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Singh K, Armstrong SC, Wagner BE, Counts J, Skinner A, Kay M, Li JS, Shah S, Zucker N, Neshteruk C, Story M, Suarez L, Kraus WE, Zizzi AR, Dunn J. Physical activity and sleep changes among children during the COVID-19 pandemic. NPJ Digit Med 2024; 7:70. [PMID: 38493216 PMCID: PMC10944532 DOI: 10.1038/s41746-024-01041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/18/2024] Open
Abstract
Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann-Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data were collected from 94 children (aged 5-17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1655 steps. Sleep onset and wake time were delayed by about an hour and 45 min, respectively, while sleep duration decreased by over 12 min as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. Trial Registration: Clinical trial registration: NCT03339440.
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Affiliation(s)
- Karnika Singh
- Duke University Department of Biomedical Engineering, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Durham, NC, USA
| | - Sarah C Armstrong
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Brooke E Wagner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Julie Counts
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Asheley Skinner
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Melissa Kay
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jennifer S Li
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Svati Shah
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Nancy Zucker
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Psychiatry and Behavioral Science, Durham, NC, USA
| | - Cody Neshteruk
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Population Health Sciences, Durham, NC, USA
| | - Mary Story
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Lilianna Suarez
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - William E Kraus
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Molecular Physiology Institute, Durham, NC, USA
| | - Alexandra R Zizzi
- Duke Center for Childhood Obesity Research, Durham, NC, USA
- Duke University Department of Pediatrics, Durham, NC, USA
| | - Jessilyn Dunn
- Duke University Department of Biomedical Engineering, Durham, NC, USA.
- Duke Center for Childhood Obesity Research, Durham, NC, USA.
- Duke University Department of Biostatistics, Durham, NC, USA.
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Blanco E, Hyde ET, Martinez SM. Assessing sleep behaviors in Latino children and adolescents: what is known, what are we missing, and how do we move forward? Curr Opin Pediatr 2024; 36:17-22. [PMID: 37933679 PMCID: PMC10825877 DOI: 10.1097/mop.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
PURPOSE OF REVIEW Sleep health is a commonly overlooked component of pediatric cardiometabolic risk. Disparities in sleep duration and meeting of pediatric sleep guidelines have been well documented among at-risk populations in the United States, including Latinos. However, sleep research often fails to describe or account for contextual and cultural factors impacting the ability for Latino families to meet guidelines. The current review focuses on recent findings related to measurement of sleep duration, understanding of contextual factors that impact sleep hygiene, and interventions designed to increase sleep duration and quality among U.S. Latino families with infants, young children, and adolescents. RECENT FINDINGS Ten studies focusing on sleep health in U.S. Latino children, using different study designs were identified. Overall, cross-sectional studies confirmed inadequate sleep among Latino children, intervention studies demonstrated promise of culturally-sensitive health behavior education for improving sleep in early childhood, and qualitative studies highlighted neighborhood and cultural factors that impact sleep quality. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH Rather than new prevalence studies on adherence to sleep recommendations among Latino families, research focusing on adapting clinical guidelines to accommodate the realities of many Latino families (e.g., co-sleeping and bedsharing) will advance our knowledge. A shift towards objective measurement of the 24-h period as well as evaluating specific contextual barriers that make It challenging to meet sleep guidelines for Latino children is needed.
