scholarly journals Longitudinal Associations Among Diet Quality, Physical Activity and Sleep Onset Consistency With Body Mass Index z-Score Among Toddlers in Low-income Families

2020 ◽  
Author(s):  
Lauren Covington ◽  
Bridget Armstrong ◽  
Angela C B Trude ◽  
Maureen M Black
Keyword(s):  
Physical Activity ◽  
Diet Quality ◽  
Low Income ◽  
Sleep Onset ◽  
Healthy Eating Index ◽  
Future Research ◽  
Z Score ◽  
Household Poverty ◽  
Z Scores ◽  
Low Income Families

Abstract Background Habits surrounding health behaviors (i.e., sleep, physical activity, diet) are developed in toddlerhood. Lack of consistent health habits may increase obesity risk among toddlers in low-income families. Purpose To compare the role of sleep onset consistency, physical activity and diet quality as mediators between household poverty and toddler weight. Methods Two hundred and seven toddlers (mean age = 20.2 months, 46% female, 68.1% Black) participating in an obesity prevention trial were assessed at three time points over 12 months. Using Actical accelerometers, we assessed sleep and physical activity at each time point for up to 1 week. We defined sleep onset consistency as the standard deviation of sleep onset across all days. We calculated the Healthy Eating Index-2015 from a 24-hr dietary recall. We used WHO standards to calculate BMI-for-age z-scores from toddlers’ weight/length, and calculated poverty ratio from parent-reported income and family size. Multilevel mediation models tested toddler sleep onset consistency, physical activity, and diet quality as mediators between household poverty and toddler BMI z-score. Results Toddlers from households with higher poverty ratios had more inconsistent sleep onset times. Toddlers with more inconsistent sleep onset times had higher BMI z-scores across all timepoints, even when accounting for physical activity and diet quality. Sleep onset consistency indirectly explained the association between household poverty and BMI z-score. Conclusions Inconsistent sleep schedules could help explain the association between poverty and BMI. Future research should examine strategies to support low-income families to develop and maintain routines as a mechanism to prevent obesity and reduce disparities. Trial registration number NCT02615158.

scholarly journals 0984 Less Consistent Bedtimes Explains The Relationship Between Household Poverty And BMI In Toddlers

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A374-A374
Author(s):  
L B Covington ◽  
B Armstrong ◽  
M M Black
Keyword(s):  
Physical Activity ◽  
Obesity Prevention ◽  
Diet Quality ◽  
Longitudinal Research ◽  
Sleep Onset ◽  
Intervention Group ◽  
Sleep Time ◽  
Healthy Eating Index ◽  
Healthy Weight ◽  
Household Poverty

Abstract Introduction Consistent bedtimes, in conjunction with physical activity and diet have been linked to healthy weight in childhood. Young children living in impoverished families are at risk for obesity, and the mechanisms of obesity etiology are not fully understood. This study compares the role of bedtime consistency, physical activity and diet quality as mediators between household poverty and toddler weight gain. Methods 207 toddlers participating in an obesity prevention trial wore Actical accelerometers for up to 7 consecutive days, at 3 time points over 12 months. At each assessment, gender-specific BMI-for-age z-scores (zBMI) were calculated from toddlers’ weight/length according to WHO standards. Household poverty ratio was calculated based on the number of household members and annual income. Diet quality was assessed using Healthy Eating Index (HEI-2015) from 24-hour dietary recall. Physical activity and sleep were measured using ankle accelerometry (Actical; Sadeh algorithm used for sleep). Bedtime consistency was defined as SD of sleep onset across 7 days. A multi-level mediation model was conducted in the SPSS macro MLmed examining toddler bedtime consistency, physical activity and diet quality as mediators between household poverty and toddler zBMI. The analysis adjusted for toddler age, gender, total sleep time and intervention group. Results Between-person effects revealed that less household poverty was associated with more consistent bedtimes. Children with less consistent bedtimes, but not poor diet quality or physical activity, had higher zBMI. Bedtime consistency indirectly explained the association between average household poverty and average toddler zBMI over 12 months. Conclusion Children who generally have less bedtime consistency, above and beyond physical activity and diet quality, had higher zBMI. This link uniquely indirectly explained the association between household poverty and zBMI. Inconsistent bedtimes may indicate lack of structure in other health behaviors, and therefore, continued longitudinal research examining family routines may inform obesity prevention strategies. Support Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), R01HD056099

scholarly journals Sleep and BMI in South African urban and rural, high and low-income preschool children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dale E. Rae ◽  
Simone A. Tomaz ◽  
Rachel A. Jones ◽  
Trina Hinkley ◽  
Rhian Twine ◽  
...  
Keyword(s):  
Physical Activity ◽  
Preschool Children ◽  
South African ◽  
Low Income ◽  
Urban Environments ◽  
Z Score ◽  
Cross Sectional ◽  
Rural And Urban ◽  
Sleep Parameters ◽  
Z Scores

