Physical Activity, Screen-Based Sedentary Behavior, and Sleep Duration in Adolescents: Youth Risk Behavior Survey, 2011-2013

The relationship between physical activity and anxiety in college students: exploring the mediating role of lifestyle habits and dietary nutrition

Background

Physical activity has been shown to be effective in treating and improving anxiety in college students. However, no studies have been conducted to examine the relationship between physical activity and anxiety in college students through mediating factors such as dietary nutrition and lifestyle habits. Therefore, the aim of this study was to examine the mediating role of lifestyle and dietary nutrition in the relationship between physical activity and anxiety.

Methods

This study used a stratified random sampling method to survey 498 college students from three universities in Fujian, China. Data on participants' demographic characteristics, physical activity, lifestyle habits, and dietary nutrition were collected and analyzed using SPSS software. The proposed structural equation model was analyzed using Amos software.

Results

The results of the study showed that dietary nutrition and lifestyle habits had significant independent mediating effects and continuous multiple mediating effects (p < 0.01) in the effects of physical activity on college students' anxiety. Dietary nutrition and lifestyle habits played an independent mediating role, accounting for 24.9% of the total effect; there was also a continuous multiple mediating effect between dietary nutrition and lifestyle habits, accounting for 13.27% of the total effect value. In addition, physical activity had a direct effect value on anxiety in college students, accounting for 36.93% of the total effect value.

Conclusion

By increasing the behavior and awareness of college students to participate in physical activity, supplemented by guiding them to develop regular lifestyle habits and correct dietary nutritional patterns, the anxiety level of college students can be effectively improved and reduced. This type of regulation is an important reference for the self-management and rehabilitation of college students with anxiety disorders. Future studies can experimentally develop a combined intervention of physical activity, lifestyle habits, and dietary nutritional to help college students better cope with anxiety.

Enhancing sleep health in urban American Indian/Alaska Native adolescents: Implications for culturally tailored interventions

BACKGROUND

Urban American Indian/Alaska Native (AI/AN) adolescents are vulnerable to sleep and other health-related disparities due to numerous social drivers, including historical trauma and relocation to urban areas. This study aims to identify strategies to increase protective factors and culturally tailor sleep health interventions for this population.

METHODS

Using community-based participatory research, the NAYSHAW study conducted in-depth interviews with urban AI/AN adolescents aged 12-19 years to understand critical components needed for developing a culturally sensitive sleep health intervention. Data from two qualitative subsamples (N = 46) and parent surveys (N = 110) were analyzed, focusing on factors that affect sleep health behaviors, including parental involvement, technology, and traditional practices.

RESULTS

Key findings include the detrimental impact of electronics use at night and protective effects of traditional practices on sleep. Parental involvement in sleep routines varied by adolescent's age. Adolescents desired sleep health education in interactive formats, whereas parents preferred workshops and digital applications for sleep health strategies. Findings suggest that interventions need to address electronics use and should also be culturally tailored to address the unique experiences of urban AI/AN adolescents.

CONCLUSIONS

Results underscore the importance of utilizing community-based strategies to develop culturally tailored sleep interventions for underserved populations, specifically urban AI/AN adolescents. Integrating traditional practices with evidence-based sleep health strategies can provide a holistic approach to improving sleep and overall well-being. Parental education and involvement will be critical to the success of such interventions.

Sleep duration and cardiorespiratory fitness in adolescents: Longitudinal analysis from the LabMed study

PURPOSE

We aimed to investigate longitudinal associations between sleep duration and cardiorespiratory fitness, in adolescents.

METHODS

Sleep duration was self-reported and cardiorespiratory fitness was assessed by the 20 m shuttle run test, both at baseline and follow-up (2-year follow-up). Participants were 734 Northern Portuguese adolescents (349 girls), aged 14.6 ± 1.8 years, from the LabMed study.

RESULTS

Significant decreases were found between baseline and follow-up for sleep duration, whereas for cardiorespiratory fitness there was an increase. Adolescents with short sleep duration at baseline had lower cardiorespiratory fitness at follow-up, comparing to those meeting the sleep guidelines (odds ratio [OR] = 0.506, 95% confidence interval [CI]: 0.326-0.785; p = .002 for whole week; OR = 0.597, 95% CI: 0.407-0.875; p = .008 for weekdays). Girls who were short sleepers at baseline had lower odds of having a healthy cardiorespiratory fitness at follow-up, comparing to those meeting the sleep guidelines (OR = 0.311, 95% CI: 0.158-0.613; p < .001 for whole week; OR = 0.469, 95% CI: 0.262-0.838; p = .011 for weekdays). No significant associations between sleep duration and cardiorespiratory fitness were found for boys.