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Affiliation(s)
- Estela Blanco
- Centro de Investigación en Sociedad y Salud, Núcleo Milenio de Sociomedicina y Escuela de Salud Pública, Universidad Mayor, Santiago, Chile
| | - Eric T. Hyde
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Public Health (Epidemiology)
| | - Suzanna M. Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
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Dunn J, Singh K, Armstrong S, Wagner B, Counts J, Skinner A, Kay M, Li J, Shah S, Zucker N, Neshteruk C, Suarez L, Kraus W, Zizzi A. Physical activity and sleep changes among children with obesity during a period of school closures related to the COVID-19 pandemic. RESEARCH SQUARE 2023:rs.3.rs-3293474. [PMID: 37790374 PMCID: PMC10543530 DOI: 10.21203/rs.3.rs-3293474/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Daily routines, including in-person school and extracurricular activities, are important for maintaining healthy physical activity and sleep habits in children. The COVID-19 pandemic significantly disrupted daily routines as in-person school and activities closed to prevent spread of SARS-CoV-2. We aimed to examine and assess differences in objectively measured physical activity levels and sleep patterns from wearable sensors in children with obesity before, during, and after a period of school and extracurricular activity closures associated with the COVID-19 pandemic. We compared average step count and sleep patterns (using the Mann Whitney U Test) before and during the pandemic-associated school closures by using data from activity tracker wristbands (Garmin VivoFit 3). Data was collected from 94 children (aged 5-17) with obesity, who were enrolled in a randomized controlled trial testing a community-based lifestyle intervention for a duration of 12-months. During the period that in-person school and extracurricular activities were closed due to the COVID-19 pandemic, children with obesity experienced objectively-measured decreases in physical activity, and sleep duration. From March 15, 2020 to March 31, 2021, corresponding with local school closures, average daily step count decreased by 1,655 steps. Sleep onset and wake time were delayed by about an hour and 45 minutes, respectively, while sleep duration decreased by over 12 minutes as compared with the pre-closure period. Step counts increased with the resumption of in-person activities. These findings provide objective evidence for parents, clinicians, and public health professionals on the importance of in-person daily activities and routines on health behaviors, particularly for children with pre-existing obesity. We demonstrate the utility of wearable sensors in objectively measuring longitudinal physical activity and sleep behavior patterns in children with obesity and in quantifying changes in their health behaviors due to disruption of structured, daily routines following in-person school closures during the COVID-19 pandemic. Trial Registration Clinical trial registration: NCT03339440.
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Migueles JH, Delisle Nyström C, Dumuid D, Leppänen MH, Henriksson P, Löf M. Longitudinal associations of movement behaviours with body composition and physical fitness from 4 to 9 years of age: structural equation and mediation analysis with compositional data. Int J Behav Nutr Phys Act 2023; 20:11. [PMID: 36750838 PMCID: PMC9903529 DOI: 10.1186/s12966-023-01417-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/27/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The associations of movement behaviours (physical activity [PA], sedentary behaviour [SB], and sleep) with body composition and physical fitness from pre-school to childhood, as well as the direction of the associations, could provide important information for healthy lifestyle promotion in children. This study investigated the longitudinal and bidirectional associations of movement behaviours with body composition and physical fitness measured at 4 and 9 years of age. METHODS This longitudinal study included baseline (n = 315, 4.5 [SD = 0.1] years) and follow-up data (n = 231, 9.6 [SD = 0.1] years) from the MINISTOP study. Movement behaviours were measured for 7 days using wrist-worn accelerometers, body composition with air-displacement plethysmography, and physical fitness with the ALPHA health-related fitness test battery. Cross-lagged panel models and mediation analyses were performed in combination with compositional data analysis. RESULTS We did not observe direct associations of the movement behaviours at 4 years with either body composition or physical fitness at 9 years (all P > 0.05). However, fat mass index at 4 years was negatively associated with vigorous PA (VPA), relative to remaining behaviours (VPA, β = - 0.22, P = 0.002) and light PA (LPA), relative to SB and sleep (β = - 0.19, P = 0.016) at 9 years. VPA (relative to remaining), moderate PA (MPA) (relative to LPA, SB, and sleep), and SB (relative to sleep) tracked from 4 to 9 years (all β ≥ 0.17, all P < 0.002), and these behaviours shared variance with fat mass index (all|β| ≥ 0.19, all P < 0.019), and aerobic, motor, and muscular fitness (all|β| ≥ 0.19, all P < 0.014) at 9 years. Mediation analysis suggested that the tracking of VPA (relative to remaining behaviours) from 4 to 9 years was negatively associated with fat mass index (β ≥ - 0.45, P = 0.012), and positively with aerobic fitness at 9 years (β ≥ 1.64, P = 0.016). CONCLUSION PA and SB tracked from the pre-school years into childhood. Fat mass index at 4 years of age was negatively associated with VPA (relative to remaining behaviours) and LPA (relative to SB and sleep) at 9 years of age. The tracking of VPA was associated with lower fat mass index and higher aerobic fitness at 9 years of age. These findings suggest that higher levels of VPA in pre-school age, if maintained throughout childhood, may support the development of healthy body composition and aerobic fitness levels in later childhood.
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Affiliation(s)
- Jairo H Migueles
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 52, Huddinge, Sweden.
