Is the association of chronotype with adolescent behavior problems mediated through social jetlag?

We examined the associations of chronotype with behavior problems in a cross-sectional study of 957 Colombian adolescents (mean age, 14.6 years; 56% female), in addition to the mediating role of social jetlag. The midpoint of bedtime and waketime on free days, corrected for sleep debt accumulated during school week (MSFsc), was estimated from parent reports and used to assess chronotype. Behavior problems were evaluated through the Youth Self-Report (YSR) and the parent-completed Child Behavior Checklist (CBCL) questionnaires. We estimated adjusted mean differences with 95% CI in externalizing, internalizing, attention, social, and thought problem scores per one hour difference in chronotype using linear regression. Later chronotype was related to internalizing and externalizing behavior problems. Eveningness was associated with higher adjusted mean YSR scores (unit difference per hour) in externalizing behavior (1.0; 95% CI: 0.6, 1.5), internalizing behavior (0.6; 95% CI: 0.2, 1.1), attention problems (0.2; 95% CI: 0.0, 0.3), social problems (0.4; 95% CI: 0.1, 0.8), and thought problems (0.3; 95% CI: 0.1, 0.6). Similar patterns were observed with the CBCL. The associations of chronotype with somatic complaints and social problems were stronger in boys than they were in girls. Later chronotype was related to social jetlag but social jetlag was only associated with somatic complaints and attention problems, and mediated 16% and 26% of their corresponding associations with chronotype. In conclusion, later chronotype is associated with behavior problems in adolescence. Social jetlag does not substantially mediate these associations.</p

Change in adiposity indicators in 299 school-age girls from Bogotá, Colombia, according to quartiles of LINE-1 DNA methylation.

1<p>For a test of linear trend when a variable that represented the median value of each quartile was introduced into a linear regression model as a continuous predictor (Wald test).</p>2<p>According to the World Health Organization growth reference for children 5–19 years <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062587#pone.0062587-deOnis2" target="_blank">[30]</a>.</p>3<p>Values are means ± SD.</p>4<p>Values are means ± SE.</p>5<p>Adjusted for baseline age and socioeconomic status.</p>6<p>Age-standardized using the LMS method with data for boys 5–16 years of age in NHANES III <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062587#pone.0062587-1" target="_blank">[32]</a>.</p>7<p>Subscapular-to-tricipital skinfold thickness ratio.</p

Characteristics of 553 school-age children from Bogotá, Colombia by quartiles of LINE-1 methylation¹.

1<p>Values are mean ± SD unless otherwise noted.</p>2<p>Total is <553 due to missing values.</p>3<p>According to the World Health Organization 2007 growth reference for children 5–19 years <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062587#pone.0062587-deOnis2" target="_blank">[30]</a>.</p>4<p>Stratum 1 of a maximum of 4, according to the local government classification for tax and planning purposes.</p

Change in height-for-age in 553 school-age children from Bogotá, Colombia, according to quartiles of LINE-1 DNA methylation¹.

1<p>Height-for-age Z-scores were determined using the World Health Organization growth reference for children 5–19 years <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062587#pone.0062587-deOnis2" target="_blank">[30]</a>.</p>2<p>For a test of linear trend when a variable that represented quartiles was introduced into a linear regression model as a continuous predictor (Wald test).</p>3<p>Values are mean ± SD.</p>4<p>Values are mean ± SE.</p>5<p>Adjusted for baseline age and socioeconomic status.</p

Change in adiposity indicators in 254 school-age boys from Bogotá, Colombia, according to quartiles of LINE-1 DNA methylation.

1<p>For a test of linear trend when a variable that represented the median value of each quartile was introduced into a linear regression model as a continuous predictor (Wald test).</p>2<p>According to the World Health Organization growth reference for children 5–19 years <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062587#pone.0062587-deOnis2" target="_blank">[30]</a>.</p>3<p>Values are means ± SD.</p>4<p>Values are means ± SE.</p>5<p>Adjusted for baseline age and socioeconomic status.</p>6<p>Age-standardized using the LMS method with data for boys 5–16 years of age in NHANES III <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062587#pone.0062587-1" target="_blank">[32]</a>.</p>7<p>Subscapular-to-tricipital skinfold thickness ratio.</p

Table_3_Claims on Ready-to-Eat Cereals: Are Those With Claims Healthier?.docx

Background: The use of advertising content strategies that suggest consuming a product will confer nutrient- and health-related benefits influences household food purchasing decisions, which increases consumption of energy-dense, nutrient-poor products. We examined the presence of marketing claims regarding nutrient content, health and nature in ready-to-eat (RTE) cereal packages in relation to the products' nutritional quality.Methods: A cross-sectional content analysis was conducted on 178 RTE cereal packages available in the six largest supermarket chains in four Colombian cities from August to November 2018. The nutritional quality of products was assessed through the nutrient profile model established by the Chilean Law of Food Labeling and Advertising law.Results: All products sampled exceeded the regulation threshold for at least one nutrient of concern (e.g., high-in calories and/or sugar). The majority (66.3%) of packages had claims related to nature, 57.3% had nutrient-content claims, and 15.7% had health benefit or risk avoidance claims. Most products with nature, nutrient-content, and health claims were high in energy (99.2, 98.0, and 92.9%, respectively) and sugar (88.1, 87.3, and 92.9%, respectively).Conclusion: RTE cereal products offered in major Colombian supermarket chains are heavily marketed using nutrition- and nature-related claims. Nearly all products with claims are high in energy and sugar, despite the messages conveyed by the claims to consumers. Results support the implementation of mandatory regulations restricting claims on food and beverage products high in nutrients of concern.</p

