Dale E Rae1, Simone A Tomaz2, Rachel A Jones3, Trina Hinkley4, Rhian Twine5, Kathleen Kahn5,6,7, Shane A Norris8, Catherine E Draper2,8. 1. Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. Dale.Rae@uct.ac.za. 2. Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 3. Early Start, Faculty of the Arts Social Science and Humanities, University of Wollongong, Wollongong, Australia. 4. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia. 5. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 6. Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden. 7. INDEPTH Network, Accra, Ghana. 8. SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Abstract
BACKGROUND: The extent to which income setting or rural and urban environments modify the association between sleep and obesity in young children is unclear. The aims of this cross-sectional observational study were to (i) describe and compare sleep in South African preschool children from rural low-income (RL), urban low-income (UL) and urban high-income (UH) settings; and (ii) test for associations between sleep parameters and body mass index (BMI). METHODS: Participants were preschoolers (5.2 ± 0.7y, 49.5% boys) from RL (n = 111), UL (n = 65) and UH (n = 22) settings. Height and weight were measured. Sleep, sedentary behaviour and physical activity were assessed using accelerometery. RESULTS: UL children had higher BMI z-scores (median: 0.39; interquartile range: - 0.27, 0.99) than the UH (- 0.38; - 0.88, 0.11) and RL (- 0.08; - 0.83, 0.53) children (p = 0.001). The UL children had later bedtimes (p < 0.001) and wake-up times (p < 0.001) and shorter 24 h (p < 0.001) and nocturnal (p < 0.001) sleep durations than the RL and UH children. After adjusting for age, sex, setting, SB and PA, for every hour less sleep obtained (24 h and nocturnal), children were 2.28 (95% CI: 1.28-4.35) and 2.22 (95% CI: 1.27-3.85) more likely, respectively, to belong to a higher BMI z-score quartile. CONCLUSIONS: Shorter sleep is associated with a higher BMI z-score in South African preschoolers, despite high levels of PA, with UL children appearing to be particularly vulnerable.
BACKGROUND: The extent to which income setting or rural and urban environments modify the association between sleep and obesity in young children is unclear. The aims of this cross-sectional observational study were to (i) describe and compare sleep in South African preschool children from rural low-income (RL), urban low-income (UL) and urban high-income (UH) settings; and (ii) test for associations between sleep parameters and body mass index (BMI). METHODS:Participants were preschoolers (5.2 ± 0.7y, 49.5% boys) from RL (n = 111), UL (n = 65) and UH (n = 22) settings. Height and weight were measured. Sleep, sedentary behaviour and physical activity were assessed using accelerometery. RESULTS: UL children had higher BMI z-scores (median: 0.39; interquartile range: - 0.27, 0.99) than the UH (- 0.38; - 0.88, 0.11) and RL (- 0.08; - 0.83, 0.53) children (p = 0.001). The UL children had later bedtimes (p < 0.001) and wake-up times (p < 0.001) and shorter 24 h (p < 0.001) and nocturnal (p < 0.001) sleep durations than the RL and UH children. After adjusting for age, sex, setting, SB and PA, for every hour less sleep obtained (24 h and nocturnal), children were 2.28 (95% CI: 1.28-4.35) and 2.22 (95% CI: 1.27-3.85) more likely, respectively, to belong to a higher BMI z-score quartile. CONCLUSIONS: Shorter sleep is associated with a higher BMI z-score in South African preschoolers, despite high levels of PA, with UL children appearing to be particularly vulnerable.
Entities:
Keywords:
Adiposity; Early childhood; Low- and middle-income country; Sleep
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