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
| | | | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
- University of South Australia, Adelaide, SA, Australia
| | - Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 52, Huddinge, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
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Alves JM, Chow T, Nguyen-Rodriguez S, Angelo B, Defendis A, Luo S, Smith A, Yunker AG, Xiang AH, Page KA. Associations Between Sleep and Metabolic Outcomes in Preadolescent Children. J Endocr Soc 2022; 6:bvac137. [PMID: 36249413 PMCID: PMC9557847 DOI: 10.1210/jendso/bvac137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Indexed: 01/29/2023] Open
Abstract
Context Growing evidence suggests an important role for sleep for the metabolic health of children. Objective We aimed to determine how sleep is related to insulin sensitivity, insulin secretion, beta-cell function, and adiposity (BMI z-scores, body fat %, waist to height ratio) using objectively measured sleep and oral glucose tolerance test (OGTT)-derived measures. Methods Sixty-two children aged 7-11 years, born at Kaiser Permanente Southern California, wore wrist accelerometers for 7 days to objectively measure sleep, completed an OGTT, and had anthropometric measures (height [cm], weight [kg], waist [cm], body fat [%]) collected. Using linear regression, associations between Matsuda insulin sensitivity index (ISI), insulinogenic index (IGI), disposition index (DI), BMI z-score, waist to height ratio, and body fat % with sleep parameters [total sleep time (TST; min), sleep efficiency (SE; %), time in bed (TIB; min), wake after sleep onset (WASO; min), and sleep latency (SL; min)] were assessed. Body fat % was tested as a mediator of the relationship between TST and ISI. Results Longer TST was associated with better insulin sensitivity (P = 0.02), but not after adjusting for body fat %. Sleep parameters were not associated with IGI or DI. Longer TST was associated with lower % body fat (P = 0.01) and lower waist-to-height-ratios (P = 0.05). Body fat % explained 62% (P = 0.01) of the relationship between TST and ISI. Longer TIB was associated with lower adiposity measures (P < 0.05). There were no associations between SE, WASO, or SL and metabolic outcomes. Conclusion Objectively measured sleep duration was associated with lower adiposity, and the relationship between sleep duration and ISI appeared partly through adiposity levels in preadolescent children. Longer sleep duration may be important for metabolic health.
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Affiliation(s)
- Jasmin Marie Alves
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA
| | - Selena Nguyen-Rodriguez
- Department of Health Science, California State University Long Beach, Long Beach, 90840-4902 CA, USA
| | - Brendan Angelo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Alexis Defendis
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Shan Luo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Department of Psychology, University of Southern California, Los Angeles, 90089 CA, USA
- Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, 90027 CA, USA
| | - Alexandro Smith
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
| | - Alexandra Grace Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, 02115 MA, USA
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, 91101 CA, USA
| | - Kathleen Alanna Page
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, 90033 CA, USA
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Marques CG, Dos Santos Quaresma MVL, Nakamoto FP, Magalhães ACO, Lucin GA, Thomatieli-Santos RV. Does Modern Lifestyle Favor Neuroimmunometabolic Changes? A Path to Obesity. Front Nutr 2021; 8:705545. [PMID: 34621773 PMCID: PMC8490681 DOI: 10.3389/fnut.2021.705545] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022] Open
Abstract
Factors linked to modern lifestyles, such as physical inactivity, Western diet, and poor sleep quality have been identified as key contributors to the positive energy balance (PEB). PEB rises adipose tissue hypertrophy and dysfunction over the years, affecting cells and tissues that are metabolically critical for energy homeostasis regulation, especially skeletal muscle, hypothalamic-pituitary-adrenal axis, and gut microbiota. It is known that the interaction among lifestyle factors and tissue metabolic dysfunction increases low-grade chronic systemic inflammation, leading to insulin resistance and other adverse metabolic disorders. Although immunometabolic mechanisms are widely discussed in obesity, neuroimmunoendocrine pathways have gained notoriety, as a link to neuroinflammation and central nervous system disorders. Hypothalamic inflammation has been associated with food intake dysregulation, which comprises homeostatic and non-homeostatic mechanisms, promoting eating behavior changes related to the obesity prevalence. The purpose of this review is to provide an updated and integrated perspective on the effects of Western diet, sleep debt, and physical exercise on the regulation of energy homeostasis and low-grade chronic systemic inflammation. Subsequently, we discuss the intersection between systemic inflammation and neuroinflammation and how it can contribute to energy imbalance, favoring obesity. Finally, we propose a model of interactions between systemic inflammation and neuroinflammation, providing new insights into preventive and therapeutic targets for obesity.
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Affiliation(s)
- Camila Guazzelli Marques
- Programa de Pós-graduação em Psicobiologia, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Ana Carolina Oumatu Magalhães
- Programa de Pós-graduação em Psicobiologia, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.,Departamento de Nutrição, Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Ronaldo Vagner Thomatieli-Santos
- Programa de Pós-graduação em Psicobiologia, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.,Departamento de Biociências, Universidade Federal de São Paulo, Santos, Brazil
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