Genotype vs. phenotype and the rise of non-communicable diseases: the importance of lifestyle behaviors during childhood

Despite continued research and growing public awareness, the incidence of non-communicable diseases (NCD) continues to accelerate. While a person may have a genetic predisposition to certain NCDs, the rapidly changing epidemiology of NCDs points to the importance of environmental, social, and behavioural determinants of health. Specifically, three lifestyle behaviours expose children to important environmental cues and stressors: physical activity, nutritional intake, and sleep behaviour. Failure to expose children to proper gene-environment interactions, through the aforementioned lifestyle behaviours, can and will predispose children to the development of NCDs. Reengineering the environments of children can induce a paradigm shift, from a predominantly biomedical health model of treating symptomology, to a more holistic model based on encouraging appropriate behavioral decisions and optimal health

Social Jetlag and Cardiometabolic Risk in Preadolescent Children.

Objective: Childhood cardiometabolic disease risk (CMD) has been associated with short sleep duration. Its relationship with other aspects of sleep should also be considered, including social jetlag (SJL) which represents the difference between a person's social rhythms and circadian clock. This study investigated whether childhood CMD risk is associated with sleep duration, sleep disturbances, and SJL. Study Design: The observational study included 332 children aged 8–10 years (48.5% female). The three independent variables were sleep duration, sleep disturbances, and SJL. SJL was calculated as the variation in hours between the midpoint of sleep during free (weekend) days and work/school days. Eleven cardiometabolic biomarkers were measured, including central blood pressure, lipids, glycated hemoglobin, arterial wave reflection, and glucose. Underlying CMD risk factors were identified using factor analysis. Results: Four underlying CMD risk factors were identified using factor analysis: blood pressure, cholesterol, vascular health, and carbohydrate metabolism. Neither sleep disturbances nor sleep duration were significantly associated with any of the four CMD factors following adjustments to potential confounders. However, SJL was significantly linked to vascular health (p = 0.027) and cholesterol (p = 0.025). Conclusion: These findings suggest that SJL may be a significant and measurable public health target for offsetting negative CMD trajectories in children. Further studies are required to determine biological plausibility

Pre-Adolescent Cardio-Metabolic Associations and Correlates: PACMAC methodology and study protocol

Introduction: Although cardiovascular disease is typically associated with middle or old age, the atherosclerotic process often initiates early in childhood. The process of atherosclerosis appears to be occurring at an increasing rate, even in pre-adolescents, and has been linked to the childhood obesity epidemic. This study will investigate the relationships between obesity, lifestyle behaviours and cardiometabolic health in pre-pubescent children aged 8–10 years, and investigates whether there are differences in the correlates of cardiometabolic health between Māori and Caucasian children. Details of the methodological aspects of recruitment, inclusion/exclusion criteria, assessments, statistical analyses, dissemination of findings and anticipated impact are described. Methods and analysis Phase 1: a cross-sectional study design will be used to investigate relationships between obesity, lifestyle behaviours (nutrition, physical activity/fitness, sleep behaviour, psychosocial influences) and cardiometabolic health in a sample of 400 pre-pubescent (8–10 years old) children. Phase 2: in a subgroup (50 Caucasian, 50 Māori children), additional measurements of cardiometabolic health and lifestyle behaviours will be obtained to provide objective and detailed data. General linear models and logistic regression will be used to investigate the strongest correlate of (1) fatness; (2) physical activity; (3) nutritional behaviours and (4) cardiometabolic health. Ethics and dissemination Ethical approval will be obtained from the New Zealand Health and Disabilities Ethics Committee. The findings from this study will elucidate targets for decreasing obesity and improving cardiometabolic health among preadolescent children in New Zealand. The aim is to ensure an immediate impact by disseminating these findings in an applicable manner via popular media and traditional academic forums. Most importantly, results from the study will be disseminated to participating schools and relevant Māori health entities

