Paths towards a healthier BMI among short and adequate sleepers: A pathway network analysis considering movement behaviors in low-income preschoolers.

INTRODUCTION: Short sleep duration has been seen as a predictor of higher body mass index (BMI) in youth. Sleep duration varies substantially along early childhood, and the paths towards a healthier BMI, considering the other movement behaviors (physical activity-PA and screen time) are unexplored in preschoolers. AIM: To construct a sleep-BMI model to capture the direct and indirect paths to intervening towards a healthier BMI, according to low-income preschoolers' compliance with the other movement behaviors. METHODS: Two hundred and seventy two preschoolers (4.5 ± 0.0; 138 boys) participated in the study. Sleep and screen time (ST) were assessed in a face-to-face interview with primary caregivers. PA was assessed using accelerometer (wGT3X-BT). Preschoolers were categorized as compliant or not with sleep, screen time, total and moderate to vigorous PA recommendations. BMIz-score was calculated according to preschoolers' sex and age. All the assessed variables, besides sex and age were included in a Network Pathway Analysis (NPA) according to age as nodes. RESULTS: At 3 years old, a direct and negative path between sleep-BMIz score was observed. At four and 5 years old, this relationship became positive. Further, girls were more compliant with sleep, ST and total PA recommendations. Total PA (TPA) showed the highest expected influence value in the general, 3 and 4 years old NPA. CONCLUSION: The NPA analysis showed different directions for the relationship between sleep and BMIz score, according to age. Intervention strategies to a healthier BMI among preschoolers compliant or not with sleep recommendations should focus in increasing TPA.

Adherence to 24-hour movement guidelines in low-income Brazilian preschoolers and associations with demographic correlates.

BACKGROUND: The importance of movement behaviors for health is well known, although few studies have examined the adherence to movement guidelines in low-income preschoolers from a middle-income country, as Brazil. This study reports the proportion of preschoolers meeting the 24-hour movement guidelines and investigates its associations with demographic correlates in Brazilian low-income preschoolers. METHODS: Two hundred and seventy preschoolers (132 boys, means age = 3.97 ± 0.80) provided physical activity (PA) data (Actigraph wGT3X). Sleep duration, screen time, and social correlates were parent-reported. Preschoolers were classified as compliant/not compliant with the 24-hour movement guidelines. Relationships between compliance with movement behaviors guidelines and demographic correlates were calculated using a network analysis (Mplus 8.0; Rstudio). RESULTS: Preschoolers were active (273.52 ± 62.08 minutes/day of total PA), though moderate-to-vigorous physical activity (MVPA) time was below the guideline (58.68 ± 22.51 minutes/day); spent more than the recommended 60 minutes/day on screen time (169.91 ± 97.07 minutes/day); and slept less than 10 hours per night (9.44 ± 1.12 hours/day). Only 3% of the sample complied with the guidelines. PA showed the highest compliance (43%), compared to sleep duration (35%) and screen time (15%). Male sex was related to adherence to MVPA recommendations, while female sex, with adherence to total PA recommendations. Child's primary caregiver was the most important centrality indicator in the network. CONCLUSION: Only 3% of the assessed preschoolers are compliant with the 24-hour movement behaviors guidelines. Strategies to promote adherence to movement behaviors among low-income preschoolers should consider child's primary caregivers to support movement behaviors.

Twenty-four-hour movement behaviours and fundamental movement skills in preschool children: A compositional and isotemporal substitution analysis.

Studies that have analysed the association between the different movement behaviours and fundamental movement skills (FMS) have considered it in an independent manner, disregarding the compositional nature of 24-h movement behaviours (24-h MB). The aim of this study was to investigate the relationship between the 24-h MB and FMS in preschoolers using a compositional data analysis . Two hundred and four preschoolers (4.5 ± 0.8 years old; 101 boys) provided objectively assessed physical activity (PA) and sedentary behaviour (SB) data (Actigraph wGT3X), and FMS (TGMD-2). Sleep duration (SD) was reported by parents. Association of daily composition of movement behaviours with FMS was explored using compositional analysis and isotemporal substitution (R Core Team, 3.6.1). When considered as a 24-h MB composition (PA, SB and SD), adjusted for age, BMI and sex, the composition predicted locomotor (r2 = 0.31), object control (r2 = 0.19), and total motor score (r2 = 0.35), respectively (all P < 0.001). Reallocation of time from light to moderate-to-vigorous PA was associated with greatest positive changes in total motor score. Achieving adequate balance between movement behaviours over the 24-h period, and its relationship with locomotor and object control skills should be considered and further investigated in early childhood.

24-hour movement behaviour and executive function in preschoolers: A compositional and isotemporal reallocation analysis.

