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Xu Y, Hua J, Wang J, Shen Y. Sleep duration is associated with metabolic syndrome in adolescents and children: a systematic review and meta-analysis. J Clin Sleep Med 2023; 19:1835-1843. [PMID: 37185064 PMCID: PMC10545995 DOI: 10.5664/jcsm.10622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
STUDY OBJECTIVES Studies on the associations between sleep duration and metabolic syndrome in adolescents and children have reported mixed results. To shed more light on this issue, we conducted this meta-analysis by synthesizing the results of previous studies. METHODS Studies were retrieved from PubMed, Ovid, Cochrane, and Embase from inception to October 2021. Fixed-effects models and random-effects models were used to analyze the effects of sleep time on metabolic syndrome in adolescents. RESULTS Data from 7 studies, including 13,305 adolescents and children, were meta-analyzed. Compared with the control group, short sleep durations were not associated with a high prevalence of metabolic syndrome in adolescents and children using a random-effects model (odds ratio = 0.92, 95% confidence interval = 0.48-1.37, I2 = 56.5%, P = .378). Using a fixed-effects model on long sleep duration, this association was statistically significant (odds ratio = 0.57, 95% confidence interval = 0.38-0.76, I2 = 0.0%, P < .001) as a protective factor compared with shorter sleep duration. CONCLUSIONS Long sleep duration, instead of short sleep duration, was significantly associated with a lower prevalence of metabolic syndrome among adolescents and children. CITATION Xu Y, Hua J, Wang J, Shen Y. Sleep duration is associated with metabolic syndrome in adolescents and children: a systematic review and meta-analysis. J Clin Sleep Med. 2023;19(10):1835-1843.
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Affiliation(s)
- Yiyang Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Jianian Hua
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiahe Wang
- Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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González-Gálvez N, Ribeiro JC, Mota J. Cardiorespiratory Fitness, Obesity and Physical Activity in Schoolchildren: The Effect of Mediation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16262. [PMID: 36498335 PMCID: PMC9736920 DOI: 10.3390/ijerph192316262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
There are only a few studies that have examined the interaction between physical activity (PA), cardiorespiratory fitness (CRF), and overweightness/obesity in adolescents, and these studies have shown some limitations. The objective of this study was to examine whether the association between PA (moderate-vigorous PA [MVPA], moderate PA [MPA], and vigorous PA [VPA]) and obesity is mediated by CRF. This cross-sectional study was conducted in six middle and high-schools in the Porto district (Portugal), comprising 632 children and adolescents. Fat mass (FM), CRF, MVPA, MPA, and VPA were assessed. The Process macro for SPSS was used. CRF was significantly associated with PA for both children and adolescents. Likewise, FM was negatively and significantly associated with CRF for both children (β = -0.337) and adolescents (β = -0.255). FM was associated with PA in children (MVPA: β = -0.102; MPA: β = -0.118; VPA: β = -0.305) and adolescents (MVPA: β: -0.103; MPA: β = -0.082; VPA: β = -0.204). The mediation analysis showed that the association between PA (MVPA//MPA/VPA) and obesity was mediated by CRF, in both children and adolescents, with a significant value in the Sobel test. Obesity is associated with CRF and MVPA, MPA, and VPA. However, CRF acted as a complete mediator between the association of obesity and PA.
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Affiliation(s)
- Noelia González-Gálvez
- Sports Injury Prevention Research Group, Facultad de Deporte, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Jose Carlos Ribeiro
- Research Center in Physical Activity, Health and Leisure (CIAFEL)—Faculty of Sport—University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), 4200-450 Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL)—Faculty of Sport—University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), 4200-450 Porto, Portugal
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [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] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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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: 0.5] [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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Typologies of Family Functioning and 24-h Movement Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020699. [PMID: 33467473 PMCID: PMC7830979 DOI: 10.3390/ijerph18020699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 01/23/2023]
Abstract
Research on the importance of the family environment on children's health behaviors is ubiquitous, yet critical gaps in the literature exist. Many studies have focused on one family characteristic and have relied on variable-centered approaches as opposed to person-centered approaches (e.g., latent profile analysis). The purpose of the current study was to use latent profile analysis to identify family typologies characterized by parental acceptance, parental monitoring, and family conflict, and to examine whether such typologies are associated with the number of movement behavior recommendations (i.e., physical activity, screen time, and sleep) met by children. Data for this cross-sectional observational study were part of the baseline data from the Adolescent Brain Cognitive Development (ABCD) study. Data were collected across 21 study sites in the United States. Participants included 10,712 children (female = 5143, males = 5578) aged 9 and 10 years (M = 9.91, SD = 0.62). Results showed that children were meaningfully classified into one of five family typologies. Children from families with high acceptance, medium monitoring, and medium conflict (P2; OR = 0.54; 95% CI, 0.39-0.76); high acceptance, medium monitoring, and high conflict (P3; OR = 0.28; 95% CI, 0.20, 0.40); low acceptance, low monitoring, and medium conflict (P4; OR = 0.24; 95% CI, 0.16, 0.36); and medium acceptance, low monitoring, and high conflict (P5; OR = 0.19; 95% CI, 0.12-0.29) were less likely to meet all three movement behavior recommendations compared to children from families with high acceptance, high monitoring, and low conflict (P1). These findings highlight the importance of the family environment for promoting healthy movement behaviors among children.
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