Association between meeting physical activity, sleep, and dietary guidelines and cardiometabolic risk factors and adiposity in adolescents

Authors: KRACHT, CHELSEA - Pennington Biomedical Research Center; CHAMPAGNE, CATHERINE - Pennington Biomedical Research Center; HSIA, DANIEL - Pennington Biomedical Research Center; MARTIN, CK - Pennington Biomedical Research Center; NEWTON JR., ROBERT - Pennington Biomedical Research Center; KATZMARZYK, PETER - Pennington Biomedical Research Center; STAIANO, A - Pennington Biomedical Research Center

Submitted to: Journal of Adolescent Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/11/2019
Publication Date: 1/24/2020
Citation: Kracht, C.L., Champagne, C.M., Hsia, D.S., Martin, C., Newton Jr., R.L., Katzmarzyk, P., Staiano, A. 2020. Association between meeting physical activity, sleep, and dietary guidelines and cardiometabolic risk factors and adiposity in adolescents. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2019.12.011.
DOI: https://doi.org/10.1016/j.jadohealth.2019.12.011

Interpretive Summary: Adolescence is an important time in the life course. Many positive behaviors contribute to adolescent health, including adequate physical activity (PA), adequate sleep, and proper dietary intake. Unhealthy behaviors may compromise healthy development during this period, related to excess weight gain and poor metabolic health. The aim of the study was to assess the associations of meeting physical activity (PA), sleep, and dietary guidelines with cardiometabolic risk factors and adiposity in adolescents. We found that few of our subjects met the PA or multiple guidelines, and those not meeting guidelines were associated with adverse cardiometabolic factors and adiposity. Low guideline attainment emphasizes the improvement of all three behaviors for adolescents' health promotion. Future research should focus on the interconnectivity of these behaviors to design behavioral approaches to concurrently facilitate adequate amounts of PA, sleep, and diet.

Technical Abstract: The aim of the study was to assess the associations of meeting physical activity (PA), sleep, and dietary guidelines with cardiometabolic risk factors and adiposity in adolescents. The sample included adolescents aged 10–16 years. Accelerometry was used to measure PA and sleep over 7 days, 24 h/d. The PA guideline was defined as >=60 min/d of moderate-to-vigorous PA. The sleep guideline was 9–11 hours (10–13 years) or 8–10 hours (14–16 years) per night. The dietary guideline was based on the Healthy Eating Index calculated from dietary recalls. Cardiometabolic risk factors and adiposity were assessed in an in-patient setting. Linear regression was used to examine the association between meeting each guideline and cardiometabolic risk factors/adiposity, adjusted for confounders and meeting other guidelines. Of the 342 participants, 251 (73%) provided complete measurements. Adolescents were 12.5 +/- 1.9 years (African American [37%] and white [57%], girls [54%], and overweight or obesity [48%]). Half met the sleep guideline (52%), few met the PA guideline (11%), and the top quintile was preselected as meeting the diet guideline (20%). Most met one (47%) or no guidelines (35%), and few met multiple guidelines (18%). Meeting the PA guideline was associated with lower cardiometabolic risk factors and adiposity (p < .05 for all). Compared with meeting no guidelines, those who met multiple guidelines had lower cardiometabolic risk factors and adiposity (p < .05 for all). Few met the PA or multiple guidelines, and those not meeting guidelines were associated with adverse cardiometabolic factors and adiposity. Multidisciplinary strategies for improving multiple behaviors are needed to improve adolescent health.