Associations between objectively measured and self‐reported sleep with academic and cognitive performance in adolescents: DADOS study

Adequate sleep has been positively related with health and school achievement out-comes during adolescence. The aim of this study was to investigate the associations ofobjectively measured and self‐reported sleep duration and quality with academic andcognitive performance in adolescents. This study was conducted with 257 adolescents(13.9 ± 0.3 years) from the DADOS study (Deporte, ADOlescencia y Salud). Objec-tively measured and self‐reported sleep duration and quality were obtained by a wrist‐worn GENEActiv accelerometer and the Spanish version of Pittsburgh Sleep QualityIndex questionnaire, respectively. Academic performance was analysed through schoolrecords using four indicators: math, language, science and grade point average score.Cognitive performance was measured using the Spanish version of the“SRA Test ofEducational Ability”. After Benjamini–Hochberg correction for the false discovery rate,objectively measured sleep duration was negatively associated with verbal ability (β=−0.179,p= .004), whilst self‐reported sleep quality was positively associated withacademic performance (βranging from 0.209 to 0.273; allp<.001). These associationsremained significant after further controlling for physical fitness and physical activity.Conversely, there were no associations between self‐reported sleep duration andobjective sleep quality with academic and cognitive performance. Our findings fit inline with previous research showing that sleep quality may play an important role onadolescents’academic performance. Further interventional research is needed to clar-ify the mechanisms by which sleep is related to academic performance in youth

Comparing estimates of physical activity in children across different cut-points and the associations with weight status

This study aimed to compare sedentary time (SED) and intensity-specific physical activity (PA) estimates and the associations of SED and PA with body mass index (BMI) and waist circumference (WC) using three different sets of cut-points in preschool-aged children. A total of 751 children (4.7 +/- 0.9 years, boys 52.7%) wore an ActiGraph GT3X+BT accelerometer on their hip for 7 days (24 h). Euclidean norm -1 G with negative values rounded to zero (ENMO) and activity counts from vertical axis (VACounts) and vector magnitude (VMCounts) were derived. Estimates of SED and light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were calculated for commonly used cut-points by Hildebrand et al., Butte et al., and Evenson et al. Furthermore, the prevalence of meeting the PA recommendation, 180 min/day of which at least 60 min/day being MVPA, were assessed for the cut-points. Multilevel mixed analysis was used to examine associations of SED and PA with BMI and WC. In accordance with the results, SED and PA intensity estimates differed largely across cut-points (i.e., SED = 22-341 min/day; light PA = 52-257 min/day; moderate PA = 5-18 min/day; vigorous PA = 7-17 min/day; MVPA = 13-35 min/day), and the prevalence of children meeting the PA recommendation varied from 4% to 70%. Associations of SED and PA with BMI or WC varied between the cut-points. Our results indicate that SED and PA estimates in preschool-aged children between studies using these cut-points are poorly comparable. Methods facilitating accelerometer-derived PA estimate comparison between studies are highly warranted.Peer reviewe

Associations of sleep-related outcomes with behavioral and emotional functioning in children with overweight/obesity

Objective To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and deviceassessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/ obesity. Study design A total of 109 children with overweight/obesity (mean age, 10.0 (±) 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). Results SDB was positively associated with all clinical scale variables (all b > 0.197, P ≤ .041) and with lower adaptability and leadership (all b 0.196, P ≤ .045) and lower adaptability (b = 0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all b > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. Conclusions Our study suggests that SDB symptoms, but not deviceassessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability. (J Pediatr 2022;246:170-8).The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the Fondo Europeo de Desarrollo Regional (DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011). L.V.T.-L. is supported by a grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). J.H.M. is supported by a grant from the Spanish Ministry of Education, Culture, and Sport (FPU15/02645). Additional support was provided by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health, by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and European Regional Development Fund (SOMM17/6107/UGR). Funding was also provided by the SAMID III network, RETICS , funded by the PNI + D + I 2017-2021 (Spain), ISCIII Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (RD16/0022 ), the EXERNET Research Network on Exercise and Health ( DEP2005-00046/ACTI ; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 Research and Innovation Program under Grant Agreement 667302, and the HL-PIVOT network Healthy Living for Pandemic Event Protection . Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Fund (project B-CTS-355-UGR18)

Revisiting the association of sedentary behavior and physical activity with all-cause mortality using a compositional approach: the Women's Health Study

