Blunted rest–activity rhythms link to higher body mass index and inflammatory markers in children

Qian, Jie; Martínez-Lozano, Nuria; Tvarijonaviciute, Asta; Scheer, Frank A.J.L.; Garaulet, Marta

doi:10.1093/sleep/zsaa256

Cited by 25 publications

(29 citation statements)

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“…( 23 ) assessed the relationship between RAR stability (IS) and metabolic syndrome in the very elderly and found that low IS was associated with increased risk of BMI-based general obesity. Of note, these previous studies ( 22 , 23 , 38 , 40 ) evaluated RAR in relation to excess body fat only as expressed by BMI. Abdominal obesity, defined according to waist circumference or waist-to-hip ratio, is an indicator of visceral fat accumulation ( 41 ) and is a more powerful predictor of chronic diseases and premature death than BMI ( 42 , 43 ).…”

Section: Discussionmentioning

confidence: 99%

“…Growing research links aberrant RAR patterns with poor health status, including greater risk of neurodegenerative disease (15)(16)(17), cardiometabolic disease (18) and mortality (19). Accelerometry-generated RAR metrics, including intradaily variability (IV, fragmentation of RAR) and interdaily stability (IS, day-to-day stability of RAR), have been associated with obesity in children, adolescents and in the elderly (20)(21)(22)(23). However, the relationship of RAR with obesity among general adults remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Rest-Activity Rhythm Is Associated With Obesity Phenotypes: A Cross-Sectional Analysis

Vungarala

Somers

et al. 2022

Front. Endocrinol.

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BackgroundThe prevalence of obesity continues to increase in spite of substantial efforts towards its prevention, posing a major threat to health globally. Circadian disruption has been associated with a wide range of preclinical and clinical disorders, including obesity. However, whether rest-activity rhythm (RAR), an expression of the endogenous circadian rhythm, is associated with excess adiposity is poorly understood. Here we aimed to assess the association of RAR with general and abdominal obesity.MethodsNon-institutionalized adults aged ≥20 years participating in the US National Health and Nutrition Examination Survey (NHANES) 2011-2014 who wore accelerometers for at least four 24-hour periods were included (N=7,838). Amplitude, mesor, acrophase and pseudo-F statistic of RAR were estimated using extended cosinor model, and interdaily stability (IS) and intradaily variability (IV) were computed by nonparametric methods. We tested the association between rest-activity rhythm and general obesity defined by body mass index and abdominal obesity by waist circumference. Waist-to-height ratio, sagittal abdominal diameter, and total and trunk fat percentages measured by imaging methods were also analyzed.ResultsIn multivariable analysis, low amplitude (magnitude of the rhythm), mesor (rhythm-corrected average activity level), pseudo-F statistic (robustness of the rhythm), IS (day-to-day rhythm stability), or high IV (rhythm fragmentation) were independently associated with higher likelihood of general or abdominal obesity (all Ps<.05). Consistently, RAR metrics were similarly associated with all adiposity measures (all Ps<.01). Delayed phase of RAR (later acrophase) was only significantly related to general and abdominal obesity in women.ConclusionsAberrant RAR is independently associated with anthropometric and imaging measures of general and abdominal obesity. Longitudinal studies assessing whether RAR metrics can predict weight gain and incident obesity are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rest-Activity Rhythm Is Associated With Obesity Phenotypes: A Cross-Sectional Analysis

Vungarala

Somers

et al. 2022

Front. Endocrinol.

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“…Lower levels of PA may also affect circadian rhythmicity through decreased exposure to natural light, as increased PA is associated with greater outdoor light exposure [30][31][32]. These changes in behaviors may affect synchronization of circadian and circannual rhythms by affecting children's exposure to the light/dark cycle and contributing to a blunting of circadian rhythmicity which may contribute to accelerated weight gain [26,27,33]. According to the CCR Model children's sleep timing, duration, and variability, PA, and light exposure represent novel pathways which may differentially influence children's BMI during the school year and summer.…”

