Carola Ray

Associations between sleeping habits and food consumption patterns among 10–11-year-old children in Finland

The increasing prevalence of overweight and obesity among children is of special concern. Inverse associations between sleep length and overweight have been found in children. Short sleeping hours result in hormonal changes, which increase perceived hunger and appetite. This could affect food intake, and consequently lead to overweight. The aim is to find out whether there is an association between adequate sleep and food consumption among 10-11-year-old school children in Finland. One thousand two hundred and sixty-five children (response rate 79 %), aged 9-11, from thirty-one schools filled in a questionnaire about their health behaviour. Inadequate sleep was measured as short sleeping hours during school nights and weekend nights, difficulties in waking up in the morning and tiredness during the day. Food consumption patterns were measured by two consumption indices, energy-rich foods and nutrient-dense foods, based on a short FFQ (sixteen items). Inadequate sleep is associated with food consumption patterns. Boys with shorter sleep duration during school nights, and who were felt tired during the day, were more likely to consume energy-rich foods. Girls with shorter sleep duration during school nights consumed more likely energy-rich foods and less likely nutrient-dense foods. Adjusting for physical activity and screen time weakened the explored associations. The associations with energy-rich foods were stronger for boys than for girls. Sleeping habits are associated with food consumption patterns. Shorter sleep duration during school nights in school children is associated with higher consumption of energy-rich foods.

Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children’s sleep habits in a longitudinal study?

BackgroundElectronic media use is becoming an increasingly important part of life for today’s school-aged children. At the same time, concern of children’s sleep habits has arisen, and cross-sectional studies have shown that electronic media use is associated with short sleep duration and sleep disturbances. The purpose of this longitudinal study was to investigate whether baseline electronic media use and media presence in a child’s bedroom predicted sleep habits as well as changes in these sleep habits 18 months later among 10- to 11-year-old children in Finland.MethodsThe school-aged children (n=353, 51% girls) from 27 schools answered a questionnaire in 2006 and again 2008 in the Helsinki region of Finland. Electronic media use was measured by computer use and TV viewing. Media presence in a child’s bedroom means the presence of a TV or a computer in a child’s bedroom. Sleep habits were measured by bedtimes on school days and at the weekend days, sleep duration, discrepancy of bedtimes, and discrepancy of sleep duration between school days and weekends. Linear regression analyses were used to examine whether electronic media use and media presence predicted sleep habits with adjustments for grade, family structure, and baseline sleep. Gender differences were also examined.ResultsThe children used a computer for one hour per day and watched TV over one hour a day in 2006. They slept over nine hours on school days and over ten hours at the weekends in 2008. Computer use and television viewing predicted significantly shorter sleep duration (p<0.001, p<0.05 respectively) and later bedtimes (p<0.001, p<0.01, respectively). Computer use also predicted unfavourable changes in sleep duration (p<0.001) and bedtimes on school days (p<0.001) and weekends (p<0.01). Among boys, media presence in the bedroom predicted poorer sleep habits and irregularity of sleep habits.ConclusionsComputer use, TV viewing, and the presence of media in children’s bedrooms may reduce sleep duration, and delay bedtimes.

Vitamin D receptor gene BsmI-polymorphism in Finnish premenopausal and postmenopausal women: its association with bone mineral density, markers of bone turnover, and intestinal calcium absorption, with adjustment for lifestyle factors.

Abstract. Bone mineral density (BMD) is regulated by genetic and environmental factors. Sixty percent to 80% of bone mass is suggested to be under polygenetic control, but the role of individual genes seems to be modest. Several studies have indicated that the vitamin D receptor (VDR) gene has a role in the regulation of BMD and bone metabolism, but the results are very controversial. We studied the associations between BsmI-polymorphism of the VDR gene and BMD and bone metabolism in 24 premenopausal (aged 22–45 years) and 69 postmenopausal (aged 48–65 years) Finnish women. The BMD of the lumbar spine and femoral neck and bone turnover markers were measured, and the intestinal calcium absorption was investigated, using a method based on the absorption of non-radioactive strontium. The genotype distribution was 16%, BB; 34.5%, Bb; and 49.5%, bb, which differs from the genotype distribution found in other Caucasian populations, but is similar to earlier Finnish reports. The winter value of 25-hydroxyvitamin-D (25-OH-D) was highest for the BB genotype in both age groups (analysis of covariance [ANCOVA]; premenopausal women P = 0.5, postmenopausal women P = 0.03, and for the groups combined P = 0.02). Lumbar spine BMD and intestinal strontium absorption were highest for the BB genotype in both age groups, but these results were nonsignificant. The markers of bone metabolism did not differ significantly between the VDR genotypes. The BB genotype had the best vitamin D status, which could explain the differences in calcium absorption between the genotypes. However, the conclusions of our study are limited because of the small number of subjects.

Role of free school lunch in the associations between family-environmental factors and children's fruit and vegetable intake in four European countries.

