID: 27139723 DOI: 10.1007/s40279-016-0537-6] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The global rise in obesity prevalence among children and adolescents has been linked to modifiable lifestyle factors, including lack of physical activity. However, no known meta-analysis has been conducted on the effects of exercise intervention on body composition and cardiometabolic risk factors in overweight and obese adolescents. OBJECTIVES The aim of this study was to (1) estimate whether exercise intervention meaningfully improves body composition and cardiometabolic risk factors in overweight and obese adolescents; and (2) discuss the implications of the findings in terms of primary healthcare provision and public health policy, using New Zealand as an exemplar context. DATA SOURCES Electronic databases (PubMed, Web of Science, SPORTDiscus, Google Scholar) from inception to May 2015. The reference lists of eligible articles and relevant reviews were also checked. STUDY SELECTION Inclusion criteria were (1) randomized controlled trial; (2) structured exercise intervention, alone or combined with any other kind of intervention; (3) control group received no structured exercise or behavioural modification designed to increase physical activity; (4) participants overweight or obese (body mass index [BMI] ≥85th percentile); and (5) participants aged between 10 and 19 years. APPRAISAL AND SYNTHESIS METHODS Initially, 1667 articles were identified. After evaluation of study characteristics, quality and validity, data from 13 articles (15 trials) involving 556 participants (176 male, 193 female, 187 unknown) were extracted for meta-analysis. Meta-analyses were completed on five body composition parameters and ten cardiometabolic parameters. Effect sizes (ESs) were calculated as mean differences, as well as standardized mean differences in order to determine effect magnitude. RESULTS Exercise intervention reduced BMI (mean 2.0 kg/m2, 95 % CI 1.5-2.5; ES moderate), body weight (mean 3.7 kg, 95 % CI 1.7-5.8; ES small), body fat percentage (3.1 %, 95 % CI 2.2-4.1; ES small), waist circumference (3.0 cm, 95 % CI 1.3-4.8; ES small), but the increase (improvement) in lean mass was trivial (mean 1.6 kg, 95 % CI 0.5-2.6). The response to an oral glucose tolerance test following exercise intervention was for a decrease in the area under the curve for insulin (mean 162 μU/μl, 95 % CI 93-231; ES large) and blood glucose (mean 39 mg/dl, 95 % CI 9.4-69; ES moderate). Improvements in the homeostatic model assessment were also noted (mean 1.0, 95 % CI 0.7-1.4; ES moderate) and systolic blood pressure (mean 7.1 mmHg, 95 % CI 3.5-10.7; ES moderate). The effects of exercise on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting insulin and fasting blood glucose were inconclusive. LIMITATIONS Most of the included trials were short term (6-36 weeks) and 13 had methodological limitations. Additionally, the meta-analyses for some of the secondary outcomes had a small number of participants or substantial statistical heterogeneity. CONCLUSIONS The current evidence suggests that exercise intervention in overweight and obese adolescents improves body composition, particularly by lowering body fat. The limited available evidence further indicates that exercise intervention may improve some cardiometabolic risk factors.
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Affiliation(s)
- Lee Stoner
- Centre for Public Health Research, Massey University, PO Box 756, Wellington, New Zealand. .,School of Sport and Exercise, Massey University, Wellington, New Zealand.