Abstract Background The extent to which income setting or rural and urban environments modify the association between sleep and obesity in young children is unclear. The aims of this cross-sectional observational study were to (i) describe and compare sleep in South African preschool children from rural low-income (RL), urban low-income (UL) and urban high-income (UH) settings; and (ii) test for associations between sleep parameters and body mass index (BMI). Methods Participants were preschoolers (5.2 ± 0.7y, 49.5% boys) from RL (n = 111), UL (n = 65) and UH (n = 22) settings. Height and weight were measured. Sleep, sedentary behaviour and physical activity were assessed using accelerometery. Results UL children had higher BMI z-scores (median: 0.39; interquartile range: − 0.27, 0.99) than the UH (− 0.38; − 0.88, 0.11) and RL (− 0.08; − 0.83, 0.53) children (p = 0.001). The UL children had later bedtimes (p < 0.001) and wake-up times (p < 0.001) and shorter 24 h (p < 0.001) and nocturnal (p < 0.001) sleep durations than the RL and UH children. After adjusting for age, sex, setting, SB and PA, for every hour less sleep obtained (24 h and nocturnal), children were 2.28 (95% CI: 1.28–4.35) and 2.22 (95% CI: 1.27–3.85) more likely, respectively, to belong to a higher BMI z-score quartile. Conclusions Shorter sleep is associated with a higher BMI z-score in South African preschoolers, despite high levels of PA, with UL children appearing to be particularly vulnerable.

Associations between diet quality and physical activity measures among a southern Ontario regional sample of grade 6 students

2010 ◽  
Vol 35 (6) ◽  
pp. 826-833 ◽  
Author(s):  
Sarah J. Woodruff ◽  
Rhona M. Hanning
Keyword(s):  
Physical Activity ◽  
Healthy Eating ◽  
Diet Quality ◽  
Odds Ratio ◽  
Weight Status ◽  
Positive Association ◽  
Healthy Eating Index ◽  
Normal Weight ◽  
Future Research ◽  
Ordinal Logistic Regression Analysis

The purpose of this study was to determine diet quality and physical activity behaviours of grade 6 students by sex and body weight status, and to determine the associations between diet quality and physical activity behaviours. The Web-based Food Behaviour Questionnaire, which included a 24-h diet recall and the modified Physical Activity Questionnaire for Older Children (PAQ-C), was administered to a cross-section of schools (n = 405 students from 15 schools). Measured height and weight were used to calculate body mass index and weight status (Cole et al. 2000). A Canadian version of the Healthy Eating Index (HEI-C) was used to describe overall diet quality. The mean HEI-C was 69.6 (13.2) with the majority (72%) falling into the needs improvement category. The overall mean physical activity score was 3.7 out of a maximum of 5, with obese subjects being less active compared with normal weight and overweight (p < 0.001). Ordinal logistic regression analysis (of HEI-C vs. all measures of the PAQ-C, sex, and weight status) revealed that HEI-C ratings were likely to be higher in students that walked to and from school 5 days per week (vs. 0 days per week; odds ratio 3.18, p = 0.010); and were active 1 evening per week (vs. none; odds ratio 3.48, p = 0.039). The positive association between diet quality and some aspects of physical activity suggests possible clustering of health behaviours. Future research should test the potential benefits of promoting 1 health behaviour (e.g., healthy eating) with another (e.g., physical activity).

scholarly journals Lifestyle Factors Associated with Metabolic Syndrome Z-Score in US Adolescents

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1492-1492
Author(s):  
Suzanne Summer ◽  
Todd Jenkins ◽  
Thomas Inge ◽  
Ranjan Deka ◽  
Jane Khoury
Keyword(s):  
Physical Activity ◽  
Metabolic Syndrome ◽  
At Risk ◽  
Diet Quality ◽  
Lifestyle Factors ◽  
Healthy Eating Index ◽  
Continuous Measure ◽  
Z Score ◽  
Relationship Of ◽  
The Relationship