OBJECTIVE To determine whether an association exists between different clusters of fruit- and vegetable-specific family-environmental factors and childrens daily fruit and vegetable intake, and whether these associations differ between countries with different school lunch policies. DESIGN Cross-sectional data from four European countries participating in the Pro Greens project in 2009. These countries have different school food policies: two serve free school lunches and two do not. Self-administered data were used. Food frequency questions served to assess fruit and vegetable intakes. The study assessed sixteen children-perceived family-environmental factors, which were clustered based on principal component analysis into five sum variables: fruit and vegetable encouragement; vegetable modelling, family routine and demand; fruit modelling; fruit and vegetable snacking practices; and fruit and vegetable allowing. SETTING Schools in Finland, Germany, Sweden and the Netherlands. SUBJECTS Schoolchildren aged 11 years (n 3317). RESULTS Multilevel logistic regression analyses revealed positive associations between nearly all clustered family-environmental factors and daily fruit and vegetable intake. The study tested a moderation effect between family-environmental factors and school lunch policy. In five out of twenty models significant interactions occurred. In the stratified analyses, most of the associations between family-environmental factors and raw and cooked vegetable intake were stronger in Germany and the Netherlands, neither of which provided free school lunches. CONCLUSIONS Children reporting more fruit- and vegetable-promoting family-environmental factors had a more frequent intake of fruits and vegetables; the associations were stronger for vegetable intakes in countries providing no free school lunches, suggesting that parental involvement is crucial when schools offer no vegetables.

Meal pattern and BMI in 9-11-year-old children in Finland.

OBJECTIVE In many studies it has been shown that breakfast is associated with normal weight in children and adolescents. Other meals, family meals and a regular meal pattern have been less studied. Therefore, the aim of the present study was to examine whether a regular meal pattern, or breakfast, lunch or dinner as separate regular meals, is associated with the BMI of children. DESIGN A cross-sectional study conducted within the Helsinki region during 2006. Study participants were measured and weighed by research staff. Children filled in a study questionnaire on their health behaviour, including the frequency of consuming meals. A regular meal was defined as one usually eaten on every school day. A regular meal pattern was defined as one consisting of a usual consumption of breakfast, school lunch and dinner on every school day. Covariance analysis was used as the statistical analysis method. SETTING Capital region, Finland, 2006. SUBJECTS A total of 604 schoolchildren (312 girls) aged 9-11 years. RESULTS Irregular breakfast and an irregular meal pattern were associated with higher BMI. Regularity of school lunch, dinner or family dinner was not associated with BMI. CONCLUSIONS A regular breakfast and meal pattern was associated with lower BMI in children, although breakfast was the only single meal associated with BMI. We conclude that, although the association between breakfast and weight status in children is fairly consistent, the role of other meals is less convincing.

The role of parents' sense of coherence in irregular meal pattern and food intake pattern of children aged 10-11 in Finland

Background: Among adults, a stronger sense of coherence (SOC) seems to promote a better coping with strain and is associated with healthier behaviours, including eating patterns. The parents’ SOC may also have a wider effect on the health behaviour of their children. The aim of this study is to determine whether there are associations between parents’ SOC and the eating patterns of their children and if this can be explained by mediating factors. Methods: Cross-sectional. In 2006, 1268 (response rate 79%) 10- and 11-year-old children in southern Finland, in a classroom situation, filled in a questionnaire assessing meal pattern and food frequency intake. Parents, 816 (response rate 64%), filled in a questionnaire assessing SOC (13 items) and eating patterns. Matching data were found from 772 child–parent pairs. χ2 tests, factor analysis, univariate analysis of variance and logistic regression analyses were used as statistical methods. Results: A weaker parental SOC was associated with children’s irregular meal pattern (p = 0.004), more frequent intake of energy-rich foods (p = 0.002) and less frequent intake of nutrient-rich foods (p = 0.051). Mediating factors, such as availability and accessibility of fruit and vegetables at home, parent’s nutrition knowledge, parents’ own fruit and vegetable intake and an irregular meal pattern, explained the association between parents’ SOC and children’s intake of nutrient-dense foods, but not the association with energy-rich foods. Conclusions: Parents’ weaker SOC was associated with children’s unhealthier eating patterns. More research is needed on the associations between parents’ SOC and other health-related behaviours in their children.

Associations of parental influence and 10–11-year-old children’s physical activity: Are they mediated by children’s perceived competence and attraction to physical activity?:

Aims: This cross-sectional study had two aims: firstly, to study the associations of parental influence in the form of encouragement, father and mother modelling and involvement on children’s physical activity (PA), and secondly, to study the mediation effect of encouragement, father and mother modelling and involvement on children’s PA through children’s perceived competence and attraction to PA. Methods: A total of 1278 children (response rate 79%), aged 10–11 years, participated in the study in the autumn of 2006. Of these children, 883 children completed all the data in a questionnaire assessing their self-reported PA, perceived competence, attraction to PA, and perceived parental influence. The associations were examined by multiple mediator analyses with bootstrapping method. All the models were adjusted with gender and grade. Results: The analyses pointed out that father modelling had a direct effect on children’s physical activity, whereas encouragement, mother modelling, and involvement had an indirect effect through perceived competence and attraction to physical activity on children’s physical activity. The strongest indirect association was formed from encouragement through attraction to physical activity to children’s physical activity. Conclusions: The results show that parents influence on children’s physical activity in a variety of ways. Parents influence their children’s physical activity in direct and indirect manners through their encouragement, involvement and modelling. Furthermore, mother and father influence their children’s physical activity in different ways. This versatility should be taken into consideration in future interventions.