DISCUSSION

There was a significant longitudinal association between short sleep duration and lower cardiorespiratory fitness levels, particularly in girls. Future interventions targeting adolescents' sleep duration should acknowledge behavioral differences between genders, as well as different behaviors adopted by boys ang girls, specifically on weekends.

Bidirectional Associations Between Daily Sleep and Wake Behaviors in Urban American Indian/Alaska Native Youth

PURPOSE

This is the first study to examine daily, bidirectional associations between sleep and wake behaviors/mood in urban American Indian/Alaska Native (AI/AN) adolescents.

METHODS

Participants were 142 urban AI/AN adolescents (mean age = 14 years, 58% female). Sleep was measured with actigraphy (total sleep time [TST] and sleep efficiency) and daily diary (bedtime, wakeup time, and sleep quality) over seven consecutive days. Wake behaviors (caffeine consumption, physical activity, participation in cultural activities, and electronic use after 8p.m.) and mood upon awakening (higher rating indicates greater happiness) were measured via daily diary for seven consecutive days. Multilevel models examined the degree to which nightly sleep predicted next day's wake behaviors and, conversely, wake behaviors and mood predicted nightly sleep, controlling for age, gender, and weekday/weekend.

RESULTS

Earlier bedtime and wakeup times predicted greater participation in physical activity the following day. Later bedtime and wakeup time, worse sleep quality, and shorter TST predicted greater electronic use the following night. Earlier bedtime and wakeup time and better sleep quality predicted higher mood ratings. Conversely, greater caffeine consumption during the day predicted both later bedtime and wakeup time. Participation in cultural activities is predicted later bedtime. More nighttime electronic use predicted both later bedtime and wakeup time, poorer sleep quality, and worse TST and sleep efficiency. Higher mood ratings in the morning predicted earlier bedtime and later wakeup time.

DISCUSSION

Findings highlight dynamic associations between sleep and wake behaviors and mood in AI/AN adolescents and may elucidate novel pathways for intervention and future research.

Association between the 24-hour movement guidelines and executive function among Chinese children

Objective

Childhood is a critical period for brain development. However, it remains unknown whether the behaviors in a typical 24-h day are related to children’s executive function (EF). This study aimed to investigate the relationship between the 24-h movement guidelines and children’s EF.

Method

Children aged 7–12 years (n = 376) were studied in 2017 in China. Physical activity (PA) was accelerometer-derived, while screen time (ST) and sleep duration were self-reported. Meeting the 24-h movement guidelines was defined as: 1) ≥ 60 min/day of moderate-to-vigorous PA; 2) ≤ 2 h/day of recreational ST; 3) 9–11 h/night of sleep. EF was assessed by the Wisconsin Card Sorting Test (WCST). Number of completed categories (CC), shifting efficiency (SE), non-perseverative errors (NPE), and failure to maintain set (FMS) were used to measure four processes of EF, respectively represented global performance, cognitive flexibility, efficiency in rule discovery, and sustained attention. Generalized linear mixed models (GLMM) were completed to explore the associations of meeting the PA, ST, and sleep duration recommendations with four processes of EF.

Results

Statistically significant positive associations were observed between the number of guidelines met, regarded as a continuous variable, with CC [β = 0.343 (95% confidence interval [CI]: 0.125, 0.561)] and SE [β = 4.028 (95% CI: 0.328, 7.727)], while number of guidelines met negatively related to NPE [β =  − 4.377 (95% CI:-7.952,-0.802)]. Participants not meeting the two recommendations for PA and sleep duration had lower scores in CC [β = -0.636(95% CI:-1.125,-0.147)] and SE [β = -10.610 (95% CI:-18.794,-2.425)] compared with those meeting the two, suggesting inferior global performance and worse efficiency in rule discovery. However, ST recommendation had no significant association with any processes of EF.

Conclusion

Meeting more recommendations of the 24-h movement guidelines was associated with superior EF in children. Specifically, more PA and healthy sleep duration should be encouraged to promote children’s EF.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13420-5.

