德国小学生客观评估的睡眠时长与体力活动、BMI 和看电视之间的横断面关联。
Cross-sectional associations of objectively assessed sleep duration with physical activity, BMI and television viewing in German primary school children.
机构信息
Division of Sports and Rehabilitation Medicine, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, D-89075, Ulm, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstr. 13, D-89075, Ulm, Germany.
出版信息
BMC Pediatr. 2019 Feb 11;19(1):54. doi: 10.1186/s12887-019-1429-3.
BACKGROUND
The global incidence of overweight and obesity has increased dramatically among children and adolescents over the past decades. Insufficient sleep duration and physical inactivity are known risk factors for overweight and obesity in children. To engage children in a healthier lifestyle knowledge about associations of sleep duration and behavioural aspects in children are vital. Therefore, this study investigated the mentioned associations in German primary school children.
METHODS
Data of 308 first and second graders (7.1 ± 0.6 years) was used; children's anthropometric data were taken during a school visit. Children's physical activity (PA) and sleep duration were assessed objectively (Actiheart©, CamNtech Ltd., Cambridge, UK); children's daily television time and socio-demographic data were collected via parental questionnaire. Linear mixed-effects regression models as well as logistic regressions were used to determine associations of PA, television viewing, age, gender, BMI z-scores and socio-economic variables on sleep duration.
RESULTS
In linear regression models young age and not having a migration background were significantly associated with long sleep duration (p < 0.001). In logistic regressions, long night time sleep (≥10:08 h; compared to medium and short sleep duration) was significantly associated with not reaching the PA guideline (OR 0.60 [0.36;0.99]), daily television viewing of less than one hour (OR 0.44 [0.24;0.80]), young age (OR 0.38 [0.21;067]), a high parental education level (OR 0.52 [0.27;0.99]) and the lack of migration background (OR 0.21 [0.10;0.48]). However, if controlling for age, gender, parental education level and migration background, reaching the PA guideline stayed no longer significantly associated with a tertiary sleep level.
CONCLUSIONS
Children in the highest sleep category showed a negative association with reaching the PA guideline and a positive association with daily television viewing. This therefore adds to previously primarily subjectively assessed associations of sleep and risk factors for obesity (related behaviours) with a detailed insight based on objective data. Hence, interventions trying to decrease children's BMI and television viewing should also aim at extending children's night-time sleep and inform parents about the importance of sufficient sleep during childhood.
TRIAL REGISTRATION
DRKS-ID: DRKS00000494 .
背景
在过去几十年中，儿童和青少年超重和肥胖的全球发病率显著增加。睡眠时间不足和缺乏身体活动是儿童超重和肥胖的已知风险因素。为了让儿童养成更健康的生活方式，了解儿童睡眠时间和行为方面的关联至关重要。因此，本研究调查了德国小学儿童的这些关联。
方法
使用了 308 名一年级和二年级学生的数据（7.1±0.6 岁）；在学校访问期间，对儿童的人体测量数据进行了测量。通过父母问卷收集了儿童的体力活动（PA）和睡眠时间；使用 Actiheart©（CamNtech Ltd.，英国剑桥）客观评估儿童的睡眠持续时间；收集了儿童每天看电视的时间和社会人口统计学数据。线性混合效应回归模型和逻辑回归用于确定 PA、看电视时间、年龄、性别、BMI z 分数和社会经济变量与睡眠持续时间的关联。
结果
在线性回归模型中，年轻和没有移民背景与长睡眠时间显著相关（p<0.001）。在逻辑回归中，与中、短睡眠时间相比，长时间夜间睡眠时间（≥10:08 小时）与未达到 PA 指南显著相关（OR 0.60 [0.36;0.99]），每天看电视时间少于一小时（OR 0.44 [0.24;0.80]），年龄较小（OR 0.38 [0.21;0.67]），父母教育水平较高（OR 0.52 [0.27;0.99]），没有移民背景（OR 0.21 [0.10;0.48]）。然而，如果控制年龄、性别、父母教育水平和移民背景，达到 PA 指南与第三级睡眠时间之间不再显著相关。
结论
睡眠时间最长的儿童与达到 PA 指南呈负相关，与每天看电视呈正相关。因此，这增加了之前主要基于主观评估的睡眠与肥胖相关风险因素（相关行为）的关联，并基于客观数据提供了更详细的见解。因此，试图降低儿童 BMI 和看电视时间的干预措施也应该旨在延长儿童夜间睡眠时间，并告知父母儿童期充足睡眠的重要性。
试验注册
DRKS-ID：DRKS00000494。
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