Adiposity in preadolescent children: Associations with cardiorespiratory fitness

Lifestyle factors contribute to childhood obesity risk, however it is unclear which lifestyle factors are most strongly associated with childhood obesity. The purpose of this cross-sectional study was to simultaneously investigate the associations among dietary patterns, activity behaviors, and physical fitness with adiposity (body fat %, fat mass, body mass index [BMI], and waist to hip ratio) in preadolescent children. Preadolescent children (N = 392, 50% female, age: 9.5 ± 1.1year, BMI: 17.9 ± 3.3 kg/m2) were recruited. Body fat (%) and fat mass (kg) were measured with bioelectrical impedance analysis. Cardiorespiratory fitness (VO2 max), muscular strength (hand-grip strength), activity, sleep, and dietary pattern was assessed. Multivariable analysis revealed that cardiorespiratory fitness associated most strongly with all four indicators of adiposity (body fat (%) (β = -0.2; p < .001), fat mass (β = -0.2; p < .001), BMI (β = -0.1; p < .001) and waist to hip ratio (β = -0.2; p < .001). Additionally, fruit and vegetable consumption patterns were associated with body fat percentage, but the association was negligible (β = 0.1; p = 0.015). Therefore, future interventions should aim to promote the use of cardiorespiratory fitness as a means of reducing the obesity epidemic in children

Scheduled napping on the night shift : consequences for the performance and neurophysiological alertness of air traffic controllers : a thesis submitted for the degree of Doctor of Philosophy of the University of Otago, Dunedin New Zealand

Rapid technological change and increasing traffic volumes worldwide are adding to the safety challenges for air traffic control. The night shift has traditionally been a period of low workload and work practices have evolved to reflect this. Thus, despite the exemplary safety record, there is a need to consider further systemic defences for maintaining performance and safety on the night shift. One possible strategy is the provision of a scheduled nap at work. In order to investigate the consequences of a scheduled nap on the night shift, 28 operational air traffic controllers were monitored across four roster cycles. Each roster cycle included one of two night shifts. Air traffic controllers were given a nap opportunity on one night shift of each type, and did not nap on the other. Information on the timing, quantity, and quality of sleep during the work week and days off was collected using actigraphy, and supported with logbook data. Sleep during the nap was measured using polysomnography, and the EEG and EOG were further utilised to determine neurophysiological alertness over the latter part of the night shift. Reaction time performance was measured three times across the night shift (beginning, middle, and end) with the psychomotor vigilance test.Actigraphy data indicated that the backward, rapidly-rotating work schedule of air traffic controllers resulted in a progressive loss of sleep across the work week. The reduction in sleep lead to an increasing cumulative sleep debt that was at a maximum prior to the night shift. This sleep debt was not related to reaction time performance at the end of the night shift, but was found to influence neurophysiological alertness.It was determined that the large majority of air traffic controllers were able to sleep during the scheduled 40 minute nap opportunity. However, the latency to sleep onset was long, the sleep short, and of relatively poor quality. Circadian and homeostatic factors increased the likelihood of entry into, and waking from, slow wave sleep (SWS). They were also found to influence reaction time performance and neurophysiological alertness. More variable performance and lowered alertness were seen at the end of the later starting (and finishing) night shift, possibly due to the combined influence of circadian and time-on-task factors. Homeostatic variables had less influence on performance at the end of the night shift, but greater acute sleep loss and higher cumulative sleep debts were related to increased neurophysiological sleepiness.performance and greater neurophysiological alertness in a dose-dependent manner, with even small amounts of stage 1 sleep effecting a performance improvement. Performance improvement was consistent across a range of reaction time measures and consistent improvements were also evident in the neurophysiological data, with the occurrence of SEMs declining, and lower spectral power evident in all frequency bands and single frequencies.These findings clearly demonstrate that a minimal quantity of sleep benefits the performance and alertness of air traffic controllers despite the "noise" of a field setting, thus providing a link between laboratory studies of napping and the actual work environment. The findings also fully support management endorsing a 40 minute napping opportunity for air traffic controllers working the night shift.The short nap sleep had no measurable effect on sleep subsequent to the night shift. However, the amount of sleep obtained in the nap was related to improved reaction time