Abstract Objectives Metabolic syndrome (MetS) is a cluster of abnormalities including abdominal obesity that increases risk for diabetes and cardiovascular disease. MetS affects ∼10% of US adolescents, but more may be at risk. The MetS severity z-score (MetS-z) is a continuous measure that may be useful for indicating MetS risk. Preventing at-risk adolescents from developing MetS may be achievable through changes in lifestyle factors such as diet and physical activity. Our objective was to evaluate the relationship of lifestyle-related factors with MetS-z in adolescents. Methods We performed a cross-sectional analysis of adolescents (12 to 19 y) from the National Health and Nutrition Examination Survey (NHANES) 2011–2016. MetS-z was calculated from sex- and race-specific equations developed for adolescents. Sagittal Abdominal Diameter (SAD, representing abdominal visceral fat) was obtained using NHANES standard procedures. Dietary intake was estimated via two 24-hour diet recall interviews and used to calculate the Healthy Eating Index (HEI)-2015 total (range 0–100) and component scores (range 0–10) indicating diet quality. Physical activity (PA, minutes/week of voluntary moderate or vigorous exercise) was reported by participants to trained interviewers and used to determine adherence to national PA guidelines of at least 60 min/day. Multivariable linear regression was used to evaluate the relationship of HEI scores, SAD and physical activity with MetS-z. Results Sample size was 1291 (49% female, 50% white) adolescents. Means (SEM) were: Age, 15.4 y (0.09); BMI z-score, 0.63 (0.04); MetS-z, −0.08 (0.03); SAD, 18.3 cm (0.14); and HEI score, 47.4 (0.46). Median min/week of PA was 178.5, with 30.4% of adolescents meeting PA guidelines. The final model (R2 = 0.53) included age, SAD (β = 0.17, P &lt; 0.0001), HEI score (β = −0.003, P = 0.09), and physical activity (β = −0.005, P = 0.69). Conclusions US adolescents consume a poor-quality diet and less than half meet physical activity guidelines, yet as a group they have a MetS z-score &lt;0, indicating low overall risk. SAD had a significant, positive association with MetS-z. While physical activity and diet were not significant in the model, results suggest the need for improvement of overall diet quality to potentially reduce risk of MetS and related chronic diseases in youth. Funding Sources None.

scholarly journals Diet Quality of Mothers of Children in NYC Head Start Is Not Associated With Child Adiposity

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 710-710
Author(s):  
Maxine Ashby-Thompson ◽  
Inge Goldstein ◽  
Isobel Contento ◽  
Randi Wolf ◽  
Judith Jacobson
Keyword(s):  
Weight Loss ◽  
African American ◽  
Head Start ◽  
Diet Quality ◽  
Kidney Diseases ◽  
Maternal Diet ◽  
The United States ◽  
Healthy Eating Index ◽  
Z Score ◽  
Z Scores

Abstract Objectives To assess whether maternal diet quality, measured when child was between ages 3 and 5, is associated with child overweight/obesity at ages 3 to 5. Methods Baseline data from the Endotoxin Obesity and Asthma longitudinal study were used for these analyses. 380 African American and Hispanic mothers of children attending NYC Head Start answered a food frequency questionnaire (FFQ) about their own intake and a demographic questionnaire about themselves and child. FFQ data were converted to Healthy Eating Index (HEI)-2015 total scores (higher scores suggest better diet quality). Anthropometric measurements (weight, height, skinfolds, and waist circumference) were obtained from children. BMI, triceps and subscapular z-scores, and weight-to-height ratio (WHtR) were calculated. Results Mean HEI total score at baseline was 64.3 ± 8.7 of 100 (considered a “D” grade or poor diet quality), but 69.8 ± 8.6 for Dominican and 60.2 ± 6.5 for Mexican mothers. Children were 50% female, 25% Mexican, 18% Dominican, 19% African American, 15% Puerto Rican and 23% Other. Mean age was 49 months. 52% of children fell below the 85th percentile for BMI, 20% between 85th and 95th, and 28% above the 95th percentile. Mother's HEI-2015 total score was not associated with child's BMI z-score (p = 0.830), child's triceps z-score (p = 0.77), child's subscapular z-score (p = 0.29), or child's WHtR (p = 0.83). More weight loss attempts by the mother (p = 0.03) and child's birthplace in (vs. outside) the United States (p = 0.01) were associated with higher BMI z-scores. Mexican ethnicity was associated with greater triceps z-scores (p = 0.03). Child's age was positively associated with subscapular z-score (p = 0.02). Child's age (p &lt; 0.001) and Mexican ethnicity (p &lt; 0.001) were associated with greater WHtR. Conclusions Maternal diet quality was not associated with child adiposity; however, mother's weight loss attempts, child's age and being born in the US, and a child being identified as Mexican were related did. A novel maternal characteristic, number of weight loss attempts, and several child characteristics suggest targets for intervention. Funding Sources National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Diseases.

