Longitudinal Associations Among Diet Quality, Physical Activity and Sleep Onset Consistency With Body Mass Index z-Score Among Toddlers in Low-income Families.

Content Provider	Europe PMC
Author	Covington, Lauren Armstrong, Bridget Trude, Angela C B Black, Maureen M
Copyright Year	2020
Description	Abstract Background Habits surrounding health behaviors (i.e., sleep, physical activity, diet) are developed in toddlerhood. Lack of consistent health habits may increase obesity risk among toddlers in low-income families. Purpose To compare the role of sleep onset consistency, physical activity and diet quality as mediators between household poverty and toddler weight. Methods Two hundred and seven toddlers (mean age = 20.2 months, 46% female, 68.1% Black) participating in an obesity prevention trial were assessed at three time points over 12 months. Using Actical accelerometers, we assessed sleep and physical activity at each time point for up to 1 week. We defined sleep onset consistency as the standard deviation of sleep onset across all days. We calculated the Healthy Eating Index-2015 from a 24-hr dietary recall. We used WHO standards to calculate BMI-for-age z-scores from toddlers’ weight/length, and calculated poverty ratio from parent-reported income and family size. Multilevel mediation models tested toddler sleep onset consistency, physical activity, and diet quality as mediators between household poverty and toddler BMI z-score. Results Toddlers from households with higher poverty ratios had more inconsistent sleep onset times. Toddlers with more inconsistent sleep onset times had higher BMI z-scores across all timepoints, even when accounting for physical activity and diet quality. Sleep onset consistency indirectly explained the association between household poverty and BMI z-score. Conclusions Inconsistent sleep schedules could help explain the association between poverty and BMI. Future research should examine strategies to support low-income families to develop and maintain routines as a mechanism to prevent obesity and reduce disparities. Trial registration number NCT02615158. Toddlers who on average had inconsistent sleep onset times, had higher body mass index z-scores compared to children with consistent sleep onset times, even when accounting for sleep duration, physical activity and diet quality.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8240137&blobtype=pdf
Page Count	12
ISSN	08836612
Volume Number	55
DOI	10.1093/abm/kaaa100
PubMed Central reference number	PMC8240137
Issue Number	7
PubMed reference number	33196078
Journal	Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine [Ann Behav Med]
e-ISSN	15324796
Language	English
Publisher	Oxford University Press
Publisher Date	2021-06-01
Publisher Place	US
Access Restriction	Open
Rights License	This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Subject Keyword	Toddlers Bedtime Obesity Poverty Physical activity Diet quality
Content Type	Text
Resource Type	Article
Subject	Psychology Psychiatry and Mental Health