Shiftwork in air traffic services : coping strategies and well-being : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

It is becoming widely recognised that shiftwork has significant implications for the health, safety and quality of life of shiftworkers. To date, little research has been carried out on how individuals cope with the problems caused by shiftwork and how effective coping strategies maintain their health and well-being. It has been proposed, by Monk (1994), that there are a number of aspects of a shiftworker's life which are important in determining the ability of an individual to cope with shiftwork. These factors are an individual's circadian rhythms, sleep patterns, and social and domestic situation. Further literature also suggests that workplace factors and coping style are an important part of tolerating shiftwork. The primary aim of the present study was to determine which factors are important in predicting the physical and mental well-being of Air Traffic Services staff working on shifts. It was hypothesised that individuals who are evening types, have few social, domestic, sleep, and work place difficulties will be physically and mentally healthy. In addition, it was hypothesised that the use of engagement strategies in dealing with shiftwork related problems will relate to better physical and mental health. To test the hypotheses, 183 Air Traffic Services staff from Melbourne centre, Australia were surveyed by questionnaire. The results of the regressions showed that physical health was predicted by variables from each of the five areas considered; circadian typology, the social and domestic situation, work place factors, sleep patterns and coping style. Mental well-being was best predicted by a single domestic variable, which is the extent to which shiftwork caused domestic problems and the two coping variables of engagement and disengagement. The results support the suggestion that in order for an individual to be able to tolerate shiftwork they must have strategies in place to help them deal with the effect of shiftwork variables on a range of factors in their lives. An additional aim of the present study was to determine the reliability of a questionnaire for use with Air Traffic Services staff. This was due to a lack of suitable questionnaires for use in this occupational context. Overall the items in the questionnaire were found to have acceptable reliability, although the collection of sleep data by subjective reporting is not recommended

Fatigue Management in the New Zealand Aviation Industry Leigh Signal

Safety Research Grants Program. The ATSB is an operationally independent bureau within the Australia

Shared responsibility for managing fatigue: Hearing the pilots

<div><p>In commercial aviation, fatigue is defined as a physiological state of reduced mental or physical performance capability resulting from sleep loss, extended wakefulness, circadian phase, and/or workload. The International Civil Aviation Organisation mandates that responsibility for fatigue risk management is shared between airline management, pilots, and support staff. However, to date, the majority of research relating to fatigue mitigations in long range operations has focused on the mitigations required or recommended by regulators and operators. Little research attention has been paid to the views or operational experience of the pilots who use these (or other) mitigations. This study focused on pilots’ views and experiences of in-flight sleep as the primary fatigue mitigation on long range flights. It also sought information about other fatigue mitigation strategies they use. Thematic analysis was used to explore written comments from diary and survey data collected during long range and ultra-long range trips (N = 291 pilots on three different aircraft types, 17 different out-and-back trips, and four airlines based on three continents). The findings indicate that the recommended fatigue mitigation strategies on long-haul flights (particularly in-flight sleep) are effective and well-utilised, consistent with quantitative findings from the same trips. Importantly however, the analyses also highlight areas that require further investigation, including flight preparation strategies in relation to the uncertainty of in-flight break allocation. There were two strategies for sleep prior to a flight: maximising sleep if pilots were expecting later breaks in the flight; or minimising sleep if they were expecting breaks earlier or at unfavourable times in the circadian cycle. They also provide a broader view of the factors that affect the amount and quality of pilots’ in-flight sleep, about which evidence has previously been largely anecdotal. The study underscores the value of including the views and experience of pilots in fatigue risk management.</p></div

Physical Activity and Metabolic Health in New Zealand European and Pacific Women from the Promise Study

Background: This study investigates relationships between physical activity (PA) andbiomarkers of metabolic health in populations with different metabolic disease risk; Pacific and NewZealand European (NZE) women with different body composition profiles. [...