This research was supported by grants from the National Institutes of Health (CA154647, CA047988, CA182913, HL043851, HL080467, and HL099355). EJS was supported by the Intramural Research Program at the National Institute on Aging. JHM was supported by a Grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). CC-S was supported by a grant from the Spanish Ministry of Science and Innovation (FJC2018-037925-I). Additional funding was provided by the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES) to FBO. The funders had no role in preparing and conducting this manuscript, in interpreting and deciding to publish the results, or in drafting the manuscript. drafting this manuscript. Open Access funding provided by the National Institutes of Health (NIH).Background: While physical activity has consistently been associated with decreased mortality rates, it remains unknown if there is a single “ideal” combination of time in physical activities of different intensities and sedentary behavior (SB) associated with the lowest rate. This study examined the associations of combinations of time in moderate-to-vigorous intensity (MVPA), higher-light intensity (HLPA), lower-light intensity activities (LLPA), and SB with mortality rates in older women. Methods: This prospective cohort study included 16,676 older women from throughout the United States enrolled in the Women’s Health Study. Women wore accelerometers on their hip from 2011 to 2015 and were followed through 2017 (mean (SD) of 4.3 (1.1) years). Deaths were confirmed with medical records, death certificates, or the National Death Index. Compositional Cox regression models were used. Results: The mean (SD) age was 72 (5.7) years at accelerometer wear; 503 women died. Compared to the least active women (mean, 3 min/day MVPA, 27 min/day HLPA, 162 min/day LLPA, and 701 min/day SB): compositional models showed an inverse L-shaped dose-response association of MVPA replacing other behaviors with mortality rates mortality rates (P = .02); SB relative to LLPA, HLPA, and MVPA was directly associated with mortality rates in a curvilinear dose-response manner (P < .001); replacing 10 min of SB for MVPA (HR (95% CI) = .86 (.73–.98)) or for HLPA (HR (95% CI.94 (.88–1.00)) associated with 14 and 6% lower mortality rates, respectively; a 47% risk reduction (HR [95% CI] = .53 [.42–.64]) was observed among women meeting physical activity guidelines (mean, 36 min/day MVPA, 79 min/day HLPA, 227 min/day LLPA and 549 min/day SB); and similar mortality rate reductions of 43% (HR (95% CI) = .57 (.41–.73)) were observed with increases in HLPA and LLPA without increasing MVPA, e.g., reallocating SB to 90 min/day of HLPA plus 120 min/day of LLPA. Conclusions: There was no “ideal” combination of physical activities of different intensities and SB associated with the lowest mortality rates. Of particular relevance to older women, replacing SB with light intensity activity was associated with lower mortality rates, and “mixing and matching” times in different intensities yielded equivalent mortality risk reductions.United States Department of Health & Human Services National Institutes of Health (NIH) - USA CA154647 CA047988 CA182913 HL043851 HL080467 HL099355Intramural Research Program at the National Institute on AgingSpanish Ministry of Education, Culture and Sport FPU15/02645Spanish Government FJC2018-037925-IUniversity of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of ExcellenceScientific Excellence Unit on Exercise and Health (UCEES)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - US

The role of heart rate on the associations between body composition and heart rate variability in children with overweight/obesity : the ActiveBrains project

Background: Heart rate variability (HRV) is negatively associated with body mass index and adiposity in several populations. However, less information is available about this association in children with overweight and obesity, especially severe/morbid obesity, taking into consideration the dependence of HRV on heart rate (HR). Objectives: (1) to examine associations between body composition measures and HRV, (2) to study differences in HRV between children with overweight and severe/morbid obesity; and (3) to test whether relationships and differences tested in objectives 1 and 2, respectively are explained by the dependency of HRV on HR. Methods: A total of 107 children with overweight/obesity (58% boys, 10.03 +/- 1.13 years) participated in this study. Body composition measures were evaluated by Dual-energy X-ray absorptiometry (DXA). HRV parameters were measured with Polar RS800CXR (R). Results: Body composition measures were negatively associated with HRV indicators of parasympathetic activity (beta values ranging from -0.207 to -0.307, all p 0.05). Conclusion: All associations between adiposity/obesity and HRV could be explained by HR, suggesting a key confounding role of HR in HRV studies in children with weight disturbances

Does sleep‑disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?