Prospective associations between sedentary behavior and physical activity in adolescence and sleep duration in adulthood

The purpose of this prospective study was to investigate whether sedentary screen time (SST) and physical activity in adolescence were related to sleep duration in adulthood and whether these associations varied by sex. We analyzed data from 9279 adolescents who participated in Waves I and V of the National Longitudinal Study of Adolescent Health (Add Health) in the United States. SST was measured by reported hours spent watching television/videos or playing video/computer games per week. Physical activity was measured with participation in school team club sports and frequency (times/week) of moderate to vigorous physical activity (MVPA). Results from multinomial regression models indicated that adolescents with more SST, particularly 15-21 h (Relative Risk Ratio [RRR] = 1.18, 95% CI: 1.02-1.36) or 22 or more hours (RRR = 1.19, 95% CI: 1.06-1.35) compared to 0-7 h per week SST, had significantly higher relative risk of short sleep (six or fewer hours) in adulthood, after controlling for demographic characteristics, socioeconomic status and health behaviors at Waves I and V, sleep duration at Wave I, and SST and MVPA at Wave V. The association between 22 or more hours per week SST in adolescence and later short sleep varied by sex (RRR = 0.75, 95% CI: 0.58-0.95) and was significantly stronger among males. Measures of physical activity in adolescence did not predict sleep duration. Decreasing adolescents' SST to prevent suboptimal sleep later in development may be a target for further investigation, particularly for males.

Use of latent class analysis as a method of assessing the physical activity level, sedentary behavior and nutritional habit in the adolescents' lifestyle: A scoping review

BACKGROUND

Currently, adolescents' lifestyle is commonly characterized by physical inactivity, sedentary behavior, and inappropriate eating habits in general. A person-oriented approach as Latent Class Analysis (LCA) can offer more insight than a variable-centered approach when investigating lifestyle practices, habits, and behaviors of adolescent population.

OBJECTIVE

The aim of the present study was to assess which variables are mostly used to represent the physical activity level, sedentary behavior SB) and nutritional habit in the adolescents' lifestyle in studies that used the LCA.

DESIGN

Scoping review.

METHODS

The study was a performed in accordance with the proposed criteria for systematic reviews and meta-analyses-Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered in PROSPERO (CRD42018108444). The original articles were searched in MEDLINE/PubMed, Scopus, ScienceDirect, Web of Science, PsycINFO, and SPORTdiscus. The Quality Assessment Tool analyzed the risk of bias of the included studies.

RESULTS

30 original articles were selected. The physical activity level (28 studies), SB and nutritional habits (18 studies) were the most common variable used to evaluate the adolescent's lifestyle by LCA model. Specifically, physical inactivity and high SB were the manifest variables with higher frequency in the negative latent classes (LCs) in adolescent girls. On the other hand, physical exercises and sports were activities more commonly labeled as positive LCs.

CONCLUSIONS

The LCA models of the most of selected studies showed that physical inactivity, high SB were the most common in the LCs with negative characteristics of the adolescents' lifestyle. Better understanding the results of analyzes of clusters of multivariate behaviors such as the LCA can help to create more effective strategies that can make the lifestyle of adolescents healthier.

Prevalence of Internet Addiction and Its Relationship With Combinations of Physical Activity and Screen-Based Sedentary Behavior Among Adolescents in China

BACKGROUND

Given the widespread prevalence and serious nature of Internet addiction (IA), this study aimed to estimate the prevalence of IA and assess the relationships between IA and combinations of physical activity (PA) and screen-based sedentary behavior (SB) among adolescents in China.

METHODS

This cross-sectional study surveyed 31,954 adolescents in grades 7 to 12 in Beijing. IA, PA, screen-based SB, and other information were obtained from a self-administrated questionnaire. The chi-square test and mixed-effects logistic regression model were applied to estimate the relationship between IA and combinations of PA and screen-based SB.

RESULTS

6.2% of the surveyed adolescents reported IA and the prevalence of low PA/high screen-based SB, high PA/high screen-based SB, low PA/low screen-based SB, and high PA/low screen-based SB were 53.7%, 19.5%, 18.8%, and 8.0%, respectively. Mixed-effects logistic regression analysis showed that adolescents with low PA/high screen-based SB were 1.99 (95% confidence interval, 1.62-2.44, P < .001) times more likely to prefer IA than those with high PA/low screen-based SB.

CONCLUSIONS

The prevalence of IA among Chinese adolescents is still high. Intervention programs like maintaining sufficient PA and reducing screen-based SB might contribute to reducing their IA.

Sex Differences in Neurophysiological Changes Following Voluntary Exercise in Adolescent Rats

Background: Adolescence is a period of time characterized by the onset of puberty and is marked by cognitive and social developments and gross physical changes that can play a role in athletic performance. Sex differences are present with differences in body size, height, physiology and behavior which contribute to differences in athletic performance as well. Pre-clinical studies representing this active group are lacking.

