Background: Ample evidence attests to the relationship between short sleep duration, sleep problems and childhood obesity. However, few studies have examined the association between sleep timing and obesity in children. Objectives: To investigate how sleep duration, problems and timing relate to obesity and obesogenic behaviours in children. Methods: Eighty-five children (58.8% girls) with severe obesity and mean (SD) age of 12.1 (2.9) years, were matched by age and sex with peers with normal weight (n = 85,12.0 [2.8] years). Sleep and moderate-to-vigorous physical activity (MVPA) were measured via accelerometer for seven consecutive days. Children self-reported emotional eating on the Dutch eating behavior questionnaire. Parents reported children's screen time and sleep problems. Results: Children with severe obesity had significantly later mean mid-sleep time, overall (36 minutes later, P < .001), on school nights (36 minutes later, P < .001) and weekend nights (39 minutes later, P = .002) compared to children with normal weight. Children with obesity had more sleep problems (P = .030), but no differences emerged in sleep duration or social jetlag. After adjusting for demographic factors, mid-sleep time was positively related to screen time (P = .030). Mid-sleep time and sleep duration were inversely related to time in MVPA (Ps ≤ .041). There were no other significant associations between the sleep variables and the obesogenic behaviours. Conclusions: Later sleep timing was related to obesogenic behaviours in children and may represent an obesity risk factor.

Background: Family-based behavioural weight loss treatment (FBT) is an evidencebased intervention for paediatric overweight/obesity (OV/OB), but little research has examined the relative efficacy of FBT across socioeconomic status (SES), and racial groups.Method: A total of 172 youth (7-11 years; 61.6% female; 70.1% White, 15.7% Black; child percent OV = 64.2 ± 25.2; 14.5% low-income) completed 4 months of FBT and 8 months of additional intervention (either active social facilitation-based weight management or an education control condition). Parents reported family income, social status (Barratt simplified measure of social status) and child race at baseline. Household income was dichotomized into < or >50% of the area median family income. Race was classified into White, Black or other/multi-race. Treatment efficacy was assessed by change in child % OV (BMI % above median BMI for age and sex) and change in child BMI % of 95th percentile (BMI % of the 95th percentile of weight for age and sex). Latent change score models examined differences in weight change between 0 and 4 months, 4 and 12 months and 0 and 12 months by income, social status and race.Results: Black children had, on average, less weight loss by 4 months compared to White children. Low-income was associated with less weight loss at 4 months when assessed independent of race. No differences by race, social status or income were detected from 4 to 12-months or from 0 to 12 months. Conclusions:FBT is effective at producing child weight loss across different SES and racial groups, but more work is needed to understand observed differences in initial efficacy and optimize treatment across all groups.

Background: Family-based behavioral weight loss treatment for childhood obesity (FBT) helps families develop strategies to facilitate healthy choices in their home and other environments (e.g., home neighborhood).The current study examines how the home food environment, both pre- and post-FBT, and the neighborhoods in which families live are associated with child weight and weight-related outcomes in FBT. Method: Parent-child dyads (n=181) completed a 16-session FBT program and completed home environment, anthropometric, and child dietary/activity assessments at pre- and post-FBT. Parents reported on availability of food, electronics, and physical activity equipment in the home. The neighborhood food and recreation environment around each dyad’s residence was characterized using existing data within a geographic information system (GIS). Results: Families successfully made healthy home environment modifications during FBT. Regression models showed reducing RED (e.g., high energy-dense and low nutrient-dense) foods and electronics in the home during FBT had positive effects on child weight and weight-related outcomes. No neighborhood food or recreation environment variables were significantly related to outcomes, although having a larger density of public recreation spaces was associated with increases in physical activity at the trend-level. Conclusions: Modifying the home environment, specifically reducing RED foods and electronics, may be particularly important for FBT success.

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Pre-pregnancy overweight/obesity and excessive gestational weight gain (GWG) independently predict negative maternal and child health outcomes. To date, however, interventions that target GWG have not produced lasting improvements in maternal weight or health at 12-months postpartum. Given that interventions solely aimed at addressing GWG may not equip women with the skills needed for postpartum weight management, interventions that address health behaviors over the perinatal period might maximize maternal health in the first postpartum year. Thus, the current study leveraged a sequential multiple assignment randomized trial (SMART) design to evaluate sequences of prenatal (i.e., during pregnancy) and postpartum lifestyle interventions that optimize maternal weight, cardiometabolic health, and psychosocial outcomes at 12-months postpartum. Pregnant women (N=300; ≤16 weeks pregnant) with overweight/obesity (BMI ≥25 kg/m 2 ) are being recruited. Women are randomized to intervention or treatment as usual on two occasions: (1) early in pregnancy, and (2) prior to delivery, resulting in four intervention sequences. Intervention during pregnancy is designed to moderate GWG and introduce skills for management of weight as a chronic condition, while intervention in the postpartum period addresses weight loss. The primary outcome is weight at 12-months postpartum and secondary outcomes include variables of cardiometabolic health and psychosocial well-being. Analyses will evaluate the combination of prenatal and postpartum lifestyle interventions that optimizes maternal weight and secondary outcomes at 12-months postpartum. Optimizing the sequence of behavioral interventions to address specific needs during pregnancy and the first postpartum year can maximize intervention potency and mitigate longer-term cardiometabolic health risks for women.