Associations of diarised sleep onset time, period and duration with total and central adiposity in a biethnic sample of young children: the Born in Bradford observational cohort study

ObjectivesTo investigate associations of parent-reported sleep characteristics with adiposity levels in a biethnic sample of young children.DesignA cross-sectional observational study.SettingThe Born in Bradford 1000 study, UK.ParticipantsChildren aged approximately 18 months (n=209; 40.2% South Asian; 59.8% white) and 36 months (n=162; 40.7% South Asian; 59.3% white).Primary and secondary outcome measuresChildren’s body mass index (BMI) z-score, sum of two-skinfolds (triceps and subscapular) and waist circumference. Adjusted regression was used to quantify associations of sleep parameters with adiposity stratified by ethnicity and age group. The results are beta coefficients (95% CIs) and unless otherwise stated represent the difference in outcomes for every 1-hour difference in sleep parameters.ResultsThe average sleep onset time was markedly later in South Asian (21:26±68 min) than white children (19:41±48 min). Later sleep onset was associated with lower BMI z-score (−0.3 (−0.5 to −0.0)) and sum of two-skinfolds (−1.5 mm (−2.8 mm to −0.2 mm)) in white children aged 18 months and higher BMI z-score in South Asian children aged 36 months (0.3 (0.0–0.5)). Longer sleep duration on weekends than weekdays was associated with higher BMI z-score (0.4 (0.1–0.8)) and waist circumference (1.2 cm (0.3–2.2 cm)) in South Asian children aged 18 months, and later sleep onset on weekends than weekdays was associated with larger sum of two-skinfolds (1.7 mm (0.3–3.1 mm)) and waist circumference (1.8 cm (0.6–2.9 cm)). Going to sleep ≥20 min later on weekends than weekdays was associated with lower waist circumference in white children aged 18 months (−1.7 cm (−3.2 cm to −0.1 cm)).ConclusionsSleep timing is associated with total and central adiposity in young children but associations differ by age group and ethnicity. Sleep onset times and regular sleep schedules may be important for obesity prevention.

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Associations of diarised sleep onset time, period and duration with total and central adiposity in a biethnic sample of young children: the Born in Bradford study

10.1101/2020.09.30.20193888 ◽

2020 ◽

Author(s):

Paul J Collings ◽

Jane E Blackwell ◽

Elizabeth Pal ◽

Helen Ball ◽

John Wright

Keyword(s):

South Asian ◽

Sleep Onset ◽

Onset Time ◽

Abdominal Adiposity ◽

Central Adiposity ◽

Z Score ◽

White Children ◽

Time Period ◽

Asian Children ◽

Sleep Parameters

Objectives: To investigate associations of sleep timing, period and duration with total and abdominal adiposity in a biethnic sample of children aged 18 and 36 months (m) Design: Cross-sectional observational study Setting: The Born in Bradford 1000 study, UK Participants: Children aged approximately 18m (n=209; 40.2% South Asian; 59.8% White) and 36m (n=162; 40.7% South Asian; 59.3% White) Primary and secondary outcome measures: Parents completed a 3-day sleep diary from which children's average daily sleep onset time, period and duration were calculated. Weekday to weekend differences in sleep parameters were also derived. As outcomes, indices of total (BMI z-score and sum of 2-skinfolds) and abdominal adiposity (waist circumference) were measured. Adjusted regression was used to quantify associations of sleep parameters with adiposity by age group and ethnicity. Results: The average daily sleep onset time was markedly later in South Asian (9:26pm ± 68 mins) than White children (7:41pm ± 48 mins). Later sleep onset was associated with lower BMI z-score and sum of 2-skinfolds in White children aged 18m. In contrast, later sleep onset was associated with higher BMI z-score in South Asian children aged 36m. For weekday to weekend differences, longer sleep duration and later sleep onset on weekends than weekdays were both associated with higher total and abdominal adiposity in South Asian children aged 18m. On the contrary, compared to consistent sleep onset times, going to sleep ≥20 minutes later on weekends than weekdays was associated with lower waist circumference in White children aged 18m. Conclusions: Sleep timing is associated with total and central adiposity in young children but associations differ by age group and ethnicity. Sleep onset times and regular sleep schedules may be important for obesity prevention.