Methods: Acute and chronic effects of exercise were evaluated. Male and female adolescent rats were given voluntary access to a running wheel for 10 consecutive days. Running behavior (males and females) and estrous cycling (females only) were analyzed daily. A second group was given 10 days of voluntary access to a running wheel, then rested for 10 days to determine the long-term effects of exercise on the adolescent brain. Brain and muscle tissue were harvested at 10 and 20 day time points to understand exercise-dependent changes in mitochondrial activity and neuroplasticity. Animal cohorts were carried out at two different sites: University of California Los Angeles and Pepperdine University.

Results: On average, running distance, intensity of run, and length of running bout increased for both male and female rats across the 10 days measured. Females ran significantly further and for longer intervals compared to males. Cortical and muscle expression of PGC1α showed similar levels at 10 days regardless of sex and exercise. There was a significant increase in expression at 20 days in all groups correlating with body size (p's < 0.05). Cortical and hippocampal levels of BDNF were similar across all groups, however, BDNF was significantly higher in exercised females at the acute compared to long-term time point.

Discussion: Adolescent rats allowed 10 days of exercise show changes in physiologic function. There are sex differences in running behavior not impacted by sex hormones. These results are important to further our understanding of how exercise impacts the adolescent brain.

Bidirectional Associations between Physical Activity and Sleep in Early-Elementary-Age Latino Children with Obesity

Low-income Latino children are at high risk for obesity and associated comorbidities. Considering the health benefits of proper sleep habits and physical activity, understanding the patterns, or the relationship between these modifiable factors may help guide intervention strategies to improve overall health in this population. Thus, the purpose was to investigate bidirectional associations between physical activity and sleep among Latino children who are overweight/obese. Twenty-three children (boys, 70%; overweight, 17%; obese, 83%) (age 7.9 ± 1.4 years) wore activity monitors on their wrist for 6 consecutive days (comprising 138 total observations). Hierarchical linear modeling evaluated temporal associations between physical activity (light physical activity, LPA; moderate to vigorous activity, MVPA) and sleep (duration and efficiency). Although there was no association between MVPA and sleep (p > 0.05), daytime LPA was negatively associated with sleep duration that night (estimate ± SE = -10.77 ± 5.26; p = 0.04), and nighttime sleep efficiency was positively associated with LPA the next day (estimate ± SE = 13.29 ± 6.16; p = 0.03). In conclusion, increased LPA may decrease sleep duration that night, but increasing sleep efficiency may increase LPA the following day. Although further investigation is required, these results suggest that improving sleep efficiency may increase the level of physical activity reached among Latino children who are overweight/obese.

Identifying patterns of movement behaviours in relation to depressive symptoms during adolescence: A latent profile analysis approach

Movement behaviour guideline adherence has been associated with lower depressive symptoms during adolescence, yet no studies have used person-centered approaches to examine this relationship. The purpose of the present study was to identify whether unique adolescent movement behaviour profiles exist, evaluate predictors of profile membership, and determine whether profile membership was associated with differences in depressive symptoms cross sectionally and longitudinally. This study involved secondary analysis of the public-use data from Wave 1 and Wave 2 of the National Study of Adolescent Health. Adolescents (N = 6436; 48% male) in grades 7 to 12 (M_age = 16.03 ± 1.75) completed measures to assess moderate-to-vigorous physical activity (MVPA), recreational screen time (ST), and sleep - collectively known as movement behaviours - and depressive symptoms. Latent profile analysis identified four profiles that had similar sleep patterns and were thus characterized by different levels of MVPA and ST: high MVPA/low ST (29%), high MVPA/high ST (4%), low MVPA/low ST (53%), and low MVPA/high ST (14%). Several socio-demographic variables were found to influence profile membership. After adjusting for covariates, findings revealed depressive symptoms were lowest among the high MVPA/low ST profile and this trend was evident one year later. Engaging in high levels of either MVPA or ST alone did not provide additive benefits for depressive symptoms compared to those who engaged in low levels of both MVPA and ST. These findings suggest intervention efforts should take an integrative approach to improve mental health outcomes among adolescents by considering each of the movement behaviours concurrently.

