Association of sleep, screen time and physical activity with overweight and obesity in Mexico

PURPOSE: Approximately 70% of adults in Mexico are overweight or obese. Unhealthy lifestyle behaviors are also prevalent. We examined the association of three lifestyle behaviors with body mass index (BMI) categories in adults from Mexico. METHODS: We used publicly available data from the ENSANUT 2016 survey (n = 6419). BMI was used to categorize participants. Differences in sleep duration, suffering from symptoms of insomnia, TV watching time, time in front of any screen, vigorous physical activity (yes vs no), moderate physical activity (> 30 min/day-yes vs. no) and walking (> 60 min/day-yes vs. no) were compared across BMI groups using adjusted linear and logistic regression analyses. RESULTS: Thirty-nine percent of participants were overweight and 37% obese. Time in front of TV, in front of any screen, sleep duration and physical activity were significantly associated with overweight and obesity. Compared to normal weight participants, participants in the obese II category spend on average 0.60 h/day (95% CI 0.36-0.84, p = 0.001) and participants in the obese III category 0.54 h/day (95% CI 0.19-0.89, p < 0.001) more in front of any screen; participants in the obese II category reported 0.55 h/day less sleep (95% CI - 0.67 to - 0.43, p < 0.001); participants in the obese III category were less likely to engage in vigorous activity (OR = 0.60, 95% CI 0.43-0.84, p ≤ 0.003), or walking (OR = 0.65, 95% CI 0.49-0.88, p = 0.005). CONCLUSION: Screen time, sleeping hours, and physical activity were associated with overweight and obesity. However, these associations were not consistent across all BMI categories. Assuming established causal connections, overweight individuals and individuals with obesity would benefit from reduced screen time and engaging in moderate/vigorous physical activity. LEVEL OF EVIDENCE: Level III: observational case-control analytic study

HIGHER WATER INTAKE AND BETTER HYDRATION STATE IS ASSOCIATED WITH LOWER RISK OF INSULIN RESISTANCE IN HEALTHY ADULTS: NHANES 2009-2012

Hyun-Gyu Suh1, Marie-Rachelle Narcisse1, Evan C. Johnson2, Lisa T. Jansen1, & Stavros A. Kavouras1, FACSM 1University of Arkansas, Fayetteville, Arkansas; 2University of Wyoming, Laramie, Wyoming Preliminary data suggest that low water intake is associated with the risk of developing diabetes, while most of U.S. adults do not meet the requirements for daily water intake. PURPOSE: To study the effect of high water intake on glucose regulation in healthy adults. METHODS: 2,233 participants from 2009-10 & 2011-12 National Health and Nutrition Examination Survey were selected to examine the association between water intake and hydration state with insulin resistance in healthy individuals (females: 48.3%, age: 44±1 y, BMI: 27.5±0.2 kg∙m-2) in the US. RESULTS: Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and data were divided into tertiles (≤1.77, 1.78-3.45, and \u3e3.45). Hydration status was assessed by urine osmolality (621±7 mmol∙kg-1) and urine flow rate (0.96±0.03 ml∙min-1). Plain water (1,203±35 mL) and total water intake (TWI; 3,190±43 mL) was assessed from a 24 h dietary recall. Urine osmolality was highest in the upper HOMA tertile (679±9 mmol∙kg-1) compared to lowest tertile (583±1 mmol∙kg-1, P\u3c0.001), while urine flow rate was highest in the lowest HOMA-IR tertile (1.03±0.04 ml∙min-1) compared to upper tertile (0.92±0.03 ml∙min-1, P=0.001). Multinomial logistic regression showed healthy adults who consumed more plain water (≥859 mL) were half as likely to be in the upper HOMA-IR tertile, compared with their peers who consumed less (≤207 mL, OR=0.50; 0.34-0.73), after adjusting for age, gender, BMI, waist circumference, race/ethnicity, education, and physical activity. Similarly, adults with higher levels of daily TWI (≥2,657 mL) had significantly lesser odds (42%) of being in the upper HOMA tertile, compared to adults with a lower level of TFI (1,598 mL, OR=0.58; 0.38-0.90). CONCLUSION: Higher plain water (≥859 mL) and total water intake (≥2,657 mL), as well as better hydration state were associated with lower insulin resistance