Funding for open access charge: Universidad de Granada/CBUA. This work is part of a PhD thesis conducted in the Official Doctoral Programme in Biomedicine of the University of Granada, Spain. Preliminary data from this manuscript has been presented previously in The International Society of Behavioral Nutrition and Physical Activity (ISBNPA) Xchange 2021 Annual Meeting. The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the "Fondo Europeo de Desarrollo Regional (FEDER)" (DEP201347540, DEP2016-79512-R, DEP2017-91544-EXP and RYC-201109011). L.V.T.-L. is supported by a Grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). J.H.M. is supported by a Grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). IEC is supported by the Spanish Ministry of Science and Innovation (RYC2019-027287-I). Additional support was obtained from the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES), by the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades, and European Regional Development Funds (ref. SOMM17/6107/UGR). In addition, funding was provided by the SAMID III network, RETICS, funded by the PNI + D + I 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) (Ref. RD16/0022), the EXERNET Research Network on Exercise and Health (DEP2005-00046/ACTI; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 research and innovation program under grant agreement No.667302, and the HL-PIVOT network-Healthy Living for Pandemic Event Protection. Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Funds (ERDF in English, FEDER in Spanish, project ref: B-CTS-355-UGR18).Approximately 4–11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8–12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β 0.065) or brain volumes (all P > 0.05). Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone.Universidad de Granada/CBUASpanish Government European CommissionSpanish Government DEP201347540 DEP2016-79512-R DEP2017-91544-EXP RYC-201109011Spanish Government FPU17/04802 FPU15/02645 FJC2018-037925-I RYC2019-027287-IUniversity of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES)Junta de Andalucia European Commission SOMM17/6107/UGRSAMID III network, RETICS - PNI + D + I 2017-2021 (Spain)ISCIII-Sub-Directorate General for Research Assessment and PromotionEuropean Commission RD16/0022EXERNET Research Network on Exercise and Health DEP2005-00046/ACTI 09/UPB/19 45/UPB/20 27/UPB/21European Commission 667302HL-PIVOT network-Healthy Living for Pandemic Event ProtectionAndalusian Operational ProgrammeEuropean Regional Development Funds (ERDF in English, FEDER in Spanish) B-CTS-355-UGR1

Calibration and Cross-Validation of Accelerometer Cut-Points to Classify Sedentary Time and Physical Activity from Hip and Non-Dominant and Dominant Wrists in Older Adults

Accelerometers’ accuracy for sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) classification depends on accelerometer placement, data processing, activities, and sample characteristics. As intensities differ by age, this study sought to determine intensity cutpoints at various wear locations people more than 70 years old. Data from 59 older adults were used for calibration and from 21 independent participants for cross-validation purposes. Participants wore accelerometers on their hip and wrists while performing activities and having their energy expenditure measured with portable calorimetry. ST and MVPA were defined as ≤1.5 metabolic equivalents (METs) and ≥3 METs (1 MET = 2.8 mL/kg/min), respectively. Receiver operator characteristic (ROC) analyses showed fair-to-good accuracy (area under the curve [AUC] = 0.62–0.89). ST cut-points were 7 mg (cross-validation: sensitivity = 0.88, specificity = 0.80) and 1 count/5 s (crossvalidation: sensitivity = 0.91, specificity = 0.96) for the hip; 18 mg (cross-validation: sensitivity = 0.86, specificity = 0.86) and 102 counts/5 s (cross-validation: sensitivity = 0.91, specificity = 0.92) for the nondominant wrist; and 22 mg and 175 counts/5 s (not cross-validated) for the dominant wrist. MVPA cut-points were 14 mg (cross-validation: sensitivity = 0.70, specificity = 0.99) and 54 count/5 s (crossvalidation: sensitivity = 1.00, specificity = 0.96) for the hip; 60 mg (cross-validation: sensitivity = 0.83, specificity = 0.99) and 182 counts/5 s (cross-validation: sensitivity = 1.00, specificity = 0.89) for the non-dominant wrist; and 64 mg and 268 counts/5 s (not cross-validated) for the dominant wrist. These cut-points can classify ST and MVPA in older adults from hip- and wrist-worn accelerometers.University of Pittsburgh Claude D. Pepper Older Americans Independence Center, Research Registry and Developmental Pilot Grant (no. NIH P30 AG024827)National Institute on Aging Professional Services Contract HHSN271201100605P supported AREA/DECOSIntramural Research Program of the National Institutes of Health, National Institute on Aging, and by research grants AG036594, and AG000181 from the National Institutes of HealthBiomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES)FEDER funds from the European Union (CB16/10/00477)Spanish Ministry of Science and Innovation (FJC2018-037925-I)Plan Propio de Investigación 2020 from the University of Granada-Programa Contratos-Puent