Recovery From Repeat Mild Traumatic Brain Injury in Adolescent Rats Is Dependent on Pre-injury Activity State

Adolescents and young adults have the highest incidence of mild traumatic brain injury (mTBI); sport-related activities are a major contributor. Roughly a third of these patients diagnosed with mTBI are estimated to have received a subsequent repeat mTBI (rTBI). Previously, animal studies have only modeled mTBI in sedentary animals. This study utilizes physical activity as a dependent variable prior to rTBI in adolescent rats by allowing voluntary exercise in males, establishing the rat athlete (rathlete). Rats were given access to locked or functional running wheels for 10 d prior to sham or rTBI injury. Following rTBI, rathletes were allowed voluntary access to running wheels beginning on different days post-injury: no run (rTBI+no run), immediate run (rTBI+Immed), or 3 day delay (rTBI+3dd). Rats were tested for motor and cognitive-behavioral (anxiety, social, memory) and mechanosensory (allodynia) dysfunction using a novel rat standardized concussion assessment tool on post-injury days 1,3,5,7, and 10. Protein expression of brain derived neurotrophic factor (BDNF) and proliferator-activated gamma coactivator 1-alpha (PGC1α) was measured in the parietal cortex, hippocampus, and gastrocnemius muscle. Sedentary shams displayed lower anxiety-like behaviors compared to rathlete shams on all testing days. BDNF and PGC1α levels increased in the parietal cortex and hippocampus with voluntary exercise. In rTBI rathletes, the rTBI+Immed group showed impaired social behavior, memory impairment in novel object recognition, and increased immobility compared to rathlete shams. All rats showed greater neuropathic mechanosensory sensitivity than previously published uninjured adults, with rTBI+3dd showing greatest sensitivity. These results demonstrate that voluntary exercise changes baseline functioning of the brain, and that among rTBI rathletes, delayed return to activity improved cognitive recovery.

PHYSICAL ACTIVITY, SCREEN TIME, NUTRITIONAL STATUS AND SLEEP IN ADOLESCENTS IN NORTHEAST BRAZIL

Objective:

To verify the prevalence of sleep quality and duration and its association with the level of physical activity, screen time and nutritional status in adolescents.

Methods:

This is a cross-sectional study with 1,432 adolescents (53.1%, female), ten to 14 years old (12.0±1.0 year) from public schools in Joao Pessoa, Northeast Brazil. Physical activity (≥300 vs. <300 minutes/week), screen time (≤2 vs. >2 h/day) and duration (<8 vs. ≥8 h/day) and perception of sleep quality (negative vs. positive perception) were measured by questionnaire. Nutritional status was assessed by body mass index (low weight / normal weight vs. overweight / obesity). Binary logistic regression was used to analyze association between variables, considering different aggregation of negative factors.

Results:

The prevalence of insufficient duration and negative perception of sleep quality was 12.6% (95%CI 10.9-14.4) and 21.0% (95%CI 18.9-23.1), respectively. There was a linear trend in the chance of the adolescents to present insufficient duration of sleep as a result of simultaneous negative factors (physical inactivity, excessive screen time, being overweight) (OR=4.31; 95%CI 1.50-12.48).

Conclusions:

Adolescents exposed simultaneously to low levels of physical activity, excessive screen time and overweight had a lower sleep duration.

Movement in High School: Proportion of Chinese Adolescents Meeting 24-Hour Movement Guidelines

The purposes of this study were (a) to examine the proportions of adolescents in China who partially or fully meet three 24-h movement guidelines on physical activity, screen-time, and sleep duration and (b) to examine whether there were gender differences in the proportion of boys and girls meeting these guidelines. The sample was made up of high school adolescents from an eastern province of China (N = 1338). The participants completed a self-reported survey on demographic variables and weekly health behaviors including physical activity, screen-time, and sleep duration. A frequency analysis was conducted to summarize the number of 24-h movement guidelines met of the total sample and by gender; chi-squared tests were used to examine the gender differences in the proportion of students meeting different guidelines, independently and jointly. A high proportion of adolescents did not meet physical activity (97.2%, 95% CI = 96.2–98.0%), or sleep (92.1%, 95% CI = 90.6–93.5%) guidelines, but met screen-time (93.6%, 95% CI = 92.4–94.7%) guidelines. Overall, only 0.3% (95%CI = 0.1–0.6%) of the sample met all three guidelines, 8.8% (95%CI = 7.5–10.2%) met two, 85.8%% (95%CI = 84.0–87.4%) met one, and 5.1% (95%CI = 4.0–6.4%) met none. There was no statistically significant percentage difference between female and male participants in meeting physical activity, screen-time viewing, or sleep duration guidelines, independently or jointly (p values > 0.05). These figures of participants meeting all three guidelines or physical activity and sleep independently are much lower than many estimates in prior research internationally. Considerations to improve adherence to physical activity and sleep guidelines are critical in this population.

