Scheduled optimal sleep duration and screen exposure time promotes cognitive performance and healthy BMI: a study among rural school children of India

Associations of 24-h movement behaviour with overweight and obesity among school-aged children and adolescents in Pakistan: An empirical cross-sectional study

BACKGROUND

Overweight and obesity among children and adolescents poses a significant public health challenge. In Pakistan, the prevalence of childhood overweight and obesity continues to rise, leading to long-term adverse effects on health. Various external influences shape children's health behaviours and outcomes, with parents, peers, schools, and communities playing crucial roles, particularly during formative years.

OBJECTIVES

This cross-sectional study aimed to investigate the associations between 24-h movement behaviour and overweight/obesity among school-aged children and adolescents, focusing on the intrapersonal, interpersonal, community, and school levels from a Social-Ecological Perspective.

METHODS

A population-based cross-sectional study was conducted from 15 January to 15 March 2023, using a representative multistage random cluster sampling method. The study enrolled 4200 participants aged 9-17 years and 3371 parents from 62 schools in central Punjab, Pakistan. Participants' body mass index (BMI) was classified based on CDC US 2000 BMI percentiles. Socio-ecological factors were analyzed using chi-square tests, binary logistic regression, and stepwise logistic regression to examine their associations with overweight and obesity.

RESULTS

The results of this study revealed that boys had 18.7% overweight and 9% obesity, while girls had 20.5% overweight and 13.2% obesity. Gender exhibited a significant association with weight status. A considerable proportion of participants did not meet recommended guidelines for junk food consumption (31.5% boys, 33.3% girls), physical activity (70% boys, 83.8% girls), screen time (37.7% boys, 41.1% girls), and sleep (55.7% boys, 54% girls). Individuals engaging in certain 24-h movement behaviours exhibited higher odds of obesity. Specifically, consuming fast food three or more days per week was associated with higher odds of obesity (odds ratio: 9.95, p < 0.01). Engaging in physical activity for less than 60 min per day, twice a week or less, was associated with higher odds of obesity (odds ratio: 3.47, p < 0.01). Spending three or more hours per day on screen time was linked to higher odds of obesity (odds ratio: 2.50, p < 0.01). Furthermore, being a short sleeper was associated with higher odds of overweight (odds ratio: 3.54, p < 0.01).

CONCLUSIONS

Children failing to meet none or only one guideline faced increased overweight/obesity risk compared to those meeting all recommendations. Individual-level factors such as eating habits, physical activity, sedentary behaviour, sleep patterns, and unhealthy lifestyle choices significantly influenced body weight status. Urgent interventions are needed to enhance physical education resources and sports facilities in schools to create healthier environments and reduce overweight/obesity prevalence among students, promoting lifelong habits of physical activity and improving health and well-being.

Association of sleep duration with overweight and obesity among school-aged children and adolescents in Pakistan-An empirical cross-sectional study

BACKGROUND

Overweight and obesity pose significant public health challenges for children and adolescents worldwide, with escalating prevalence rates in Pakistan, leading to long-term health consequences. Proximal environments, including parental, peer, school, and community influences, are pivotal in shaping children's health behaviors during developmental stages. This study investigates the association between sleeping behaviors and overweight/obesity among Pakistani school-aged children and adolescents (9-17 years).

MATERIALS AND METHODS

A population-based cross-sectional study enrolled 4108 participants from 62 schools across randomly selected districts in central Punjab province. Overweight and obesity were determined using WHO references. Statistical analyses included Chi-square tests, Pearson correlation coefficients, and logistic regressions.