Adherence to healthy behaviours promotes several health benefits in preschool children, including executive function (EF). Recently, the predictive power of the 24-hour movement behaviour (24 h MB) composition on health outcomes has been evidenced; however, its relationship with EF in preschoolers is unknown. Thus, the present study had two objectives: (1) to analyse the associations between the 24 h MB composition and EF of preschoolers; and (2) to investigate the theoretical changes in EF when time in different movement behaviours is reallocated. This cross-sectional study was carried out with 123 preschoolers (3-5 years old) of low socioeconomic status. Physical activity (PA) and sedentary behaviour were assessed using an accelerometer for 7 days, sleep time was obtained through interviews with parents, and EF was measured using the Early Tool Box battery. To verify the association between 24 h MB and EF, compositional data analysis was used, and for time reallocation, compositional isotemporal substitution analysis was utilized. It was observed that the 24 h MB composition was positively associated with EF (p < .0001; R² = 0.34), and that reallocating 5, 10, 15 or 20 min of the time spent on sleep and light PA to moderate-to-vigorous PA, respectively, was associated with significant improvements in EF (p < .05). These findings provide hitherto unseen insight into the relationship between 24 h MB and EF in preschool children, and warrants consideration for researchers and practitioners seeking to improve EF and PA in preschool children.

A Network Perspective on the Relationship Between Moderate to Vigorous Physical Activity and Fundamental Motor Skills in Early Childhood.

BACKGROUND: The relationship between moderate to vigorous physical activity (MVPA) and fundamental motor skill (FMS) is inconsistent in early childhood, due to its complex and nonlinear characteristics. This study aimed to analyze the nonlinear relationships between MVPA, FMS, body mass index (BMI), sex, and age in preschoolers. METHODS: This cross-sectional study with preschoolers (n = 204; 4.0 [0.8] y old; 99 boys), provided objective physical activity data, FMS assessments, and BMI. The associations between MVPA, FMS, BMI, sex, and age were explored using the network analysis (RStudio and qgraph). RESULTS: Boys were more motor competent than girls in all FMS skills, while girls were more active than boys during the weekend. Older children were less active than their younger peers during these days. MVPA is weak and differently related to each FMS, and the leap skill emerged with the highest betweenness and strength values in the network. CONCLUSIONS: For the assessed preschoolers, when considering BMI, age, and sex, the relationships between MVPA and FMS are inconsistent, and leap emerged as the main variable. During early childhood, these variables are connected as part of a complex system in which each skill has a dynamic role within the emerging pattern.

Associação dos hábitos alimentares e da aptidão cardiorrespiratória com o estado nutricional de escolares / Association of eating habits and cardiorespiratory fitness with the nutritional status of students

RESUMO O objetivo deste estudo foi verificar se há associação independente e combinada dos hábitos alimentares e da aptidão cardiorrespiratória com o estado nutricional de escolares. Trata-se de um estudo de corte transversal, com 171 crianças (86 meninos e 85 meninas) com idade de seis a 12 anos, de uma escola pública de Porto Alegre-RS. Os hábitos alimentares foram avaliados com o Inquérito de Frequência Alimentar. A aptidão cardiorrespiratória foi avaliada pelo teste de corrida/caminhada de 6 minutos. O índice de massa corporal e aptidão cardiorrespiratória foram avaliados seguindo os protocolos propostos pelo PROESP-BR. Para análise dos dados utilizou-se estatística descritiva, modelos de regressão linear generalizada e anova de duas vias. Um maior consumo de frutas (β:-1,24; IC:-2,42 -0,06) e um menor consumo de doces (β:-1,56; IC:-2,797 -0,34) estão associados a um menor valor médio de IMC. Ainda, crianças com níveis adequados de APCR apresentaram valores inferiores de índice de massa corporal (β:- 3,11; IC:-3,93 -2,29). Quando avaliados de forma combinada, os hábitos alimentares e aptidão cardiorrespiratória exerceram maior influência sobre os valores de índice de massa corporal. Portanto, hábitos alimentares adequados e níveis satisfatórios de APCR estão associados a um adequado estado nutricional.

ABSTRACT The aim of this study was to verify whether there is an independent and combined association of eating habits and cardiorespiratory fitness with the nutritional status of schoolchildren. This is a cross-sectional study with 171 children (86 boys and 85 girls) aged six to 12 years, from a public school in Porto Alegre - RS. Eating habits were assessed using the Food Frequency Survey. Cardiorespiratory fitness was assessed by the 6-minute running / walking test. The body mass index and cardiorespiratory fitness were evaluated following the protocols proposed by PROESP-BR. For data analysis, descriptive statistics, generalized linear regression models and two-way anova were used. Higher consumption of fruits (β: -1.24; CI: -2.42 -0.06) and lower consumption of sweets (β: -1.56; CI: -2.797 -0.34) are associated with lower mean BMI value. Still, children with adequate levels of APCR had lower values ​​of body mass index (β: - 3.11; CI: -3.93 -2.29). When evaluated in a combined manner, eating habits and cardiorespiratory fitness had a greater influence on body mass index values. Therefore, adequate eating habits and satisfactory levels of CRP are associated with an adequate nutritional status.