Twenty-Four-Hour Movement Guidelines and Body Weight in Youth

OBJECTIVE

To examine the prevalence of youth meeting the 24-hour healthy movement guidelines (ie, ≥60 minutes of moderate-to-vigorous physical activity, ≤2 hours of screen time, age-appropriate sleep duration), and which combination of meeting these guidelines was most associated with bodyweight status, in a nationally representative US sample.

STUDY DESIGN

Cross-sectional data from the 2016-2017 National Survey of Children's Health were used. A multinomial regression model of body weight status was generated (underweight, overweight, obese vs healthy weight) and then stratified by sex. Analyses were adjusted for potential confounders.

RESULTS

The sample (n = 30 478) was 50.4% female, 52.4% white, and the mean age was 13.85 ± 2.28 years; 15% percent were obese and 15.2% were overweight. Overall, 9.4% met all 3 of the 24-hour healthy movement guidelines, 43.6% met 2, 37.9% met 1, and 9.1% met none. Meeting zero guidelines (vs 3) was associated with the greatest likelihood of overweight (aOR, 1.85; 95% CI, 1.31-2.61), and obesity (aOR, 4.25; 95% CI, 2.87-6.31). Females (aOR, 4.97; 95% CI, 2.59-9.53) had higher odds of obesity than males (aOR, 3.99; 95% CI, 2.49-6.40) when zero (vs 3) guidelines were met. Meeting the moderate-to-vigorous physical activity guideline, either alone or in combination with screen time or sleep duration (vs all 3), was associated with the lowest odds for overweight and obesity in the full sample.

CONCLUSION

Meeting all movement guidelines was associated with the lowest risk for obesity, particularly in females. Meeting the moderate-to-vigorous physical activity guideline may be a priority to prevent overweight and obesity in youth.

The association among demographic factors, health behaviors and sleep quality in youth with Autism Spectrum Disorder

BACKGROUND

A majority of youth with Autism Spectrum Disorder (ASD) have disrupted sleep patterns, but there has been limited research examining factors associated with sleep in this population.

OBJECTIVE

The objective of this study was to compare demographic and lifestyle behaviors with sleep quality in youth with ASD.

METHODS

A total of 49 children (12.44 years; 78% male) with ASD wore the Actigraph GT9X accelerometer over seven days and nights to assess moderate to vigorous physical activity (MVPA), sedentary behavior (SB), total sleep duration, and sleep efficiency. Parents reported their child's weekly amount of screen time and demographic information. Participants were classified according to whether they met sleep criteria for duration and efficiency (8-9 h of sleep duration and ≥85% sleep efficiency). T-tests and ANOVA were used to compare demographic and lifestyle factors between the groups.

RESULTS

Participants who meet both sleep duration and efficiency criteria had greater minutes of MVPA per day (113.65 min/day) than participants who only met sleep efficiency criteria (40.27 min/day) and participants who did not meet either sleep criteria (67.5 min/day; p < 0.0001). Additionally, participants who met both sleep criteria had fewer minutes of SB compared to those who only met sleep efficiency criteria (384.79 vs 526.05 min/day; p = 0.02).

CONCLUSIONS

Youth who had indicators of good sleep quality had greater amounts of MVPA and lower amounts of SB. Studies should further examine the relationship between sleep and health behaviors in youth with ASD to determine causal mechanisms, leading to more effective sleep interventions.

Combined Patterns Of Physical Activity And Screen-Related Sedentary Behavior Among Chinese Adolescents And Their Correlations With Depression, Anxiety And Self-Injurious Behaviors

Background and purpose

There are increasing concern about independent associations between physical activity, screen-based sedentary behavior (SSB), and psychological problems, but only a few studies have attempted to explore combined patterns of physical activity and SSB in adolescents and their correlations with psychological problems. This study was aimed at identifying combined patterns of moderate-to-vigorous physical activity (MVPA) and SSB and examining the prevalence of different combined patterns and their correlations with depression, anxiety, and self-injurious behavior among Chinese adolescents.

Methods

Junior and senior high school students (N = 13,659; mean age 15.18±1.89) were recruited. Latent class analysis was conducted to identify combined patterns of MVPA and SSB. Associations between subgroups of MVPA and SSB and socio-demographic characteristics were assessed by logistic regression. Their correlation with depression, anxiety, and self-injurious behaviors was assessed by analysis of variance with analysis stratified by gender.