| | - David Rowlands
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Ariel Morrison
- School of Public Health, New Mexico State University, Las Cruces, NM, USA
| | - Daniel Credeur
- School of Human Performance and Recreation, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael Hamlin
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
| | - Kim Gaffney
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | | | - Anna Matheson
- Centre for Public Health Research, Massey University, PO Box 756, Wellington, New Zealand
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Stoner L, Castro N, Signal L, Skidmore P, Faulkner J, Lark S, Williams MA, Muller D, Harrex H. Sleep and Adiposity in Preadolescent Children: The Importance of Social Jetlag. Child Obes 2018; 14:158-164. [PMID: 29298086 DOI: 10.1089/chi.2017.0272] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND While short and poor quality sleep have been associated with childhood obesity, no known studies have examined social jetlag. Social jetlag is the discrepancy between an individual's circadian clock and social rhythms, and is measured as the difference in hours between the midpoint of sleep during work/school days and on free (weekend) days. This study investigated the independent associations between sleep duration, sleep disturbances, and social jetlag with adiposity in children. METHODS A cross-sectional study, including 341 children (50% female) aged 8-10 years. Five dependent variables: body fat (%), fat mass (kg), fat mass index (FMI, kg/m2), waist to hip ratio, and body mass index (kg/m2). Three independent variables: average sleep duration, sleep disturbances, and social jetlag. RESULTS Following adjustment for confounders, sleep duration was not associated with any variable, and sleep disturbances were associated with FMI (β = 0.047, 95% CI: 0.002, 0.093 kg/m2), while social jetlag was associated with all five adiposity variables, including an absolute 3% greater body fat (β = 2.963, 95% CI: 0.40, 5.53%) per 1 hour of social jetlag. CONCLUSIONS Social jetlag may be an important and measurable public health target in children.
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Affiliation(s)
- Lee Stoner
- 1 Department of Exercise and Sport Science, University of North Carolina at Chapel Hill , Chapel Hill, NC
| | - Nicholas Castro
- 2 School of Sport and Exercise, Massey University , Wellington, New Zealand .,3 Speep-Wake Research Centre, Massey University , Wellington, New Zealand
| | - Leigh Signal
- 4 Department of Human Nutrition, University of Otago , Dunedin, New Zealand
| | - Paula Skidmore
- 5 Sport and Exercise, University of Winchester , Winchester, United Kingdom
| | - James Faulkner
- 6 Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA
| | - Sally Lark
- 2 School of Sport and Exercise, Massey University , Wellington, New Zealand .,3 Speep-Wake Research Centre, Massey University , Wellington, New Zealand
| | - Michelle A Williams
- 6 Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA
| | - Diane Muller
- 4 Department of Human Nutrition, University of Otago , Dunedin, New Zealand
| | - Harriet Harrex
- 5 Sport and Exercise, University of Winchester , Winchester, United Kingdom
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Stoner L, Weatherall M, Skidmore P, Castro N, Lark S, Faulkner J, Williams MA. Cardiometabolic Risk Variables in Preadolescent Children: A Factor Analysis. J Am Heart Assoc 2017; 6:e007071. [PMID: 29021277 PMCID: PMC5721889 DOI: 10.1161/jaha.117.007071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/09/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Atherosclerosis begins during preadolescence and is occurring at an accelerated rate. This acceleration has been linked to poor lifestyle behaviors and subsequent cardiometabolic complications. Although the clustering of cardiometabolic risk factors has been recognized for over 2 decades, previous studies in children have predominantly examined the relationships between atherosclerosis and individual cardiometabolic risk factors or have grouped together preadolescent and adolescent children. Further, no known studies have included glycated hemoglobin or central hemodynamic measures such as central systolic blood pressure and augmentation index. METHODS AND RESULTS Principal component analysis was performed on a cross-sectional sample of 392 children (aged 9.5 years, 50% girls) from 3 representative sample sites across New Zealand. Four factors explained 60% of the variance in the measured variables. In order of variance explained, the factors were: blood pressure (central systolic blood pressure and peripheral systolic and diastolic blood pressure), adiposity (waist circumference, body mass index, and glycated hemoglobin), lipids (total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol), and vascular (augmentation index, heart rate, and fasting blood glucose). CONCLUSIONS In accordance with previous findings in adults and adolescents, one common factor is unlikely to define cardiometabolic health in preadolescent children. Each of the factors, except vascular, which was predominantly explained by augmentation index, are in agreement with previous findings in adolescents. An additional novel finding was that glycated hemoglobin and fasting blood glucose loaded onto different factors, supporting previous work suggesting that fasting blood glucose indicates short-term glycemic control, whereas glycated hemoglobin reflects chronic glycemic control. CLINICAL TRIAL REGISTRATION URL: www.anzctr.org.au/. ID: ACTRN12614000433606.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, NC
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Paula Skidmore
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Nicholas Castro
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - Sally Lark
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - James Faulkner
- Department of Sport & Exercise, University of Winchester, United Kingdom
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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