Associations of Sedentary Behaviour, Physical Activity, Cardiorespiratory Fitness and Body Composition with Risk of Sleep-Related Breathing Disorders in Children with Overweight/Obesity: A Cross-Sectional Study

The aim of this study was to examine the associations of sedentary behaviour, physical activity, cardiorespiratory fitness (CRF), and body composition parameters with risk of sleep-related breathing disorders (SRBD) in children with overweight/obesity. One-hundred and nine children (10.0 +/- 1.1 years old, 45 girls) with overweight (n = 27) and obesity (n = 82) were included. Television viewing time was self-reported by using the Spanish adaptation of the "Youth Activity Profile" (YAP) questionnaire. Sedentary time and physical activity were measured with accelerometry. CRF was assessed with the 20-m shuttle-run test and body composition parameters with Dual-energy X-ray absorptiometry. SRBD were evaluated by using the Spanish version of the Pediatric Sleep Questionnaire. Television viewing time was positively associated with risk of SRBD (r = 0.222, p = 0.021). CRF was negatively correlated with risk of SRBD (r = -0.210, p = 0.030). Body composition parameters were positively associated with risk of SRBD (all p < 0.05), except fat mass index. Stepwise regression analyses showed that body mass index (BMI) explained the largest proportion of the variance in SRBD (r(2) = 0.063, p = 0.01) and television viewing time was the only one added after BMI (r(2) change = 0.048, p = 0.022). This study supports the notion that higher body weight status negatively influences risk of SRBD and adds that unhealthy behaviours could contribute to worsen SRBD, related to an increased risk of cardiovascular diseases. All the significant association observed in this manuscript were of small magnitude, indicating than other factors in addition to the one hereby studied contribute to explain the variance in SRBD

Associations of objectively-assessed physical activity and sedentary time with hippocampal gray matter volume in children with overweight/obesity

This study investigated physical activity (PA) and sedentary time (SED) in relation to hippocampal gray matter volume (GMV) in pediatric overweight/obesity. Ninety-three children (10 ± 1 year) were classified as overweight, obesity type I, or type II–III. PA was assessed with non-dominant wrist accelerometers. GMV was acquired by magnetic resonance imaging (MRI). Neither PA nor SED associated with GMV in the hippocampus in the whole sample (p > 0.05). However, we found some evidence of moderation by weight status (p < 0.150). Moderate-to-vigorous PA (MVPA) positively associated with GMV in the right hippocampus in obesity type I (B = 5.62, p = 0.017), which remained when considering SED, light PA, and sleep using compositional data (γ = 375.3, p = 0.04). Compositional models also depicted a negative association of SED relative to the remaining behaviors with GMV in the right hippocampus in overweight (γ = −1838.4, p = 0.038). Reallocating 20 min/day of SED to MVPA was associated with 100 mm3 GMV in the right hippocampus in obesity type I. Multivariate pattern analysis showed a negative-to-positive association pattern between PA of increasing intensity and GMV in the right hippocampus in obesity type II–III. Our findings support that reducing SED and increasing MVPA are associated with greater GMV in the right hippocampus in pediatric overweight/obesity. Further studies should corroborate our findings.MINECO/FEDER DEP2013-47540 DEP2016-79512-R RYC-2011-09011Spanish Ministry of Education, Culture and Sport FPU15/02645 FPU17/04802Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz PI-0002-2017Spanish Government FJC2018-037925-IAlicia Koplowitz FoundationSpanish Ministry of Economy and Competitiveness RTI2018-095284-J-100University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of ExcellenceScientific Excellence Unit on Exercise and Health (UCEES)Junta de AndaluciaConsejeria de Conocimiento, Investigacion y UniversidadesEuropean Union (EU)SAMID III network, RETICS - PN I + D+I 2017-2021 (Spain)ISCIII-Sub-Directorate General for Research Assessment and PromotionEuropean Union (EU) RD16/0022EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACT