Cross-sectional associations of actigraphy-assessed sleep with dietary outcomes in emerging adults.

BACKGROUND/OBJECTIVES: Emerging adults (~18-28 years of age) have a high prevalence of poor sleeping habits and poor diet quality; however, little is known on whether these poor sleeping habits are associated with dietary outcomes in this age group. This study assessed associations between actigraphy-based sleep with energy intake (EI), overall diet quality, and measures of meal timing in emerging adults. SUBJECTS/METHODS: Data on 135 emerging adults (age = 19.4 ± 1.3 years; body mass index (BMI) = 26.5 ± 6.9 kg/m2; 58% female; 65% White) from the RIGHT Track Health project were used. Measures included actigraphy-assessed sleep duration, sleep efficiency, sleep timing midpoint, day-to-day sleep duration and sleep timing midpoint variability and combined sleep duration and sleep timing behaviors (early-bed/late-rise, early-bed/early-rise, late-bed/late-rise, late-bed/early-rise); EI (three 24-h dietary recalls), diet quality (Healthy Eating Index 2015 total score) and meal timing outcomes (timing of first and last meal intake, total duration, and midpoint of the eating window). RESULTS: Shorter sleep duration, later sleep timing midpoint and greater sleep efficiency, as well as combined late-bed/late-rise and late-bed/early-rise groups, were associated with lower diet quality. Greater sleep timing midpoint variability was associated with higher EI, and the late-bed/early-rise group had significantly delayed first meal timing. CONCLUSION: In emerging adults, shorter sleep duration and later sleep timing are associated with lower overall diet quality, and greater sleep timing variability is associated with higher EI. Future research is needed to examine the role of sleep on diet quality and eating habits to identify potential targets for nutritional interventions in this age group.

Interactions between poor sleep and negative social cognition pose risk for lower maternal sensitivity.

The extent to which mother and infant sleep predict maternal sensitivity as (a) main effects and (b) moderate the association between social cognition about infant crying (i.e., cry processing) and maternal sensitivity was examined in a sample of 299 mother-infant dyads (43% of mothers non-White; 50.5% of infants female). Infant- and mother-oriented cry processing were assessed prenatally using a video recall procedure and mothers self-reported demographics and characteristics reflecting emotional risk. When infants were 2 months old, mothers reported their depressive symptoms and mother and infant sleep. Maternal sensitivity and infant negative mood were observed during free play and the still face. There were no main effects of mother or infant sleep on maternal sensitivity over and above covariates. However, infant total sleep duration across night and day and mother sleep disturbance moderated the effect of mother-oriented cry processing on sensitivity. Specifically, mother-oriented cry processing was associated with lower maternal sensitivity only among mothers whose infants had lower sleep duration and who reported more sleep disturbances. Moderating effects were not apparent for infant night wakings or time awake or mothers' total sleep problems. Constrained opportunities for sleep or respite across the entire day and the totality of mothers' nighttime sleep disturbances, not just those specific to infants' night wakings, undermine maternal sensitivity by exacerbating mothers' preexisting tendency to have self-focused and negative reactions to infant distress. The efficacy of interventions designed to facilitate maternal sensitivity and infant adjustment may be enhanced by adding targeted foci on maternal and infant sleep. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations of actigraphy-assessed sleep variables with adiposity and serum cardiometabolic outcomes in emerging adults.

This study assessed associations of actigraphy-assessed sleep with adiposity and serum cardiometabolic outcomes in emerging adults, and whether sex and race modified these associations. Data on 147 emerging adults (age = 19.4 ± 1.3 years; body mass index = 26.4 ± 7.0 kg m-2 ; 59% female; 65% White) from RIGHT Track Health were used. Actigraphy-based sleep measures included sleep duration, sleep efficiency, sleep timing midpoint, day-to-day sleep duration and sleep timing midpoint variability. Combined sleep duration and sleep timing behaviours were also derived (early-bed/late-rise, early-bed/early-rise, late-bed/late-rise, late-bed/early-rise). Outcomes included body mass index and BodPod-assessed fat mass index, fasting serum leptin, C-reactive protein, and homeostatic model assessment-insulin resistance. Sleep duration was 5.4 h per night. We noted an inverse association between sleep duration and homeostatic model assessment-insulin resistance. The early-bed/early-rise group had greater body mass index, C-reactive protein and homeostatic model assessment-insulin resistance compared with the early-bed/late-rise group (referent). Sex modified associations of sleep efficiency with C-reactive protein; stratified results revealed positive association between sleep efficiency and C-reactive protein in males, but not females. Race modified associations of sleep duration with body mass index and leptin, and of sleep duration variability with C-reactive protein. Stratified analyses revealed inverse associations between sleep duration with body mass index and leptin in Black, multiracial/other race individuals only. Positive association between sleep duration variability and C-reactive protein was noted in White individuals only. Shorter sleep duration, particularly when combined with earlier sleep timing, is associated with greater adiposity and serum cardiometabolic outcomes. Additional studies are needed to assess individual- and contextual-level factors that may contribute to sex and race differences in sleep health and cardiometabolic risk in emerging adults.

Associations among eating behaviors, food security status, and dietary intake during pregnancy.

Dietary intake of certain food groups and/or nutrients during pregnancy has been associated with maternal and infant pregnancy-related outcomes. Few studies have examined how behavioral and environmental factors interact to influence prenatal diet. We examined associations between eating behaviors (dietary restraint, emotional eating, external eating) and food security status regarding dietary intake of selected nutrients/food groups during pregnancy. Participants (N = 299; 29% Non-Hispanic Black; 16% ≤ high school education; 21% food insecure) completed validated questionnaires to assess estimated daily intake of food groups/nutrients during pregnancy [e.g., added sugars from sugar-sweetened beverages (SSBs), % of energy from fat, fruit and vegetable (FV) intake] via National Cancer Institute Dietary Screener Questionnaires); eating behaviors (Dutch Eating Behavior Questionnaire); and food security status (6-item USDA Food security Module). Separate hierarchical multiple regressions for each dietary outcome were conducted controlling for maternal age, education, income-to-needs, race/ethnicity, pre-pregnancy BMI, and gestational diabetes. A significant interaction was found between dietary restraint and food security status on added sugar intake from SSBs (ß = -0.15, p = 0.02). The negative association between restraint and added sugar from SSBs was stronger among food insecure participants (ß = -0.47, p < 0.001 vs. ß = -0.15, p = 0.03). Higher external eating (ß = 0.21, p < 0.01) and lower restraint (ß = -0.13, p = 0.03) were associated with higher % of energy from fat and living in a food insecure household (ß = -0.15, p = 0.01) was associated with lower FV intake. Understanding dietary intake during pregnancy requires consideration of the broader context in which eating behaviors occur.

Physiologic and Behavioral Correlates of Energy Intake in Emerging Adulthood: Cross-Sectional Analysis of the RIGHT Track Health Study.

BACKGROUND: Consistent findings have reported that FFM is associated with EI. However, conjoint assessments of physiologic (body composition, fasting serum leptin) and behavioral [eating behaviors and physical activity (PA)] correlates of EI during emerging adulthood have not been examined. OBJECTIVES: We assessed associations between physiologic and behavioral correlates of EI within the context of one another in emerging adults (18-28 years old). We also assessed these associations in a subsample after the removal of probable EI underreporters. METHODS: Cross-sectional data from 244 emerging adults (age = 19.6 ± 1.4 y; BMI = 26.4 ± 6.6 kg/m2; 56.6% female) from the RIGHT Track Health study were used. Measures included body composition (BOD POD), eating behaviors (Three-Factor Eating Questionnaire), objective and subjective PA (accelerometer-derived total activity counts and Godin-Shephard Leisure-Time Exercise Questionnaire), fasting serum leptin, and EI (three 24-hour dietary recalls). Correlates independently associated with EI were entered into a backward stepwise linear regression model. Correlates that met the criteria of P < 0.05 were retained. Analyses were repeated in a subsample after removing probable EI underreporters (n = 48). Effect modification by sex (male and female) and BMI (BMI < 25 kg/m2, BMI ≥ 25 kg/m2) categories was also assessed. RESULTS: In the full sample, FFM (ß: 18.4; 95% CI: 9.9, 26.8), leptin (ß: -84.8; 95% CI: -154.3, -15.4), dietary restraint (ß: -35.2; 95% CI: -59.1, -11.3), and subjective PA (ß: 2.5; 95% CI: 0.04, 4.9) were significantly associated with EI. After the removal of probable underreporters, only FFM remained significantly associated with EI (ß: 43.9; 95% CI: 27.2, 60.6). No evidence of effect modification by sex or BMI categories was noted. CONCLUSIONS: Although physiologic and behavioral correlates were associated with EI in the full sample, only FFM remained a robust correlate of EI in a subsample of emerging adults after removing probable EI underreporters.

Childhood Adversity Predicts Maternal Pre-Pregnancy BMI but not Gestational Weight Gain.

INTRODUCTION: Obesity and excessive weight gain during pregnancy have lasting implications for both women and infant health. Adverse childhood experiences and stressful life events have been associated with pre-pregnancy obesity and excessive gestational weight gain. However, the effect of each has been examined independently and scant work has investigated the effects of both in the same analysis. The current study examined the unique and conjoint effects of adverse childhood experiences and recent stressful life events on women's pre-pregnancy BMI and gestational weight gain. METHODS: A racially and socioeconomically diverse sample of 176 pregnant women completed questionnaires and anthropometric measurements during the third trimester and two months postpartum. RESULTS: Maternal adverse childhood experiences were uniquely associated with pre-pregnancy BMI (ß = 0.21, p = .02), but not gestational weight gain. Recent stressful life events did not uniquely predict pre-pregnancy BMI or gestational weight gain, nor did it explain the association between adverse childhood experiences and pre-pregnancy BMI. Adverse childhood experiences and recent stressful life events did not interact to predict either of the women's weight outcomes. DISCUSSION: Adverse childhood experiences have lasting unique effects on women's pre-pregnancy BMI. Obesity is related to several perinatal health issues for the mother and child, thus understanding the effects of childhood adversity on women's weight outcomes is critical. Routine screening for ACEs among women of childbearing age and pregnant women, paired with referrals and educational resources, can mitigate the deleterious effects of childhood adversity on women and infant health.

Interactive effects of maternal physiological arousal and regulation on maternal sensitivity: Replication and extension in an independent sample.

This study examined the extent to which mothers' physiological arousal (i.e., skin conductance level [SCL] augmentation) and regulation (i.e., respiratory sinus arrhythmia [RSA] withdrawal) interacted to predict subsequent maternal sensitivity. Mothers' (N = 176) SCL and RSA were measured prenatally during a resting baseline and while watching videos of crying infants. Maternal sensitivity was observed during a free-play task and the still-face paradigm when their infants were 2 months old. The results demonstrated that higher SCL augmentation but not RSA withdrawal predicted more sensitive maternal behaviors as a main effect. Additionally, SCL augmentation and RSA withdrawal interacted, such that well-regulated maternal arousal was associated with greater maternal sensitivity at 2 months. Further, the interaction between SCL and RSA was only significant for the negative dimensions of maternal behavior used to derive the measure of maternal sensitivity (i.e., detachment and negative regard) suggesting that well-regulated arousal is particularly important for inhibiting the tendency to engage in negative maternal behaviors. The results replicate findings from mothers in previous studies and demonstrate that the interactive effects of SCL and RSA in relation to parenting outcomes are not sample specific. Considering joint effects of physiological responding across multiple biological systems may enhance understanding of the antecedents of sensitive maternal behavior.

Longitudinal associations between specific types of emotional reactivity and psychological, physical health, and school adjustment.

Using a multimethod, multiinformant longitudinal design, we examined associations between specific forms of positive and negative emotional reactivity at age 5, children's effortful control (EC), emotion regulation, and social skills at age 7, and adolescent functioning across psychological, academic, and physical health domains at ages 15/16 (N = 383). We examined how distinct components of childhood emotional reactivity directly and indirectly predict domain-specific forms of adolescent adjustment, thereby identifying developmental pathways between specific types of emotional reactivity and adjustment above and beyond the propensity to express other forms of emotional reactivity. Age 5 high-intensity positivity was associated with lower age 7 EC and more adolescent risk-taking; age 5 low-intensity positivity was associated with better age 7 EC and adolescent cardiovascular health, providing evidence for the heterogeneity of positive emotional reactivity. Indirect effects indicated that children's age 7 social skills partially explain several associations between age 5 fear and anger reactivity and adolescent adjustment. Moreover, age 5 anger reactivity, low-, and high-intensity positivity were associated with adolescent adjustment via age 7 EC. The findings from this interdisciplinary, long-term longitudinal study have significant implications for prevention and intervention work aiming to understand the role of emotional reactivity in the etiology of adjustment and psychopathology.

Longitudinal Associations Among Food Insecurity During Pregnancy, Parental Mental Health Symptoms, Controlling Feeding Styles, and Infant Food Responsiveness.

BACKGROUND: Research is needed to identify pathways by which household food insecurity (FI) contributes to parental controlling feeding styles and infant food responsiveness, 2 factors that play a role in shaping obesity risk across infancy and early childhood. OBJECTIVES: This longitudinal study tested the hypothesis that prenatal FI would be positively associated with higher infant food responsiveness via greater parental mental health symptomatology and controlling feeding styles (pressuring, restrictive). METHODS: Participants included a community sample of 170 birth parents and their infants participating in an ongoing longitudinal study. Parents self-reported household FI and mental health symptoms (depression and anxiety) during pregnancy. Postnatally, parents reported their mental health symptoms, their use of controlling feeding styles, and infant food responsiveness. Path analyses with bias-corrected 95% bootstrapped CIs tested direct and indirect associations between prenatal FI and infant food responsiveness. RESULTS: Prenatal FI was indirectly associated with higher infant food responsiveness via greater parental mental health symptomatology and pressuring to finish (b = 0.01; 95% CI: 0.001, 0.025). Prenatal FI was associated with greater parental mental health symptomatology across the peripartum period (ß = 0.54; P < 0.001), which in turn was associated with more pressuring to finish at 2 months pospartum (ß = 0.29; P = 0.01) and higher infant food responsiveness at 6 months (ß = 0.17; P = 0.04). There were no direct effects of prenatal FI on controlling feedings styles or infant food responsiveness. CONCLUSIONS: Our findings point to parental mental health as a potential pathway by which FI may be associated with obesity-promoting parental feeding styles and infant appetitive behaviors. In addition to ensuring reliable access to enough quality food during pregnancy, multipronged assistance that promotes emotional well-being during the peripartum period and clinical guidance on noncontrolling feeding styles could benefit parent and infant health and well-being.

Bidirectional associations between maternal controlling feeding and food responsiveness during infancy.

Parental controlling feeding styles and practices have been associated with greater food-approaching appetitive behaviors (i.e., food responsiveness) linked to childhood obesity. Recent longitudinal research suggests that this relationship may be reciprocal such that controlling feeding predicts child appetite and vice versa. However, to date no studies have considered these associations during infancy. The current study investigates prospective bidirectional associations between controlling feeding (restriction, pressure, and food to soothe) and infant food responsiveness. Mothers (N = 176) reported their controlling feeding and their infant's food responsiveness at infant age 2, 6, and 14 months. A 3-wave cross-lagged panel model was used to test the effect of controlling feeding at an earlier time point on infant food responsiveness at a later time point, and vice versa. Maternal controlling feeding and infant food responsiveness showed moderate stability across infancy. Net of covariates, we observed parent-driven prospective relations between pressuring feeding styles and food to soothe with infant food responsiveness. Pressuring to finish was a significant predictor of increases in food responsiveness from 2 to 6 months (p = 0.004) and pressuring with cereal was a significant predictor of increases in food responsiveness from 6 to 14 months (p = 0.02). Greater use of situational food to soothe was marginally associated with higher food responsiveness from 2 to 6 months (p = 0.07) and 6 to 14 months (p = 0.06). Prospective associations between restrictive feeding styles and infant food responsiveness were not observed. Findings point to pressuring feeding styles and food to soothe as potential early life intervention targets to prevent increases in food responsiveness in infancy. Longitudinal research with follow-up in the toddler and preschool years are needed to understand how these associations unfold over time and whether child-driven effects of food responsiveness become apparent as children get older.

Maternal Depressive Symptoms and Adolescents' Unhealthy Behavior: A 15-year Longitudinal Study.

OBJECTIVES: First, to leverage 15 years of longitudinal data, from child ages 2 to 17, to examine whether maternal depressive symptoms in early and middle childhood and in adolescence predict their child's unhealthy behaviors during adolescence. Second, to examine whether the timing of maternal depressive symptoms or specific unhealthy behaviors matter and whether child depressive symptoms and body mass index explain these associations. METHODS: Data came from a prospective-longitudinal community sample with multi-informant data (N = 213) from child ages 2 to17. A cumulative adolescent unhealthy behavior index was calculated, summing the presence of poor sleep, poor diet, physical inactivity, sedentary behavior, and smoking. Regression analyses examined associations of maternal depressive symptoms in early childhood (ages 2 to 5), middle childhood (ages 7 to 10), and adolescence (age 15) with adolescents' unhealthy behaviors (ages 16 to17). Indirect effects of child depressive symptoms and body mass index were tested using a path model. RESULTS: Adolescents' unhealthy behaviors were common (eg, 2 out of 3 engaged in at least 1 unhealthy behavior). Higher levels of maternal depressive symptoms in middle childhood and adolescence were associated with adolescent engagement in more unhealthy behaviors at ages 16 to 17. Maternal depressive symptoms in early childhood were associated with adolescent unhealthy behaviors through indirect effects involving children's depressive symptoms and continuity of maternal depressive symptoms. CONCLUSIONS: Maternal depressive symptoms are associated with the number of adolescent unhealthy behaviors, both directly and indirectly. Promoting mothers' mental health can be crucial for promoting children's health behaviors and health.

Women's Social Well-Being During Pregnancy: Adverse Childhood Experiences and Recent Life Events.

Background: Adverse experiences during childhood and recent stressful life events are each associated with women's reduced well-being and poorer health during pregnancy. Few studies, however, have focused upon pregnant women's social well-being, and inclusion of both independent variables in the same analysis is rare. This study focuses upon adverse experiences during childhood as well as recent life events in relationship to four aspects of social well-being: social support, couple aggression for partnered women, neighborhood safety, and food insecurity. Materials and Methods: A diverse community sample of 176 pregnant women completed questionnaires during their third trimester. A cross-sectional design was used that included retrospective reports of childhood experiences, as well as reports of recent life events and current well-being. Results: Adverse experiences during childhood were uniquely associated with couple aggression (ß = 0.206, p = 0.026) and lower neighborhood safety (ß = -0.185, p = 0.021). Recent stressful life events were uniquely associated with lower social support (ß = -0.247, p = 0.001) and greater food insecurity (ß = 0.494, p = 0.000). For social support and food insecurity, there was a significant indirect pathway from adverse childhood experiences through recent stressful life events. Adverse child experiences and recent stressful life events did not interact. Conclusions: A life-course perspective that considers women's experiences across their life span is critical for use by both researchers and health practitioners. Adverse childhood experiences and recent stressful life events are important for understanding social features of pregnant women's daily lives.

Infant appetite and weight gain in early infancy: Moderating effects of controlling feeding styles.

Excessive infant weight gain is a strong predictor of later obesity. While controlling feeding has been linked to negative weight outcomes, research has not considered associations between infant appetite and maternal feeding simultaneously in relation to infant weight. This longitudinal study examined infant food responsiveness and slowness in eating as predictors of infant weight outcomes and tested controlling feeding styles (restrictive and pressuring) as moderators. Data came from a diverse sample of mothers and their infants participating in an ongoing longitudinal study. Mothers (n = 159) reported infant appetite and feeding styles at 2 postnatal timepoints (2-month visits and 6-month visits). The infant weight outcomes included change in weight-for-age z-scores (WAZ-change) and rapid weight gain (RIWG; WAZ-change ≥ 0.67 SD) from birth to the second postnatal visit. Data were analyzed using hierarchical multiple and logistic regressions, controlling for birthweight, gestational age, maternal race/ethnicity, feeding mode, and residing with an intimate partner. Over 25% of infants exhibited RIWG. Greater infant food responsiveness predicted both greater infant weight gain and RIWG status. Infant food responsiveness and slowness in eating interacted with controlling feeding styles in a unique way. Infants with higher food responsiveness whose mothers were less restrictive had greater weight gain (b = 0.61, p < 0.001) and increased probability of RIWG (b = 2.71, p < 0.01) than infants with more restrictive mothers. Higher slowness in eating was associated with a lower RIWG probability among infants of mothers with lower pressuring feeding (b = -1.86, p < 0.05). For infants with a large appetite, some level of restrictive feeding may be beneficial for preventing excessive weight gain while pressuring may exacerbate the positive association between faster eating and RIWG.

Maternal sleep problems, depression, and infant negative emotionality are associated with maternal feeding to soothe in early infancy.

Maternal overreliance on feeding to soothe to relieve infants' distress has been associated with higher rates of childhood obesity. Limited research has examined infant and maternal characteristics that predict maternal feeding to soothe. The goal of the present study was to examine the role of infant (temperament) and maternal (depression, sleep problems) characteristics as predictors of maternal feeding to soothe. Mothers (N = 176) completed the Food to Soothe Scale, the Infant Behavior Questionnaire-Revised Very Short Form, the Center for Epidemiological Studies Depression Scale, and the Pittsburgh Sleep Questionnaire when their infants were 6 months old. Hierarchical multiple regression was used. Maternal depression only predicted feeding to soothe among mothers receiving WIC benefits, and this association was no longer significant when maternal sleep problems were added to the model. Maternal sleep problems predicted higher feeding to soothe as a main effect and in interaction with infant negative emotionality, maternal depression, and to a lesser extent WIC status. Specifically, infant negative emotionality was only associated with greater feeding to soothe among mothers with higher sleep problems, and sleep problems were only associated with greater feeding to soothe among depressed mothers and mothers receiving WIC benefits. The findings suggest that addressing multiple stressors, including maternal sleep, in the early postnatal period may strengthen the effectiveness of early child obesity interventions that target maternal feeding behaviors.

Racial Disparities in Neighborhood and Household Socioeconomic Disadvantage Predict Postpartum Weight Retention.

Introduction: Structural racism leads to neighborhood-level socioeconomic disadvantage, which determines adverse birth outcomes. Individual socioeconomic disadvantage is associated with compromised healthy pregnancy outcomes. This study aimed to investigate the pathways by which race, neighborhood socioeconomic disadvantage, and household socioeconomic disadvantage predict subsequent maternal postpartum weight retention. Method: A total of 176 (N=176) racially diverse women were studied from the third trimester to 6 months after delivery. Neighborhood socioeconomic disadvantage was defined by information from the American Community Survey based on women's census tract and self-reports of neighborhood healthy food availability, safety, violence, and walking environment. Household socioeconomic disadvantage included food insecurity, income-to-needs ratio, and maternal education. Pregnancy health risk was operationalized using a summative index that included prepregnancy overweight/obesity, excessive gestational weight gain, and diagnosed hypertensive disorders during pregnancy. Postpartum weight retention was operationalized as a 6-month postpartum weight minus prepregnancy weight. Data were analyzed using structural equation modeling with bootstrapped CIs to estimate indirect effects. Results: One third of participants retained more than 22 lbs. of pregnancy weight gain 6 months after delivery. Increased household socioeconomic disadvantage (ß=0.64, p=0.039) and pregnancy health risk (ß=0.34, p=0.002) were directly associated with higher postpartum weight retention. Maternal race/ethnicity had an indirect impact on postpartum weight retention through neighborhood socioeconomic disadvantage and household socioeconomic disadvantage. Non-Hispanic Black women had greater neighborhood socioeconomic disadvantage than non-Hispanic White women (White vs Black ß= -0.62; p<0.001) and all other women (other vs Black ß= -0.22; p=0.013). In addition, Black women had greater household socioeconomic disadvantage than White women (White vs Black ß= -0.35; p=0.004), both of which in turn predicted higher postpartum weight retention. Conclusions: To prevent postpartum weight retention, education on behavior change to lose weight is essential, but it must be offered in the context of basic resources, at both the neighborhood and household levels.

The Families and Schools for Health Project: A Longitudinal Cluster Randomized Controlled Trial Targeting Children with Overweight and Obesity.

This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG-compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = -0.05) and BMI-M% (B = -2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.

Bidirectional Associations between Restrained Eating and Body Mass Index in Middle Childhood.

The nature of the association between dietary restraint and weight has been examined in adult samples, but much less is known about this relationship among children. The current study examined the transactional associations among restrained eating behavior and weight among boys and girls during middle childhood. Data for this study came from 263 children participating in the Families and Schools for Health Project (FiSH), a longitudinal study of the psychosocial correlates of childhood obesity. Participants were interviewed by trained researchers in their third- and fourth-grade year when they completed questionnaires and anthropometric assessments. Dietary restraint was assessed using the restrained eating subscale of the Dutch Eating Behavior Questionnaire (DEBQ), and weight was assessed using Body Mass Index z-scores (BMIz). Bidirectional associations between variables were examined using cross-lagged models controlling for children's sex, ethnicity, and weight in first grade. Results indicated that weight in grade 3 was related to greater dietary restraint in grade 4 (B = 0.20, p = 0.001), but dietary restraint in grade 3 was not associated with weight in grade 4 (B = 0.01, p = 0.64). Neither child sex nor race/ethnicity were associated with BMIz or dietary restraint at either time point. Findings from this study advance the existing limited understanding of eating behavior development among children and show that weight predicts increases in children's dietary restraint in middle childhood.