scholarly journals Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amber L. Pearson ◽  
Kimberly A. Clevenger ◽  
Teresa H. Horton ◽  
Joseph C. Gardiner ◽  
Ventra Asana ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Low Income ◽  
Spatial Data ◽  
Vigorous Physical Activity ◽  
Future Research ◽  
Cardiometabolic Health ◽  
Multilevel Regression ◽  
Critical Pathway ◽  
Perceived Safety

Abstract Introduction Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one’s neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health. Methods In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety. Results In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (β = − 2.34, p = 0.017), depression scores (β = − 4.22, p = 0.006), and BMI (β = − 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots. Conclusion Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity—via stress reduction and concomitant effects on cardiometabolic health.

scholarly journals The Relationship Between Feeding Styles and BMI Z-score in Infants (P11-014-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Amrik Khalsa ◽  
Kristen Copeland ◽  
Roohi Kharofa ◽  
Sheela Geraghty ◽  
Thomas DeWitt ◽  
...  
Keyword(s):  
Higher Education ◽  
Infant Feeding ◽  
Low Income ◽  
Z Score ◽  
Feeding Styles ◽  
Feeding Style ◽  
Modifiable Factors ◽  
Z Scores ◽  
Laissez Faire ◽  
The Relationship

Abstract Objectives The objective of this study was to determine the relationship between infant feeding styles (the attitudes and behaviors parents use to direct their child's eating) and infant BMI z-score in a low-income, predominately non-Hispanic Black population. Methods Parent-infant dyads were recruited during the infant's 6, 9, or 12 month well-child visits from two urban primary care clinics that primarily serve a Medicaid population (89%). Feeding styles were measured using the Infant Feeding Style Questionnaire (IFSQ) and categorized into: pressuring, restrictive, responsive, or laissez-faire. Predominant feeding style was defined by selecting the style with the greatest deviation from the mean score of each style. Infant anthropometrics were extracted from the electronic medical record from birth through 18 months. Infant BMI z-scores were calculated based on WHO growth charts. Associations between feeding styles and BMI z-scores were examined using mixed models controlling for multiple measures per person, demographics and feeding covariates. Results Data from 198 dyads were analyzed for this study (Table 1). Parents identified as mothers (n = 196), non-Hispanic Black (n = 136), with a median age of 27 years (IQR 23.0 – 30.0). Half the infants were male (n = 99) with a median age at enrollment of 8.98 months [IQR 6.8-10.3]. Parent's predominant feeding style were (in descending order): Laissez-faire: 30%; Restrictive: 28%; Responsive: 23%; and Pressuring: 19%. Predominant feeding style at enrollment was not associated with BMI z-score between 0–18 months, but there was a significant sex differences in BMI z-score for the Laissez-faire and Restrictive feeding styles (Figure 1). Additionally, parents with higher education and a predominately Restrictive feeding style had children with higher BMI z-scores whereas parents with higher education and a Laissez-faire or Pressuring feeding style had children with lower BMI z-score (Figure 2). Conclusions Parent's predominant feeding style during infancy in a low-income population is not associated with infant's BMI in the first two years of life, but some styles demonstrate differences by sex or parental education. Further studies are needed to better understand the modifiable factors for increased BMI in the first 2 years. Funding Sources NIH T32 Institutional grant. Supporting Tables, Images and/or Graphs

scholarly journals Dietary and Physical Activity Behaviors in Women with Polycystic Ovary Syndrome per the New International Evidence-Based Guideline

