The importance of cardiorespiratory fitness and sleep duration in early CVD prevention. BMI, resting heart rate and questions about sleep patterns are suggested in risk assessment of young adults, 18-25 years.The cross-sectional Lifestyle, biomarkers and atherosclerosis (LBA) study.

Abstract

Background: Cardiorespiratory fitness (CRF) and sleep habits are lifestyle factors with potential to prevent cardiovascular disease (CVD). CVD is the leading cause of death worldwide, it is therefore important to establish a healthy lifestyle at young age. In the Lifestyle, biomarkers and atherosclerosis (LBA) study we have examined 834 healthy non-smoking adults, 18-25 years. The general purpose of the LBA study was to study the effect of lifestyle on traditional biomarkers known to influence CVD risk. The aims of the present study were to evaluate sleep habits of the young adult women and men participating in the LBA study, and to compare the importance of sleep habits and other lifestyle habits on clinically relevant biomarkers for CVD. Additional aim was to find easy and reliable non-invasive biomarkers to detect young adults with increased risk to develop CVD later in life. Methods: The participants have previously been examined for lifestyle factors, biomarkers and CVD risk score. They filled in a validated computerized questionnaire about their general physical and mental health. The questionnaire included questions on sleep duration and experienced quality of sleep. Results: In total 27% of the young adult participants reported difficulties to fall asleep or experiences anxious sleep with several awakenings per night. The experienced anxious sleep was not related to higher CVD risk score, but sleep quality and sleep duration was correlated. Shorter sleep duration was significantly associated to higher body mass index (BMI), body fat %, homeostasis model assessment of insulin resistance (HOMA-IR) and CVD risk. The modifiable lifestyle factor with highest odds ratio (OR) for CVD risk was CRF. Sleep duration was the second most influential lifestyle factor, more important than moderate- and vigorous physical activity (MVPA) and food habits. Correlations between CRF and heart rate (HR) (P<0.01) and HOMA-IR and BMI (P<0.01) was observed, indicating that BMI and resting HR in combination with questions about sleep patterns are easy and reliable non-invasive biomarkers to detect young adults who needs counselling about a healthy lifestyle. Conclusion: Decreased sleep duration in combination with decreased CRF, in young adults, is a serious health issue.

Associations of actigraphy‐assessed sleep variables with adiposity and serum cardiometabolic outcomes in emerging adults

“…A significant inverse association between sleep duration and HOMA‐IR was noted in the entire sample, suggesting that those with shorter sleep durations have less advantageous HOMA‐IR/greater insulin resistance. These results corroborate prior findings in emerging adults (Fernström et al, 2020), and provide further evidence of an association between short sleep duration and HOMA‐IR as a risk factor for cardiometabolic disease in this population.…”

“…wake‐time – ½ sleep duration), as well as greater day‐to‐day sleep duration and sleep timing variability are associated with greater adiposity and adverse cardiometabolic outcomes (Chaput et al, 2020; Morales‐Ghinaglia & Fernandez‐Mendoza, 2023). Consistent evidence suggests that emerging adults and college students with shorter sleep duration and/or poorer sleep quality have greater adiposity (Bailey et al, 2014; Fernström et al, 2020; Kahlhöfer et al, 2016; Krističević et al, 2018; Meyer et al, 2012; Peltzer & Pengpid, 2017; Quick et al, 2014; Sa et al, 2020; Vargas et al, 2014; Yang et al, 2020), but much of this evidence is limited to self‐reported sleep variables and/or using body mass index (BMI) as a single indicator of adiposity/obesity.…”

“…Short sleep duration and poor sleep quality are also consistently associated with disruptions in serum metabolic and inflammatory outcomes (Irwin et al, 2016; Koren & Taveras, 2018; Leproult & Van Cauter, 2010; Singh et al, 2022), which increases cardiometabolic risk. In emerging adults, there is initial evidence to suggest that short sleep duration, poor sleep quality and sleep duration variability are associated with worse serum cardiometabolic outcomes, including greater insulin resistance (as assessed by homeostatic model assessment of insulin resistance [HOMA‐IR]; Fernström et al, 2020) and elevated C‐reactive protein (CRP; Bakour et al, 2017; Okun et al, 2009; Park et al, 2020). Further evidence on associations of multiple actigraphy‐assessed sleep variables and serum cardiometabolic outcomes is needed to compliment these findings in emerging adults.…”