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Waist circumference centiles for UK South Asian children

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315722 ◽

2019 ◽

Vol 105 (1) ◽

pp. 80-85

Author(s):

Mahjabeen Shah ◽

Dimple Radia ◽

Huw David McCarthy

Keyword(s):

Waist Circumference ◽

Outcome Measures ◽

South Asian ◽

Cross Sectional Study ◽

Variation Method ◽

Obesity Prevalence ◽

Cross Sectional ◽

White Children ◽

Asian Populations ◽

Asian Children

ObjectivesTo develop waist circumference (WC) centile curves for UK South Asian children, to make comparisons with published centiles for British, indigenous Indian and Pakistani children, as well as to make anthropometric comparisons with their UK white peers.DesignCross-sectional study.SettingSchool-aged children from London boroughs (main measures: 2004–2007).Participants1562 (652 boys, 910 girls) UK South Asian and 1120 (588 boys, 532 girls) UK white children aged 4.0–13.9 years.InterventionsWC, height, weight and body mass index (BMI).Main outcome measuresThe outcome measures were smoothed WC centile curves, constructed using the LMS (L = skewness, M = median, S = coefficient of variation) method. SD scores (SDS) were generated using UK90 and British (WC) growth references.ResultsWC increased with age for both sexes, rising more steeply at the upper centiles after the age of 6 years. Overall, UK South Asian children, similar to indigenous South Asian populations, had higher WC values than the British WC references. However, compared with their UK white peers, UK South Asian children had significantly (p<0.001) lower mean WC (UK white SDS=0.74 and SDS=0.64 vs UK South Asian SDS=0.32 and SDS=0.21 for boys and girls, respectively). Obesity prevalence was greater using WC than BMI for both ethnicities. At the 90th centile, for UK South Asian children, prevalence was 21.5% vs 24.4% for boys and 17% vs 24.5% for girls based on BMI and WC, respectively.ConclusionsThese curves represent the first WC centiles for UK South Asian children up to the age of 14 years. With a continued rise in childhood obesity, they provide a useful historical control for future comparisons.

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Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors

10.21203/rs.2.18426/v2 ◽

2020 ◽

Author(s):

Paul Collings ◽

Sufyan A Dogra ◽

Silvia Costa ◽

Daniel D Bingham ◽

Sally E. Barber

Keyword(s):

Physical Activity ◽

Young Children ◽

South Asian ◽

Sedentary Time ◽

Activity Levels ◽

Light Physical Activity ◽

Asian Children ◽

Physical Activity Levels ◽

Vector Magnitude ◽

British Children

Abstract Background: Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods: This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3,181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 minutes of total physical activity including ≥60 minutes moderate-to-vigorous physical activity (MVPA) per day). Results: There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions: Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels.

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Ethnic differences in height growth trajectories and early life factors: findings from the UK Millennium Cohort Study

Longitudinal and Life Course Studies ◽

10.1332/175795919x15719917311075 ◽

2020 ◽

Vol 11 (1) ◽

pp. 105-119

Author(s):

Yi Lu ◽

Anna Pearce ◽

Leah Li

Keyword(s):

South Asian ◽

Ethnic Differences ◽

Early Life ◽

White Children ◽

Black African ◽

Explanatory Factors ◽

Asian Children ◽

Uk Millennium Cohort Study ◽

The Uk ◽

Lower Birthweight

Height growth is an important biomarker for early life exposures that influence later disease risk. Previous studies show that ethnic minority children in the UK tend to be born lighter but experience more rapid infancy growth than White peers. However, whether subsequent child-to-adolescent growth differs by ethnic group is insufficiently understood. We used the data from 15,239 singletons in the UK Millennium Cohort Study and applied mixed-effects cubic growth models to examine ethnic differences in height trajectories between 3y and 14y. Models were subsequently adjusted for potential early life explanatory factors. Compared with White counterparts, South Asian children had lower birthweight and shorter parents on average, but were slightly taller at 3y by 0.5cm [95% CI: 0.2–0.9] and had comparable childhood and adolescent trajectories, except that girls had a slower growth in adolescence. Height of South Asians relative to White children increased after adjusting for birthweight (taller by 1.3cm at 3y). Black African/Caribbeans were taller than White children at all ages between 3y and 14y (at 3y boys: 2.2cm, 1.2–2.7; girls: 3.2cm, 2.6–3.8) with height differences widening in childhood and reducing in adolescence. Adjustment for potential explanatory factors did not alter these differences. Despite having lower birthweight, contemporary UK South Asian children had comparable child-to-adolescent growth as White children. Black African/Caribbeans were considerably taller than other ethnic groups. Future research is needed in understanding the role of genetic and other environmental factors (such as diet) in these distinct growth patterns across ethnic groups and their health implications.

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Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors

10.21203/rs.2.18426/v1 ◽

2019 ◽

Author(s):

Paul Collings ◽

Sufyan A Dogra ◽

Silvia Costa ◽

Daniel D Bingham ◽

Sally E. Barber

Keyword(s):

Physical Activity ◽

Young Children ◽

South Asian ◽

Sedentary Time ◽

Activity Levels ◽

Light Physical Activity ◽

Asian Children ◽

Physical Activity Levels ◽

Vector Magnitude ◽

British Children

Abstract Background: Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location.Methods: This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3,181 valid days of triaxial accelerometry. Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 minutes of total physical activity including ≥60 minutes moderate-to-vigorous physical activity (MVPA) per day).Results: There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of their daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher at weekends compared to weekdays. In South Asian children, sedentary time was lower at weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys.Conclusions: Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels.

