Examining 24-hour activity and sleep behaviors and related determinants in Latino adolescents and young adults with obesity

Authors: SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); NAVABI, NEEKU - Arizona State University; VANDER WYST, KILEY - Arizona State University; HERNANDEZ, EDITH - Children'S Nutrition Research Center (CNRC); CASTRO, FELIPE - Arizona State University; AYERS, STEPHANIE - Arizona State University; MENDEZ, JENNY - Mountain Park Health Center; SHAIBI, GABRIEL - Arizona State University

Submitted to: Health Education and Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/28/2021
Publication Date: 11/18/2021
Citation: Soltero, E.G., Navabi, N., Vander Wyst, K.B., Hernandez, E., Castro, F.G., Ayers, S.L., Mendez, J., Shaibi, G.Q. 2021. Examining 24-hour activity and sleep behaviors and related determinants in Latino adolescents and young adults with obesity. Health Education and Behavior. https://doi.org/10.1177/10901981211054789.
DOI: https://doi.org/10.1177/10901981211054789

Interpretive Summary: Hispanic children and young adults are disproportionately burdened by type 2 diabetes. In addition to physical activity, other important behaviors like sitting for too long and not getting enough sleep can lead to increased risk for type 2 diabetes. Few (30%) Hispanic youth meet physical activity recommendations and they are less likely to meet sleep recommendations compared to non-Hispanic white adolescents. These behaviors get increasingly worse with age, increasing the risk for disease as youth transition into young adulthood. The purpose of this study was to measure the average time spent in physical activity, sedentary, and sleep behaviors across a 24-hour cycle in Hispanic adolescents and young adults with obesity and to examine the impact of these behaviors on type 2 diabetes risk. We also used qualitative interviews to identify individual, social, and environmental factors that drive these behaviors. We found that adolescents and young adults were highly likely to meet physical activity recommendations; however, they also spent 10 hours or more in sedentary pursuits. Poor sleep quality was associated with higher levels of adiposity in both age groups as well as fasting and 2-hour glucose in young adults. We also found that youth who reported receiving more social support was associated with increased physical activity in both age groups. Yet, we also found that social support such as talking on the phone, or internet-based social media app or video game also led youth to engage in long bouts of sedentary time. Both adolescents and young adults discussed auditory noises, lights, and safety, as factors that led to poor sleep quality. These findings suggest that while physical activity is critical for reducing the risk for type 2 diabetes, reducing time spent in sedentary behaviors and improving sleep are also important for reducing diabetes risk in high-risk Hispanic adolescents and young adults. Our findings also point to the need to better understand and address social and environmental factors that drive activity and sleep behaviors to improve these behaviors in this high-risk population.

Technical Abstract: Activity and sleep behaviors across the 24-hour cycle contribute to the development of type 2 diabetes (T2D); however, few studies have examined 24-hour activity and sleep behaviors in Latino adolescents and young adults with obesity. In this mixed-methods study quantitative data was collected on T2D risk and 24-hour activity and sleep behaviors while qualitative data was collected on individual, social, and environmental determinants of these behaviors. Wrist-worn accelerometers worn 24-hours a day for 7 days assessed moderate-to-vigorous physical activity (MVPA), sedentary behaviors (SB), and sleep, in adolescents (N=38; 12-16 years) and young adults (N=22; 18-22 years). Sleep regularity was also assessed. T2D-related outcomes included adiposity (BMI, body fat%, waist circumference), fasting, and 2-hour glucose in both age groups. Interviews were conducted with a subsample of participants (N=16 adolescents, N=15 young adults) to identify behavioral determinants. Descriptive analyses were used to develop 24-hour activity and sleep profiles, correlations were used to examine associations among behaviors and T2D-related outcomes. Interviews were transcribed and coded to identify emergent themes regarding determinants. High levels of PA were observed among adolescents (M=103.8+/-67.5 mins/day) and young adults (M=96.8+/-78.8 mins/day) as well as high levels of SB across both age groups (>=10 hours/day). Sleep regularity was negatively associated with adiposity (all ps<0.05) in both age groups as well as fasting and 2-hour glucose in young adults (all ps<0.05). Social support was associated with PA in both age groups; however, it also motivated SB in some youth. Both adolescents and young adults discussed auditory noises, lights, and safety, as determinants that inhibit sleep. While PA is critical for disease reduction, reducing SB and improving sleep are also important to reducing T2D risk in high-risk Hispanic adolescents and young adults. Qualitative findings regarding behavioral determinants should be leveraged in future health promotion and disease prevention strategies.