Section: Introductionmentioning

confidence: 99%

Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study

Moreno

Razjouyan

Lester

et al. 2021

Int J Behav Nutr Phys Act

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Objectives and background Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian parameters and change in body mass index (BMI) during these time periods. Methods This was a prospective observational study with 119 children ages 5 to 8 years with three sequential BMI assessments: early school-year (fall), late school-year (spring), and beginning of the following school-year in Houston, Texas, USA. Sleep midpoint, sleep duration, variability of sleep midpoint, physical activity, and light exposure were estimated using wrist-worn accelerometry during the school-year (fall) and summer. To examine the effect of sleep parameters, physical activity level, and light exposure on change in BMI, growth curve modeling was conducted controlling for age, race, sex, and chronotype. Results Children’s sleep midpoint shifted later by an average of 1.5 h during summer compared to the school-year. After controlling for covariates, later sleep midpoints predicted larger increases in BMI during summer, (γ = .0004, p = .03), but not during the school-year. Sleep duration, sleep midpoint variability, physical activity levels, and sedentary behavior were not associated with change in BMI during the school-year or summer. Females tended to increase their BMI at a faster rate during summer compared to males, γ = .06, p = .049. Greater amounts of outdoor light exposure (γ = −.01, p = .02) predicted smaller increases in school-year BMI. Conclusions Obesity prevention interventions may need to target different behaviors depending on whether children are in or out of school. Promotion of outdoor time during the school-year and earlier sleep times during the summer may be effective obesity prevention strategies during these respective times.

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“…Specific pediatric diseases such as type 1 diabetes and prematurity can further induce internal misalignment and CV risk, creating a feedback loop between disease expression and circadian disruption (180,181). Obese children have lower-amplitude circadian rhythms, and even when BMI is controlled for, inflammation inversely correlates with the strength of the rhythm (182). Cardioprotective physiology, such as nocturnal blood pressure dipping, is also important in children yet appears to be disrupted by several pediatric disease states (183)(184)(185).…”

Section: Risk In Childrenmentioning

confidence: 99%

Circadian disruption and human health

Fishbein¹,

Knutson²,

Zee³

2021

Journal of Clinical Investigation

197

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Circadian (circa, "about," and diem, "day") rhythms are endogenous oscillations with an approximately 24-hour cycle. Circadian rhythms in physiology and behavior are organized by a central "master" clock, the suprachiasmatic nucleus (SCN) located in the anterior hypothalamus, that coordinates alignment between external synchronizing agents with circadian clocks in other brain regions, as well as in peripheral tissues. Circadian rhythms are modulated by endogenous (genetic, physiological) as well as environmental (light) and behavioral (activity, feeding) factors. In this Review, we use "circadian disruption" as a nonspecific umbrella term to describe a disturbance, dysregulation, or problem that negatively affects circadian function, but as Vetter has pointed out, there is a need for clearer terminology and quantification of circadian disruption (1). It is becoming increasingly clear that circadian disruption in humans can result in broad and significant consequences for mental and physical health (2, 3). Furthermore, changes in circadian function are often accompanied by sleep-wake disturbances, which also contribute to poor health outcomes. The interrelationship between circadian rhythms and human disease can create a vicious cycle between disease expression and circadian disruption, as exemplified in immunologic (4, 5), cardiometabolic (6), neurodegenerative, and psychiatric disorders (7). General mechanisms of circadian disruptionIn humans, measures of circadian disruption include the phase (timing), relationship between internal-internal or internal-external rhythms (alignment), the period and amplitude of circadian rhythms. Disturbance of circadian phase alignment and amplitude are the most common measures that have been associated with adverse health consequences. As outlined in Figure 1, circadian disruption can occur at multiple levels, from intrinsic changes at the molecular, cellular, tissue, or system level to misalignment among different organizational levels and/or with behavioral and environmental cycles. The "molecular circadian clock" refers to genes that maintain autoregulatory feedback loops in which oscillating outputs regulate their own expression (circadian locomotor output cycles kaput [CLOCK], brain and muscle ARNTlike [BMAL], period [PER], rev-erb/nuclear receptor subfamily 1, group D [NR1D], and cryptochrome [CRY]; ref. 4). Biomarkers of circadian rhythm and circadian disruptionAlthough the SCN rhythm cannot be directly measured in humans, the timing of melatonin onset and amplitude measured in plasma or saliva, or the melatonin metabolite 6-sulfatoxymelatonin in urine, are gold standard biomarkers of circadian rhythms. The collection of 24-hour urine samples is particularly useful to assess circadian amplitude of melatonin in special populations, such as pediatric patients in whom blood or salivary samples might be difficult to obtain (8), and has been shown to be a useful treatment-responsive biomarker of circadian disruption in neurologic diseases, such as Alzheimer's disease (AD) (9)...

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Blunted rest–activity rhythms link to higher body mass index and inflammatory markers in children

Cited by 25 publications

References 64 publications

Rest-Activity Rhythm Is Associated With Obesity Phenotypes: A Cross-Sectional Analysis

Rest-Activity Rhythm Is Associated With Obesity Phenotypes: A Cross-Sectional Analysis

Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study

Circadian disruption and human health

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