This study indicates that high consumption of 100% fruit juice and total SCBs is associated with increased asthma risk in children. The positive association between consumption of 100% fruit juice and asthma is an unexpected finding that needs confirmation in future studies.
The adverse association of screen time with adiposity was partly mediated by physical activity, but not by snacking. The association of screen time with TC/HDLC ratio was almost completely mediated by adiposity. Our results may suggest that future efforts in society and public health should be directed to replace screen time with physical activity for reducing children's adiposity and cardiometabolic risk.
SUMMARYWe investigated associations of time in bed and multiple sleep quality characteristics with cardiometabolic markers in children. Data from the prevention and incidence of asthma and mite allergy study, a populationbased prospective birth-cohort study started in 1996-1997 in the Netherlands, were analysed. In total 1481 children aged 11-12 years completed a questionnaire (including questions on sleep) and underwent a medical examination. We measured body mass index, waist circumference, totaland high-density lipoprotein cholesterol, blood pressure and glycated haemoglobin. Results showed that in girls, some sleep characteristics were related to anthropometrics (body mass index, waist circumference) and cholesterol. Girls who had a long time in bed (11-12.5 h) had 0.16 lower body mass index z-score (95% confidence interval À0.31; À0.01) and 0.99 cm smaller waist circumference (95% confidence interval À2.01; À0.13) compared with girls who spent 10-10.5 h in bed. Girls who went to bed late and rose early had 0.16 mM higher total cholesterol (95% confidence interval 0.01; 0.31) and 0.08 mM higher high-density lipoprotein cholesterol (95% confidence interval 0.01; 0.14) than 'early to bed/early rise' girls. Girls with night-time awakenings had 0.14 mM higher total cholesterol (95% confidence interval 0.03; 0.25) than girls without nighttime awakenings. Girls who felt sleepy/tired ≥1 day per week had 0.10 mM lower high-density lipoprotein cholesterol (95% confidence interval À0.16; À0.04) and 0.17 mM higher total cholesterol/high-density lipoprotein cholesterol ratio (95% confidence interval 0.02; 0.32) than girls who did not feel sleepy. No associations were found for boys. Sleep characteristics were not related to blood pressure and glycated haemoglobin, and effect sizes of the associations in girls were small. Therefore, we consider it premature to propose that improved sleep could reduce cardiovascular risk during childhood.
IN TROD UCTI ONStudies in adults have shown that inadequate sleep is associated with metabolic syndrome and diabetes (Van Cauter et al., 2008) and with cardiometabolic risk factors, including weight status (Cappuccio et al., 2010), cholesterol, blood pressure (BP;Bjorvatn et al., 2007) and glucose metabolism (Spiegel et al., 2005).Because cardiometabolic risk factors track from adolescence into adulthood (Camhi and Katzmarzyk,
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