RESULTS

The study analyzed the prevalence and associations of sleep duration with body weight status among Pakistani school-aged children and adolescents. Significant differences were observed in sleep patterns across different school levels and sexes. Boys were more likely to be short or long sleepers compared to girls, with weekday short sleep significantly associated with lower rates of overweight (9.0% vs 14.6%, P < 0.001) and obesity (3.8% vs 2.6%, P < 0.001). On weekends, short sleep was linked to higher prevalence of overweight (9.6%, P = 0.019) and obesity (6.2%, P < 0.001) compared to normal sleepers. Linear regression revealed that weekday sleep duration (β = 0.213, P < 0.001), weekend sleep duration (β = 0.142, P < 0.001), and sleeping problems (β = 0.182, P < 0.001) were positively associated with higher body weight status, explaining 11.0% of the variance in weight status. Logistic regression indicated that short sleepers had significantly higher odds of being overweight (OR = 2.69, P < 0.001) and obese (OR = 5.65, P < 0.001) compared to normal sleepers. Long sleep also showed significant associations with overweight (OR = 2.41, P < 0.001) and obesity (OR = 1.73, P < 0.001).

CONCLUSIONS

Sleeping behaviors emerge as significant contributors to body weight-status issues among Pakistani school-aged children and adolescents. Understanding these factors is imperative for effective policy and program development to combat childhood obesity. Targeted intervention strategies tailored to vulnerable groups are essential for public health efforts. Insights from this study provide valuable guidance for addressing this urgent health concern.

Associations between meeting 24h movement behavior guidelines and cognition, gray matter volume, and academic performance in children and adolescents: a systematic review

BACKGROUND

24-h movement behaviors have a close relationship with children and adolescents' cognition, gray matter volume, and academic performance. This systematic review aims to precisely explore the associations between meeting different combinations of guidelines and the aforementioned indicators, in order to better serve public health policy.

METHODS

Computer retrieval was conducted on CNKI, Web of Science, PubMed, SPORT Discus and Cochrane library databases. The screening and data extraction processes were conducted by two researchers. This study used the Joanna Briggs Institute checklist for methodological quality assessment and the Grading of Recommendations Assessment, Development, and Evaluation system for the evaluation of the level of evidence. Descriptive statistical analysis is performed using frequency and percentage on the extracted data and key findings, primarily to assess the consistency of the positive benefits associated with meeting different guidelines and outcome variables.

RESULTS

A total of 10 studies were included (with 16 correlation analyses conducted), involving 51,566 children and adolescents aged between 4.2 and 15.9 years old. The included studies generally agreed upon the following associations: adherence to the screen time (ST) guidelines is positively linked to fluid intelligence; adherence to the sleep duration (SD) guidelines is positively linked to literacy; adherence to both ST and SD guidelines is associated with increased fluid intelligence and gray matter volume; and overall adherence to all guidelines is positively correlated with fluid intelligence. The included studies reported low certainty of evidence. Additionally, the included studies have provided clear evidence, but some studies did not strictly control confounding factors, and it is also unclear whether there is a larger effect size, hence the level of evidence is relatively low.

CONCLUSION

There are varying degrees of associations between different combinations of guidelines and cognition, gray matter volume, and academic performance, but further research is needed to confirm these findings, especially the relatively limited role of meeting physical activity guidelines.

Has the COVID-19 outbreak altered the prevalence of low back pain among physiotherapy students?

OBJECTIVE

To evaluate the prevalence of low back pain (LBP) among physiotherapy students during the COVID-19 lockdown in the State of Israel.

PARTICIPANTS/METHODS

One hundred and sixty four physiotherapy students from all four-year student levels were invited to participate. One hundred and thirty-seven students (83.5%) were recruited in the study with 79 females (57.7%) and 58 males (42.3%). We used a structured anonymous questionnaire that sought standard information on age, height, weight, sports activity and low back pain (LBP) prevalence during three periods.

RESULTS

No significant differences were noted in the prevalence of LBP between the lockdown period compared to 12-month period in all four-year levels. More so, our findings showed that LBP prevalence among physiotherapy students was greater during the 12-month period compared to the lifetime period.

CONCLUSIONS

This study indicates that COVID-19 lockdown has no negative impact on the prevalence of LBP among physiotherapy students.