Population specificity affects prediction of appendicular lean tissues for diagnosed sarcopenia: a cross-sectional study / La especificidad de la población impacta en la predicción de los tejidos magros apendiculares para la sarcopenia diagnosticada: un estudio transversal

INTRODUCTION: sarcopenia is a disease characterized by reduced musculoskeletal tissue and muscle strength. The estimation of appendicular lean soft tissue by DXA (ALSTDXA) is one of the criteria for the diagnosis of sarcopenia. However, this method is expensive and not readily avaiable in clinical practice. Anthropometric equations are low-cost and able to accurate predict ALST, but such equations have not been validated for male Brazilian older adults between the ages of 60 to 79 years. To this end, this study sought to validate the existing predictive anthropometric equations for ALST, and to verify its accuracy for the diagnosis of sarcopenia in male Brazilian older adults. METHODS: this cross-sectional study recruited and enrolled 25 male older adults (69.3 ± 5.60 years). ALSTDXA and anthropometric measures were determined. ALST estimations with 13 equations were compared to ALSTDXA. The validity of the equations was established when: p > 0.05 (paired t-test); standard error of the estimate (SEE) < 3.5 kg; and coefficient of determination r² > 0.70. RESULTS: two Indian equations met the criteria (Kulkarini 1: 22.19 ± 3.41 kg; p = 0.134; r² = 0.78; EPE = 1.3 kg. Kulkarini 3: 22.14 ± 3.52 kg; p = 0.135; r² = 0.82; SEE = 1.2 kg). However, these equations presented an average bias (Bland-Altman: 0.54 and 0.48 kg) and 'false negative' classification for the ALST index. Thus, three explanatory equations were developed. The most accurate equation demonstrated a high level of agreement (r2 adj = 0.87) and validity (r²PRESS = 0.83), a low predictive error (SEEPRESS = 1.53 kg), and an adequate ALST classification. CONCLUSION: anthropometric models for predicting ALST are valid alternatives for the diagnosis and monitoring of sarcopenia in older adults; however, population specificity affects predictive validity, with risks of false positive/negative misclassification

INTRODUCCIÓN: la sarcopenia es una enfermedad caracterizada por una reducción del tejido musculoesquelético y la fuerza muscular. Uno de los criterios utilizados para su diagnóstico es la determinación de tejido blando magro apendicular por DXA (TBMADXA), método costoso que no siempre está disponible en la práctica clínica. Las ecuaciones antropométricas suponen un bajo coste y predicen bien el TBMA, pero con una validez desconocida para los varones brasileños de 60 a 79 años. Por lo tanto, nuestro objetivo fue validar las ecuaciones antropométricas existentes predictivas del TBMA y verificar su precisión para el diagnóstico de sarcopenia en varones brasileños de edad avanzada. MÉTODOS: participaron en este estudio transversal 25 hombres de edad avanzada (69,3 ± 5,60 años). Se determinaron el TBMADXA y las medidas antropométricas. Las ecuaciones predictivas del TBMA se compararon con el TBMADXA. La validez de las ecuaciones en las comparaciones se confirmó cuando: p > 0,05 (prueba de la "t" pareada); error estándar estimado (EEE) < 3,5 kg; coeficiente de determinación r² > 0,70. RESULTADOS: dos ecuaciones indias cumplieron los criterios (Kulkarini 1: 22,19 ± 3,41 kg; p = 0,134; r² = 0,78; EEE = 1,3 kg. Kulkarini 3: 22,14 ± 3,52 kg; p = 0,135; r² = 0,82; EEE = 1,2 kg). Sin embargo, presentaron sesgo promedio (Bland-Altman: 0,54 y 0,48 kg) y clasificación de 'falso negativo' para el índice de TBMA. Por lo tanto, se crearon tres ecuaciones explicativas. La ecuación más precisa mostró un alto acuerdo (r2 adj = 0,87), uma alta validez (r²PRESS = 0,83), um bajo error predictivo (EEEPRESS = 1,53 kg) y uma clasificación del TBMA adecuada. CONCLUSIÓN: los modelos antropométricos para predecir el TBMA son alternativas válidas para el diagnóstico y el seguimiento de la sarcopenia en los ancianos. Pero la especificidad de la población afecta a su validez predictiva, con riesgos de incorrección por clasificación falsa positiva/negativa