Heart Rate Dynamics During Acute Recovery From Maximal Aerobic Exercise in Young Adults.

INTRODUCTION: Resting heart rate (HRrest), heart rate variability (HRV), and HR recovery (HRR) from exercise provide valuable information about cardiac autonomic control. RR-intervals during acute recovery from exercise (RRrec) are commonly excluded from HRV analyses due to issues of non-stationarity. However, the variability and complexity within these trends may provide valuable information about changes in HR dynamics. PURPOSE: Assess the complexity of RRrec and determine what physiologic and demographic information are associated with differences in these indices in young adults. METHODS: RR-intervals were collected throughout maximal treadmill exercise and recovery in young adults (n = 92). The first 5 min of RRrec were (1) analyzed with previously reported methods that use 3-interval lengths for comparison and (2) detrended using both differencing(diff) and polynomial regression(res). The standard deviation of the normal interval (SDNN), root mean square of successive differences (rMSSD), root mean square (RMS) of the residual of regression, and sample entropy (SampEn) were calculated. Repeated measures analysis of covariance (ANCOVA) tested for differences in these indices for each of the methodological approaches, controlling for race, body fat, peak oxygen uptake (VO2p eak), and resting HR (HRrest). Statistical significance was set at p < 0.05. RESULTS: VO2p eak and HRrest were significantly correlated with traditional measures of HRR and the variability surrounding RRrec. SampEndiff and SampEnres were correlated with VO2p eak but not HRrest or HRR. The residual-method provided a significantly (p = 0.04) lower mean standard error (MSE) (0.064 ± 0.042) compared to the differencing-method (0.100 ± 0.033). CONCLUSIONS: Complexity analysis of RRrec provides unique information about cardiac autonomic regulation immediately following the cessation of exercise when compared to traditional measures of HRR and both HRrest and VO2peak influence these results.

Emerging self-regulatory skills in childhood predict cardiometabolic risk in adolescence.

Cardiometabolic risk (CMR) has increased among adolescents. A growing literature shows that childhood self-regulatory skills are associated with obesity and CMR. However, the developmental nature of self-regulation has not been considered in existing studies. Therefore, it is unclear how specific types of self-regulation (i.e., attentional, emotional, behavioral, cognitive) at different points in development, may differentially predict CMR. Using a multi-method longitudinal design, we assessed a sample of 117 children repeatedly between ages 2 and 16. At ages 2, 4, and 7 years, self-regulation (emotional, attentional, behavioral, and cognitive) skills that were hypothesized to have emerged were assessed. Adolescent CMR indicators were assessed at age 16. Latent profile analyses identified three profiles of adolescent CMR: Low Risk (41%), Dyslipidemia Risk (49.6%), and High Risk (9.4%). Distinct self-regulation skills at each childhood age predicted CMR during adolescence. Specifically, emotional regulation skills at ages 2 and 4, food-related behavioral regulation and attentional regulation at age 4, and attentional and cognitive regulation skills at age 7 predicted adolescent CMR. Self-regulation skills are modifiable, and thus, childhood interventions aimed at improving self-regulation could reduce CMR for decades to come. However, these results suggest that the multifaceted, developmental nature of self-regulation must be considered to most effectively inform preventive interventions aimed at lowering CMR. Additionally, our study highlights the need for additional research on adolescents who show elevations of CMR without meeting criteria for obesity.

Physical Activity and Health-Related Changes During Transition Out of Collegiate Football: A Case Series.

Two American collegiate football linemen completed physical activity surveys, anthropometric assessments, dietary recalls, and blood draws across a 20-month period during which Player A continued training professionally in football while Player B transitioned out of the sport after his final collegiate season. Few changes were observed for Player A, whereas notable changes in physical activity, body mass, and endocrine factors associated with metabolic regulation were noted in Player B. Considerable alterations in physical activity and biomarkers occurred in the immediate transition out of competitive football, suggesting the possibility of long-term health consequences in the absence of future positive lifestyle behavioral changes. Alternatively, the adoption or maintenance of health behaviors could reverse risks. With a greater emphasis on lifespan wellness, this level 2 exploratory case series illustrates a key opportunity for athletic trainers to monitor athletes' cardiometabolic risks over an extended period and implement transitional care strategies to promote postcompetitive health.