The Current Prevalence of Underweight, Overweight, and Obesity Associated with Demographic Factors among Pakistan School-Aged Children and Adolescents-An Empirical Cross-Sectional Study

Purpose: This study investigated the most recent estimates of underweight, overweight, and obesity prevalence in Pakistani school-aged children and adolescents. Methods: A cross-sectional study was conducted using a convenience random clustered sampling approach with 3,551 Pakistani school children aged 9 to 17 years from 52 schools throughout seven districts in central Punjab province. The CDC US 2000 was used to define underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obesity (95th percentile ≤ BMI) for different school grade cohorts (primary, middle, secondary, and higher secondary schools). As a trend test, the Chi-square test was used. A Spearman correlation analysis (r) was used to determine the correlations between demographic variables and weight status. A regression analysis was conducted to explore the predictive power of demographic factors in relation to body weight. Results: In Pakistani school-aged children and adolescents, the prevalence of underweight, normal weight, overweight, and obesity was 21.9%, 66.9%, 5.8%, and 5.4%, respectively. Significant correlations with body weight status were shown for individual demographic parameters (age, gender, school type, and school grade). Children in urban areas were more likely to be underweight, overweight, or obese than those in rural areas. Boys were found to have a lower BMI than girls. Accordingly, more boys than girls were underweight (odds ratio (OR) = 1.57, 95% CI: 1.33-1.85) and more girls had a higher risk of obesity than boys (OR = 1.39, 95% CI: 1.03-1.86). Lower grades showed more underweight (OR = 1.66, 95% CI: 1.39-1.99) whereas higher grades showed a higher risk of obesity (OR = 1.91, 95% CI: 1.41-2.57). Conclusions: In Pakistani school-aged children and adolescents, underweight, overweight, and obesity were prevalent. Compared with studies from 2011, the risk of overweight and obesity in Pakistan has decreased. However, this may also be due to the fact that students in Pakistan have a lower BMI compared to other countries. This issue has also been seen in the present study and is confirmed here by the high number of cases of underweight students. Future research studies should look into additional weight status correlates and factors. To evaluate the association between weight status and behavioral and other health variables, future research should use longitudinal or interventional designs.

Risk factors associated with endometritis in zero-grazed dairy cows on smallholder farms in Rwanda

Clinical endometritis (CLE) and subclinical endometritis (SCLE) manifesting at the cow- and herd-levels has been associated with multiple risk factors (RFs), but hardly are RFs with direct influences separated from those with mediated indirect influences. This study identified and quantified the direct and indirect associations of cow- and herd-levels RFs with CLE and SCLE cases observed among 466 zero-grazed dairy cows that were in their 21-60 days postpartum (dpp). The cases were observed in a cross-sectional survey of smallholder farms (n = 370) in Rwanda. The direct and indirect associations were constructed with odds ratio (OR) derived from multiple logistic regression modelling. The cow-level RFs that had direct positive association with CLE and SCLE were the season of calving (OR: 5.0, 2.1), dystocia (OR: 1.9, 2.2), poor body condition score (OR: 4.1, 2.2), stillbirth (OR: 3.5, 3.3), and retained placenta (OR: 1.4, 1.8) while mastitis (OR: 2.5) and parity (OR: 1.5) had a direct positive association with SCLE. Breed and parity of cow, sex of calf, and twin births had indirect positive association with both CLE and SCLE cases. At the herd-level, unhygienic cowshed (OR: 25.1, 8.9) had direct positive association with both CLE and SCLE cases. In contrast, earthen floor cowshed (OR: 6.6) and large herd size (OR: 3.1) had direct positive association with CLE and not using bedding materials (OR: 1.5) had direct positive association with SCLE. Herd-level RFs that showed indirect positive association with both CLE and SCLE cases were farm size (OR: 2.9) and farmer's experience in dairying (OR: 1.7) while housing cows within the first 30 dpp (OR: 0.1) showed indirect negative association. These results show which RFs have strong direct and indirect influences on CLE and SCLE cases at the cow- and herd-levels. Effective management of those RFs should be a priority in extension education and services to enable smallholder farmers effectively manage them to prevent and control endometritis among their zero-grazed dairy cows.