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2711 ◽  
Author(s):  
Annie W. Lin ◽  
Maryam Kazemi ◽  
Brittany Y. Jarrett ◽  
Heidi Vanden Brink ◽  
Kathleen M. Hoeger ◽  
...  
Keyword(s):  
Physical Activity ◽  
Polycystic Ovary Syndrome ◽  
Dietary Intake ◽  
Diet Quality ◽  
Polycystic Ovary ◽  
Healthy Eating Index ◽  
Evidence Based ◽  
Ovary Syndrome ◽  
International Evidence ◽  
Evidence Based Guideline

Lifestyle modifications are recommended as first-line therapy in polycystic ovary syndrome (PCOS). However, usual dietary and physical activity (PA) behaviors of women with PCOS remain uncertain, likely owing to controversy in diagnostic criteria. Our objective was to contrast the usual dietary and PA behaviors of women with PCOS (n = 80) diagnosed by the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS to that of controls (n = 44). Study outcomes were dietary intake, diet quality (Healthy Eating Index-2015), and PA (questionnaire, waist-worn accelerometers). Women with PCOS met the acceptable macronutrient distribution ranges for carbohydrate, fat, and protein, but did not meet the recommended dietary reference intakes for vitamin D (mean (95% confidence interval); 6 (5–7) μg/d), vitamin B9 (275 (252–298) μg/d), total fiber (24 (22–26) g/d), or sodium (4.0 (3.6–4.4) g/d). Women with PCOS also met the US recommendations for PA. No differences were detected in dietary intake, diet quality, or PA levels between groups (p ≥ 0.11). In conclusion, women with and without PCOS have comparable dietary and PA behaviors. A lack of unique targets for dietary or PA interventions supports the position of the new guideline to foster healthy lifestyle recommendations for the management of PCOS.

scholarly journals Associations between Diet Quality and Body Composition in Young Children Born with Very Low Body Weight

2020 ◽  
Vol 150 (11) ◽  
pp. 2961-2968
Author(s):  
Meghan McGee ◽  
Sharon Unger ◽  
Jill Hamilton ◽  
Catherine S Birken ◽  
Zdenka Pausova ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Neurodevelopmental Outcomes ◽  
Donor Milk ◽  
Added Sugars ◽  
Air Displacement Plethysmography ◽  
Z Scores

ABSTRACT Background Very low birth weight (VLBW; &lt;1500 g) infants have increased adiposity and metabolic disease risk in adulthood. Limited evidence suggests low-quality childhood diets are a predisposing risk factor. Despite this, to our knowledge no study has yet examined associations between diet quality and body composition in VLBW individuals. Objective The objective of this study was to determine associations between Healthy Eating Index-2010 (HEI-2010) scores and consumption of fruits/vegetables, added sugars, and macronutrients with body composition in 5.5-y-old children born VLBW. We hypothesized HEI-2010 scores were inversely associated with adiposity. Methods This cohort study leveraged the 5.5-y follow-up to the Donor Milk for Improved Neurodevelopmental Outcomes randomized controlled trial. From June 2016 to July 2018, participants attended a follow-up visit at The Hospital for Sick Children, Canada, or were visited in their home. All 316 surviving infants from the trial were eligible, and the caregivers of 158 children (50%; 53% male) consented to follow-up. Diet quality (HEI-2010) and usual intake of fruits/vegetables, added sugars, and macronutrients were determined from two 24-h dietary recalls (ASA24). Linear regressions evaluated associations of diet with BMI (kg/m2) and waist circumference z-scores, total fat, fat-free mass (air displacement plethysmography), and skinfolds. Results Mean ± SD age at follow-up was 5.7 ± 0.2 y, birth weight was 1013 ± 264 g, and gestational age was 27.9 ± 2.5 wk. Dietary data and BMI z-scores were available for all children; 123 completed air displacement plethysmography. HEI-2010 score was 58.2 ± 12.4 out of 100, and 27% of children had poor quality diets (scores ≤50). HEI-2010 scores were inversely associated with BMI z-score, but only in children with obese mothers. A 10-point increase in HEI-2010 score was associated with reduced BMI (β: −0.5 SD; 95% CI: −0.7, −0.2) and subscapular (−0.3 SD; 95% CI: −0.6, −0.06) z-scores. Conclusions Improving diet quality in children born VLBW with obese mothers may be an important strategy to prevent excess adiposity. This trial was registered at clinicaltrials.gov as Optimizing Mothers' Milk for Preterm Infants (OptiMoM) Program of Research: Study 1-Impact of Donor Milk at Kindergarten, NCT02759809.

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