Family characteristics predicting favourable changes in 10 and 11-year-old children's lifestyle-related health behaviours during an 18-month follow-up.

Lifestyle-related health behaviours such as screen time, physical activity, sleep duration, and food intake tend to change into non-favourable directions when children become young adolescents. Cross-sectional studies show that family characteristics are important determinants for childrens health behaviours. This study examined whether family characteristics such as parenting practices at meals and family involvement predict a more favourable change in childrens lifestyle-related health behaviours during an 18-month follow-up. 745 children in school grades 4 and 5 (response rate 65%) filled in a baseline questionnaire in the autumn of 2006. A follow-up was conducted in the spring of 2008 (91%). Several health behaviours had changed in a non-favourable direction. Baseline parenting practices at meals and family involvement predicted some of the changes in the lifestyle-related health behaviours in 2008. Parenting practices at meals predicted a smaller increase in TV, DVD viewing time, and a smaller decrease in fruit intake. Amongst family involvement determinants, less time alone at home after school predicted a smaller increase in screen time, a smaller decrease in sleep duration, and a smaller increase in soft drink intake. For conclusion several family characteristics predicted favourable changes in childrens lifestyle-related health behaviours.

Increased health and well-being in preschools (DAGIS): rationale and design for a randomized controlled trial

BackgroundEffective interventions that target socioeconomic status (SES) differences to avoid the potential widening of inequalities in health are needed. Children at preschool age is a valuable intervention target since sedentary behaviors, physical activity (PA), dietary behaviors, and sleep habits, jointly called the energy balance-related behaviors (EBRBs), are established in early childhood and tend to persist later in life. The interventions are most effective, when they focus on evidence-based factors. One potential factor associated with EBRBs and SES is children’s stress regulation, which receives special attention in this study. Based on the socioecological approach, the combinations of multiple levels (e.g. individual, environmental, societal) of analysis and diverse methodologies (e.g. surveys, observations, biological measurements) are used to assess the healthfulness of environments (e.g. social, physical, learning, policy) in preschool and family settings. The intervention aimed to diminish SES differences in EBRBs is then conducted in the preschool setting.Methods/designThe DAGIS study is divided into two phases. The first phase comprises focus group interviews and a cross-sectional survey. Parents and preschool personnel in low SES neighborhoods participated in interviews about children’s sedentary behaviors, dietary behaviors, and PA in 2014. In the cross-sectional survey beginning in autumn 2015, preschools will be recruited from a random sample of preschools in 3–5 municipalities in Southern Finland. A total of 800 children will wear an accelerometer for seven days. Children’s hair and saliva samples will be taken. Parents and preschool personnel will complete questionnaires on EBRBs, social and physical environments and SES factors. The quality of preschool environment is also observed. In the second phase, an intervention targeting to narrowing SES differences in EBRBs is conducted. The effects of the intervention will be evaluated in randomised controlled trial. The implementation of the intervention will also be evaluated.ConclusionIf effective, this unique preschool-based study will be able to narrow the SES differences in preschool children’s EBRBs. This study is anticipated to identify the most important modifiable factors in preschool and family environmental settings associated with children’s EBRBs, especially in children from low SES backgrounds.Trial registrationISRCTN57165350 (January, 8th, 2015).

Does eating family meals and having the television on during dinner correlate with overweight? A sub-study of the PRO GREENS project, looking at children from nine European countries.

OBJECTIVE Family meals have been negatively associated with overweight in children, while television (TV) viewing during meals has been associated with a poorer diet. The aim of the present study was to assess the association of eating family breakfast and dinner, and having a TV on during dinner, with overweight in nine European countries and whether these associations differed between Northern and Southern & Eastern Europe. DESIGN Cross-sectional data. Schoolchildren reported family meals and TV viewing. BMI was based on parental reports on height and weight of their children. Cut-off points for overweight by the International Obesity Task Force were used. Logistic regressions were performed adjusted by age, gender and parental education. SETTING Schools in Northern European (Sweden, the Netherlands, Iceland, Germany and Finland) and Southern & Eastern European (Portugal, Greece, Bulgaria and Slovenia) countries, participating in the PRO GREENS project. SUBJECTS Children aged 10-12 years in (n 6316). RESULTS In the sample, 21 % of the children were overweight, from 35 % in Greece to 10 % in the Netherlands. Only a few associations were found between family meals and TV viewing during dinner with overweight in the nine countries. Northern European children, compared with other regions, were significantly more likely to be overweight if they had fewer family breakfasts and more often viewed TV during dinner. CONCLUSIONS The associations between family meals and TV viewing during dinner with overweight were few and showed significance only in Northern Europe. Differences in foods consumed during family meals and in health-related lifestyles between Northern and Southern & Eastern Europe may explain these discrepancies.