Table_1_Claims on Ready-to-Eat Cereals: Are Those With Claims Healthier?.docx

Background: The use of advertising content strategies that suggest consuming a product will confer nutrient- and health-related benefits influences household food purchasing decisions, which increases consumption of energy-dense, nutrient-poor products. We examined the presence of marketing claims regarding nutrient content, health and nature in ready-to-eat (RTE) cereal packages in relation to the products' nutritional quality.Methods: A cross-sectional content analysis was conducted on 178 RTE cereal packages available in the six largest supermarket chains in four Colombian cities from August to November 2018. The nutritional quality of products was assessed through the nutrient profile model established by the Chilean Law of Food Labeling and Advertising law.Results: All products sampled exceeded the regulation threshold for at least one nutrient of concern (e.g., high-in calories and/or sugar). The majority (66.3%) of packages had claims related to nature, 57.3% had nutrient-content claims, and 15.7% had health benefit or risk avoidance claims. Most products with nature, nutrient-content, and health claims were high in energy (99.2, 98.0, and 92.9%, respectively) and sugar (88.1, 87.3, and 92.9%, respectively).Conclusion: RTE cereal products offered in major Colombian supermarket chains are heavily marketed using nutrition- and nature-related claims. Nearly all products with claims are high in energy and sugar, despite the messages conveyed by the claims to consumers. Results support the implementation of mandatory regulations restricting claims on food and beverage products high in nutrients of concern.</p

Table_2_Claims on Ready-to-Eat Cereals: Are Those With Claims Healthier?.docx

Background: The use of advertising content strategies that suggest consuming a product will confer nutrient- and health-related benefits influences household food purchasing decisions, which increases consumption of energy-dense, nutrient-poor products. We examined the presence of marketing claims regarding nutrient content, health and nature in ready-to-eat (RTE) cereal packages in relation to the products' nutritional quality.Methods: A cross-sectional content analysis was conducted on 178 RTE cereal packages available in the six largest supermarket chains in four Colombian cities from August to November 2018. The nutritional quality of products was assessed through the nutrient profile model established by the Chilean Law of Food Labeling and Advertising law.Results: All products sampled exceeded the regulation threshold for at least one nutrient of concern (e.g., high-in calories and/or sugar). The majority (66.3%) of packages had claims related to nature, 57.3% had nutrient-content claims, and 15.7% had health benefit or risk avoidance claims. Most products with nature, nutrient-content, and health claims were high in energy (99.2, 98.0, and 92.9%, respectively) and sugar (88.1, 87.3, and 92.9%, respectively).Conclusion: RTE cereal products offered in major Colombian supermarket chains are heavily marketed using nutrition- and nature-related claims. Nearly all products with claims are high in energy and sugar, despite the messages conveyed by the claims to consumers. Results support the implementation of mandatory regulations restricting claims on food and beverage products high in nutrients of concern.</p

Table_4_Claims on Ready-to-Eat Cereals: Are Those With Claims Healthier?.docx

Background: The use of advertising content strategies that suggest consuming a product will confer nutrient- and health-related benefits influences household food purchasing decisions, which increases consumption of energy-dense, nutrient-poor products. We examined the presence of marketing claims regarding nutrient content, health and nature in ready-to-eat (RTE) cereal packages in relation to the products' nutritional quality.Methods: A cross-sectional content analysis was conducted on 178 RTE cereal packages available in the six largest supermarket chains in four Colombian cities from August to November 2018. The nutritional quality of products was assessed through the nutrient profile model established by the Chilean Law of Food Labeling and Advertising law.Results: All products sampled exceeded the regulation threshold for at least one nutrient of concern (e.g., high-in calories and/or sugar). The majority (66.3%) of packages had claims related to nature, 57.3% had nutrient-content claims, and 15.7% had health benefit or risk avoidance claims. Most products with nature, nutrient-content, and health claims were high in energy (99.2, 98.0, and 92.9%, respectively) and sugar (88.1, 87.3, and 92.9%, respectively).Conclusion: RTE cereal products offered in major Colombian supermarket chains are heavily marketed using nutrition- and nature-related claims. Nearly all products with claims are high in energy and sugar, despite the messages conveyed by the claims to consumers. Results support the implementation of mandatory regulations restricting claims on food and beverage products high in nutrients of concern.</p

CONSORT flow diagram.

CONSORT flow diagram.</p