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Differences in total and regional body fat and their association with BMI in UK-born White and South Asian children: findings from the Born in Bradford birth cohort

Wellcome Open Research ◽

10.12688/wellcomeopenres.16659.1 ◽

2021 ◽

Vol 6 ◽

pp. 65

Author(s):

Gillian Santorelli ◽

Jane West ◽

Tiffany Yang ◽

John Wright ◽

Maria Bryant ◽

...

Keyword(s):

Body Fat ◽

South Asian ◽

Cross Sectional Study ◽

Cardiometabolic Disease ◽

Central Adiposity ◽

Cross Sectional ◽

White Children ◽

Born In Bradford ◽

Total Body Fat ◽

Total Body

Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although the mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~20% higher, they had a median of 2kg more total FM, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in each BMI category, as was truncal, android and gynoid FM, with the greatest differences between ethnic groups observed in the healthy and overweight categories. Conclusions: Greater TBF% and total and regional FM in the healthy- and overweight BMI categories observed in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.

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Accelerometer-derived sleep onset timing and cardiovascular disease incidence: a UK Biobank cohort study

10.1101/2021.06.23.21259390 ◽

2021 ◽

Author(s):

Shahram Nikbakhtian ◽

Angus B Reed ◽

Bernard Dillon Obika ◽

Davide Morelli ◽

Adam C Cunningham ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Disease Incidence ◽

Sleep Onset ◽

Onset Time ◽

Sensitivity Analyses ◽

Accelerometer Data ◽

Uk Biobank ◽

Onset Timing ◽

Sleep Parameters

Aims Growing evidence suggests that sleep quality is associated with cardiovascular risk. However, research in this area often relies upon recollection dependant questionnaires or diaries. Accelerometers provide an alternative tool for deriving sleep parameters measuring sleep patterns objectively. This study examines the associations between accelerometer derived sleep onset timing and cardiovascular disease (CVD). Methods and Results We derived sleep onset and waking up time from accelerometer data collected from 103,712 UK Biobank participants over a period of seven days. From this, we examined the association between sleep onset timing and CVD incidence using a series of Cox proportional hazards models. 3172 cases of CVD were reported during a mean follow-up period of 5.7 (±0.49) years. An age- and sex-controlled base analysis found that sleep onset time of 10:00pm-10:59pm was associated with the lowest CVD incidence. A fully adjusted model, additionally controlling for sleep duration, sleep irregularity, and established CVD risk factors, was unable to eliminate this association, producing hazard ratios of 1.24 (95% CI, 1.10-1.39; p<0.005), 1.12 (1.01-1.25; p=0.04), and 1.25 (1.02-1.52; p=0.03) for sleep onset <10:00pm, 11:00pm-11:59pm, and & ≥12:00am, respectively, compared to 10:00pm-10:59pm. Importantly, sensitivity analyses revealed this association was stronger in females, with only sleep onset <10:00pm significant for males. Conclusions Our findings suggest an independent relationship between sleep onset timing and risk of developing CVD, particularly for women. We also demonstrate the potential utility of collecting information about sleep parameters via accelerometry-capable wearable devices, which may serve as novel cardiovascular risk indicators.

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Differences in total and regional body fat and their association with BMI in UK-born White and South Asian children: findings from the Born in Bradford birth cohort

Wellcome Open Research ◽

10.12688/wellcomeopenres.16659.2 ◽

2021 ◽

Vol 6 ◽

pp. 65

Author(s):

Gillian Santorelli ◽

Jane West ◽

Tiffany Yang ◽

John Wright ◽

Maria Bryant ◽

...

Keyword(s):

Body Fat ◽

South Asian ◽

Fat Mass ◽

Cardiometabolic Disease ◽

Central Adiposity ◽

White Children ◽

Body Regions ◽

Born In Bradford ◽

Total Body Fat ◽

Total Body

Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~20% higher, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in SA children compared to white children in the same BMI category. Fat mass index (FMI) was higher in all body regions in SA children in all BMI categories; as was total and truncal FMI in healthy and overweight, but not obese, SA children.. Conclusions: Greater TBF% and total and regional FM in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below the obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.

