Associations between sleep patterns and lifestyle behaviors in children: an international comparison

J-P Chaput¹, P T Katzmarzyk², A G LeBlanc³, M S Tremblay¹, T V Barreira⁴, S T Broyles², M Fogelholm⁵, G Hu², R Kuriyan⁶, A Kurpad⁶, E V Lambert⁷, D E Rae⁷, C Maher⁸, J Maia⁹, V Matsudo¹⁰, V Onywera¹¹, O L Sarmiento¹², M Standage¹³, C Tudor-Locke¹⁴, P Zhao¹⁵, T Olds⁸; ISCOLE Research Group

Affiliations

¹ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada.
² Pennington Biomedical Research Center , Baton Rouge, LA, USA.
³ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada.
⁴ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Exercise Science, University of Syracuse, Syracuse, NY, USA.
⁵ Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland.
⁶ St. Johns Research Institute , Bangalore, India.
⁷ Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa.
⁸ Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia.
⁹ CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal.
¹⁰ Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo, Brazil.
¹¹ Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya.
¹² School of Medicine Universidad de los Andes , Bogota, Colombia.
¹³ Department for Health, University of Bath , Bath, UK.
¹⁴ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA.
¹⁵ Tianjin Women's and Children's Health Center , Tianjin, China.

PMID: 27152187
PMCID: PMC4850622
DOI: 10.1038/ijosup.2015.21

Review

Associations between sleep patterns and lifestyle behaviors in children: an international comparison

J-P Chaput et al. Int J Obes Suppl. 2015 Dec.

. 2015 Dec;5(Suppl 2):S59-65.

doi: 10.1038/ijosup.2015.21. Epub 2015 Dec 8.

Authors

Affiliations

¹ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada.
² Pennington Biomedical Research Center , Baton Rouge, LA, USA.
³ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada.
⁴ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Exercise Science, University of Syracuse, Syracuse, NY, USA.
⁵ Department of Food and Environmental Sciences, University of Helsinki , Helsinki, Finland.
⁶ St. Johns Research Institute , Bangalore, India.
⁷ Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa.
⁸ Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia , Adelaide, South Australia, Australia.
⁹ CIFI2D, Faculdade de Desporto, University of Porto , Porto, Portugal.
¹⁰ Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS) , Sao Paulo, Brazil.
¹¹ Department of Recreation Management and Exercise Science, Kenyatta University , Nairobi, Kenya.
¹² School of Medicine Universidad de los Andes , Bogota, Colombia.
¹³ Department for Health, University of Bath , Bath, UK.
¹⁴ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA.
¹⁵ Tianjin Women's and Children's Health Center , Tianjin, China.

PMID: 27152187
PMCID: PMC4850622
DOI: 10.1038/ijosup.2015.21

Abstract

Objectives: Although evidence is accumulating on the importance of a good night's sleep for healthy eating and activity behaviors, existing research has mainly been conducted in high-income, developed countries with limited sociocultural variability. This study is the first to examine the associations between sleep patterns and lifestyle behaviors in children from 12 countries in five major geographic regions of the world.

Methods: This observational, multinational cross-sectional study included 5777 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom and the United States. Nocturnal sleep duration (hours per night), sleep efficiency (%) and bedtime (h:min) were monitored over 7 consecutive days using an accelerometer. Lifestyle behaviors included moderate-to-vigorous physical activity (MVPA), total sedentary time (SED), self-reported screen time (ST) and healthy/unhealthy diet patterns (HDP/UDP). Multilevel modeling analyses were used to account for the hierarchical nature of the data.

Results: Overall, participants averaged 8.8 (s.d. 0.9) hours of sleep with 96.2% (s.d. 1.4) sleep efficiency and a mean bedtime of 2218 hours. After adjustment for age, sex, highest parental education and BMI z-score, results showed that (i) sleep duration was negatively associated with MVPA, SED and UDP score; (ii) sleep efficiency was negatively associated with MVPA and UDP score, and positively associated with SED; and (iii) later bedtime was positively associated with SED, ST and UDP score, and negatively associated with MVPA and HDP score. Results using categories of sleep patterns were consistent with the linear associations. Results also revealed that associations between sleep patterns and MVPA, SED and ST were significantly different between study sites, with stronger associations in high-income countries compared with low/middle-income countries.

Conclusions: Sleep characteristics are important correlates of lifestyle behaviors in children. Differences between countries suggest that interventions aimed at improving sleep and lifestyle behaviors should be culturally adapted.

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Conflict of interest statement

MF has received a research grant from Fazer Finland and has received an honorarium for speaking for Merck. AK has been a member of the Advisory Boards of Dupont and McCain Foods. RK has received a research grant from Abbott Nutrition Research and Development. VM is a member of the Scientific Advisory Board of Actigraph and has received an honorarium for speaking for The Coca-Cola Company. TO has received an honorarium for speaking for The Coca-Cola Company. The remaining authors declare no conflict of interest.

Figures

**Figure 1**
Trends in lifestyle behaviors across quintiles of nocturnal sleep duration in boys (black bars) and girls (white bars). Error bars represent s.d.'s for moderate-to-vigorous physical activity (MVPA), sedentary time and screen time score. S.e.'s are represented for healthy/unhealthy diet pattern scores. P-values for linear trends across quintiles in both boys and girls are shown in the figure. The models are adjusted for age, highest parental education and BMI z-score.

**Figure 2**
Trends in lifestyle behaviors across quintiles of nocturnal sleep efficiency in boys (black bars) and girls (white bars). Error bars represent s.d.'s for moderate-to-vigorous physical activity (MVPA), sedentary time and screen time score. S.e.'s are represented for healthy/unhealthy diet pattern scores. P-values for linear trends across quintiles in both boys and girls are shown in the figure. The models are adjusted for age, highest parental education and BMI z-score.

**Figure 3**
Trends in lifestyle behaviors across quintiles of nocturnal bedtime in boys (black bars) and girls (white bars). Error bars represent s.d.'s for moderate-to-vigorous physical activity (MVPA), sedentary time and screen time score. S.e.'s are represented for healthy/unhealthy diet pattern scores. P-values for linear trends across quintiles in both boys and girls are shown in the figure. The models are adjusted for age, highest parental education and BMI z-score.

See this image and copyright information in PMC

References

1. Ohayon MM. Determining the level of sleepiness in the American population and its correlates. J Psychiatr Res 2012; 46: 422–427. - PubMed
1. Akerstedt T, Nilsson PM. Sleep as restitution: an introduction. J Intern Med 2003; 254: 6–12. - PubMed
1. Matricciani L, Olds T, Petkov J. In search of lost sleep: secular trends in the sleep time of school-aged children and adolescents. Sleep Med Rev 2012; 16: 203–211. - PubMed
1. Keyes KM, Maslowsky J, Hamilton A, Schulenberg J. The Great Sleep Recession: changes in sleep duration among US adolescents, 1991-2012. Pediatrics 2015; 135: 460–468. - PMC - PubMed
1. Gruber R, Carrey N, Weiss SK, Frappier JY, Rourke L, Brouillette RT et al. Position statement on pediatric sleep for psychiatrists. J Can Acad Child Adolesc Psychiatry 2014; 23: 174–195. - PMC - PubMed

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Associations between sleep patterns and lifestyle behaviors in children: an international comparison

Affiliations

Associations between sleep patterns and lifestyle behaviors in children: an international comparison

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources

Other Literature Sources