Results

Four latent classes were identified: high MVPA/low SSB group (64.7%), low MVPA/low SSB (26.7%), low MVPA/high SSB (4.8%), and low MVPA/moderate SSB (3.9%). Generally, the high MVPA/low SSB class was a relatively healthy group. The low MVPA/high SSB class was at risk of enduring depression, anxiety, and self-injurious behavior, with boys being more at risk than girls.

Conclusion

Four latent subgroups of MVPA and SSB were identified in Chinese adolescents. The findings highlight the potential role of concurrent MVPA and SSB, with gender-specific characteristics in the primary prevention of adolescent depression, anxiety, and self-injurious behaviors.

A latent class analysis of health lifestyles and suicidal behaviors among US adolescents

BACKGROUND

Previous studies have documented the link between individual health behaviors and suicide, but little is known about the influence of health lifestyles on suicide among adolescents. This study aims to identify the unobserved patterns of health behaviors and to examine their associations with adolescent suicidal behaviors to inform screening of suicidality.

METHODS

Data were derived from a nationally representative sample of adolescents (n = 14,506, ages 12-18, 50.9% female) in the national school-based 2017 Youth Risk Behavior Survey. Latent class analysis was performed based on 13 health behaviors related to diet (e.g., frequency of consuming breakfast, fruits/vegetables, soda), physical activity (frequencies of physical activity, sports team participation), sleep, and media use (TV/computers). Suicidal behaviors were measured by three dichotomized variables, including suicidal ideation, plan, and attempts. Multivariate logistic regressions were used to examine associations between identified classes and suicidal behaviors.

RESULTS

Four classes of health lifestyles were identified. Class 1 (23.6%) consistently engaged in health-promoting behaviors, including eating breakfast daily, high intake of fruits/vegetables, physically active, and infrequent use of TV/computers. Class 2 (37.7%) had an irregular diet, moderate exercise, and high computer use. Class 3 (31.8%) had moderate diet, frequent exercise, and moderate sleep. Class 4 (6.9%) had the lowest engagement in health-promoting behaviors. Class 4 had higher odds of suicide plan than Class 1 (OR = 1.50, 95% CI = 1.10-2.05). Notably, Class 2 and 3 were less likely to attempt suicide than Class 1 (OR = 0.74, 95% CI = 0.57-0.95 for Class 2; OR = 0.65, 95% CI = 0.48-0.89 for Class 3).

LIMITATIONS

Due to the cross-sectional design, no causal inference can be drawn.

CONCLUSIONS

Both Class 1 (consistent) and Class 4 (lowest) engagement in health-promoting behaviors were associated with increased suicidal behaviors. Suicide prevention efforts that examine both lifestyles are keys to early detection of suicidal ideation and plans, and prevention of suicide attempts.

Bidirectional, Daily Temporal Associations between Sleep and Physical Activity in Adolescents

This study evaluated the daily, temporal associations between sleep and daytime physical activity and sedentary behavior among adolescents from the Fragile Families & Child Wellbeing Study. A sub-sample of the cohort at age 15 (N = 417) wore actigraphy monitors for one week during the school year from which we derived daily minutes in sedentary and moderate-to-vigorous physical activity (MVPA) and nighttime sleep measures. Multilevel models tested temporal associations of nightly sleep onset, offset, duration, and sleep maintenance efficiency, with daily MVPA and sedentary behavior. More MVPA than an individual's average was associated with earlier sleep onset (p < 0.0001), longer duration (p = 0.03), and higher sleep maintenance efficiency (p < 0.0001). On days with more sedentary behavior than an individual's average, sleep onset and offset were delayed (p < 0.0001), duration was shorter (p < 0.0001), and sleep maintenance efficiency was higher (p = 0.0005). Conversely, nights with earlier sleep onset predicted more next-day sedentary behavior (p < 0.0001), and nights with later sleep offset and longer sleep duration were associated with less MVPA (p < 0.0001) and less sedentary time (p < 0.0001, p = 0.004) the next day. These bidirectional associations between sleep and physical activity suggest that promoting MVPA may help to elicit earlier bedtimes, lengthen sleep duration, and increase sleep efficiency, critical for healthy adolescent development.

Activity-related behavior typologies in youth: a systematic review

BACKGROUND

Clusters of adolescents differentiated by patterns of physical activity and sedentary behavior (activity-related typologies) are common. Understanding both the characteristics of adolescents and modifiable correlates of these typologies, can help to develop interventions for those most at risk. This systematic review aimed to synthesize the socio-demographic characteristics and modifiable correlates of activity-related behavioral typologies among adolescents.

METHODS

A systematic search of seven electronic databases was conducted to identify quantitative studies using person-oriented statistical approaches to identify activity-related behavioral typologies among 12-18 year-olds. This systematic review was registered in Prospero (registration number: CRD42016046879).

RESULTS

Thirty-six studies met the inclusion criteria and were classified according to three sub-themes based on behaviors included in the typologies (1. physical activity and sedentary behavior only; 2. physical activity, sedentary behavior and risk-related behaviors; 3. physical activity, sedentary behavior and diet). Studies were mostly cross-sectional and relied on self-report measures. Methods were considerably heterogeneous, however results revealed some consistency in typologies within specific groups. For example, typologies characterized by unhealthy behavior patterns (e.g., characterized by physical inactivity, high sedentary behavior and poor diet or high risk-related behaviors) comprised more older adolescents. With the exception of socio-demographics (age, sex, body mass index and socio-economic status), very few correlates have been studied to date (mostly school-related behavioral factors and intrapersonal influences), with evidence largely from typologies comprised of physical activity, sedentary behavior and diet.

CONCLUSIONS

More research is needed to assess a range of modifiable correlates associated with activity-related behavior typologies among adolescents. This will allow for more targeted interventions, to achieve long-lasting, positive behavior change in adolescent populations.

Sleep problems and mental health among young Norwegian adolescents

PURPOSE

The present study investigated the associations between the aspects of sleep problems and mental health in Norwegian young adolescents.

MATERIALS AND METHODS

Adolescents (12-13 years) were recruited from the primary schools in Telemark County, Norway. Sleep related problems were assessed by asking parents three questions related to their childrens' sleep quality, sleep sufficiency, and daytime sleepiness. Parents reported data on mental health by the extended version of the Strengths and Difficulties Questionnaire (SDQ), and information on the child's physical activity, screen time, eating pattern, gender, and background variables. Height and weight were objectively measured. Complete data were obtained for 690 adolescents.

RESULTS

Multiple logistic regressions were used. Bivariate analyses indicated important associations between the sleep aspects and mental health. When adjusting the sleep variables for each other, lifestyle factors and background variables, sleep quality problems were associated with any psychiatric problem (OR_adj: 4.0, CI: 2.0-8.2), emotional problems (OR_adj: 15.1, CI: 3.4-66.8), and hyperactivity-inattention problems (OR_adj: 5.1, CI: 2.2-12.1). Daytime sleepiness problems were associated with any psychiatric problem (OR_adj: 2.3, CI: 1.2-4.4), and hyperactivity-inattention problems (OR_adj: 2.5, CI: 1.1-5.5). Bivariate associations between problems with sufficient sleep and mental health problems lost the significance when adjusted for other sleep variables.

CONCLUSIONS

The results indicate that different aspects of sleep problems may be important underlying factors for mental health problems in adolescents, independently of lifestyle factors, BMI-category, gender, and background variables. This highlights the importance of examining specific sleep problems when investigating associations between sleep and mental health.

Do sedentary behavior and physical activity spatially cluster? Analysis of a population-based sample of Boston adolescents

Sedentary behavior and lack of physical activity are key modifiable behavioral risk factors for chronic health problems, such as obesity and diabetes. Little is known about how sedentary behavior and physical activity among adolescents spatially cluster. The objective was to detect spatial clustering of sedentary behavior and physical activity among Boston adolescents. Data were used from the 2008 Boston Youth Survey Geospatial Dataset, a sample of public high school students who responded to a sedentary behavior and physical activity questionnaire. Four binary variables were created: 1) TV watching (>2 hours/day), 2) video games (>2 hours/day), 3) total screen time (>2 hours/day); and 4) 20 minutes/day of physical activity (≥5 days/week). A spatial scan statistic was utilized to detect clustering of sedentary behavior and physical activity. One statistically significant cluster of TV watching emerged among Boston adolescents in the unadjusted model. Students inside the cluster were more than twice as likely to report > 2 hours/day of TV watching compared to respondents outside the cluster. No significant clusters of sedentary behavior and physical activity emerged. Findings suggest that TV watching is spatially clustered among Boston adolescents. Such findings may serve to inform public health policymakers by identifying specific locations in Boston that could provide opportunities for policy intervention. Future research should examine what is linked to the clusters, such as neighborhood environments and network effects.