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Multifactorial correlates of blood pressure in South Asian children in Canada: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027844 ◽

2019 ◽

Vol 9 (4) ◽

pp. e027844 ◽

Cited By ~ 1

Author(s):

Adeleke Fowokan ◽

Zubin Punthakee ◽

Charlotte Waddell ◽

Miriam Rosin ◽

Katherine M Morrison ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

South Asian ◽

Stepwise Regression ◽

Cross Sectional Study ◽

Z Score ◽

Sectional Study ◽

Cross Sectional ◽

Asian Children ◽

Z Scores

ObjectiveWe sought to explore various correlates of blood pressure (BP) and hypertension, and to identify the most important aggregate combination of correlates for BP in South Asian children.DesignCross-sectional studySettingCommunity-based recruitment in two Canadian citiesParticipantsSouth Asian children (n=762) provided a range of physiological, lifestyle and social variables. BP was assessed using an automated device. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and BP were transformed to z-scores using published standards.Outcome measuresLinear and logistic regression analyses were used to explore associations between the range of variables with BP z-scores and hypertension while stepwise regression was used to identify aggregate factors that provided explanatory capacity for systolic BP (SBP) and diastolic BP (DBP) z-scores.ResultsA range of variables were associated with BP z-score and hypertension in unadjusted analysis. On adjustment for confounders, the association between age (β=−0.054, 95% CI=−0.078 to 0.029), female sex (β=−0.208, 95% CI=−0.350 to –0.067), height (β=0.022, 95% CI=0.011 to 0.033), weight (β=0.047, 95% CI=0.040 to 0.055), BMI z-score (β=0.292, 95% CI=0.249 to 0.336), WC z-score (β=0.273, 95% CI=0.219 to 0.326), WHtR z-score (β=0.289, 95% CI=0.236 to 0.342), heart rate (β=0.016, 95% CI=0.010 to 0.022), child’s perception of body image (β=0.183, 95% CI=0.128 to 0.239) and grip strength (β=0.025, 95% CI=0.007 to 0.043) with SBP z-score remained. In stepwise regression, age, sex, BMI z-score, heart rate and weight accounted for 30% of the variance of SBP z-score, while age, BMI z-score, heart rate and daily fast food intake accounted for 23% of the DBP z-score variance.ConclusionOur findings suggest that variables, such as age, sex, height, adiposity and heart rate, provide stronger explanatory capacity to BP variance and hypertension risk than other variables in South Asian children.

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Antenatal Iron-Folic Acid Supplementation Is Associated with Improved Linear Growth and Reduced Risk of Stunting or Severe Stunting in South Asian Children Less than Two Years of Age: A Pooled Analysis from Seven Countries

Nutrients ◽

10.3390/nu12092632 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2632

Author(s):

Yasir Bin Nisar ◽

Victor M. Aguayo ◽

Sk Masum Billah ◽

Michael J. Dibley

Keyword(s):

Folic Acid ◽

South Asia ◽

South Asian ◽

Child Growth ◽

Preschool Age ◽

Birth Size ◽

Z Score ◽

Severe Stunting ◽

Asian Children ◽

Reduced Risk

In South Asia, an estimated 38% of preschool-age children have stunted growth. We aimed to assess the effect of WHO-recommended antenatal iron, and folic acid (IFA) supplements on smaller than average birth size and stunting in South Asian children <2 years old. The sample was 96,512 mothers with their most recent birth within two years, from nationally representative surveys between 2005 and 2016 in seven South Asian countries. Primary outcomes were stunting [length-for-age Z-score (LAZ) < –2], severe stunting [length-for-age Z-score (LAZ) < –3], length-for-age Z score, and perceived smaller than average birth size. Exposure was the use of IFA supplements. We conducted analyses with Poisson, linear and logistic multivariate regression adjusted for the cluster survey design, and 14 potential confounders covering the country of the survey, socio-demographic factors, household economic status, maternal characteristics, and duration of respondent recall. The prevalence of stunting was 33%, severe stunting was 14%, and perceived smaller than average birth size was 22%. Use of antenatal IFA was associated with a reduced adjusted risk of being stunted by 8% (aRR 0.92, 95% CI 0.89, 0.95), of being severely stunted by 9% (aRR 0.91, 95% CI 0.86, 0.96) and of being smaller than average birth size by 14% (aRR 0.86, 95% CI 0.80, 0.91). The adjusted mean LAZ was significantly higher in children whose mothers used IFA supplements. Maternal use of IFA in the first four months gestation and consuming 120 or more supplements throughout pregnancy was associated with the largest reduction in risk of child stunting. Antenatal IFA supplementation was associated with a significantly reduced risk of stunting, severe stunting, and smaller than average perceived birth size and improved LAZ in young South Asian children. The early and sustained use of antenatal IFA has the potential to improve child growth outcomes in South Asia and other low-and-middle-income countries with high levels of iron deficiency in pregnancy.

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