Maroje Sorić

Validation of a multi-sensor activity monitor for assessing sleep in children and adolescents

OBJECTIVE To assess the validity of a multi-sensor activity monitor in estimating sleep and wake compared to polysomnography in children and adolescents. METHODS A total of 43 children and adolescents (29 boys, 14 girls), aged 7-17years (mean age [SD] = 11.0 [2.4] years) participated in the study. Participants wore the SenseWear Pro(3) Armband™ (SWA) body monitor (BodyMedia Inc) during an overnight polysomnographic assessment in a paediatric sleep laboratory. Sleep measures included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency (SE). RESULTS No systematic bias of the SWA was noted for any of the sleep measures assessed, but limits of agreement were wide and amounted to -76 to +58min for SOL, -75 to 102min for WASO, -109 to +99min for TST and -22 to +20% for SE. In addition, no effect of gender, age group (children versus adolescents) or overweight on the accuracy of the SWA was found. CONCLUSIONS The SenseWear Armband™ showed good agreement with polysomnography at the group level, while at the individual level rather, poor agreement between the two methods was observed. Consequently, at this point the use of the SWA in the clinical evaluation of sleep cannot be advocated.

Physical activity levels and estimated energy expenditure in overweight and normal-weight 11-year-old children.

Aim:  To objectively evaluate physical activity and energy expenditure in overweight and normal‐weight 11‐year‐old children.

Associations of objectively assessed sleep and physical activity in 11-year old children

Abstract Aim: Objective methods were used to evaluate children’s sleep and physical activity over several days in order to test the hypotheses that: (1) low average sleep duration and/or sleep efficiency are linked to a low amount of physical activity; and (2) a reduction in sleep quantity and/or sleep efficiency during the night is followed by a decrease in physical activity the following day. Methods: This is a multi-centre, observational study involving 276 children, aged 10.5–12 years, from diverse urban settings in Croatia, Slovenia and the US. Sleep and activity were monitored for 2–6 days (median = 4) using the Sensewear Armband™ multi-sensor body monitor. Results: While average sleep duration and efficiency were unrelated to physical activity, within-subjects associations revealed that an extra hour spent in bed during the night was followed by a 16-minute decrease in moderate-to-vigorous physical activity (p < 0.001). This was accompanied by a 4.5 kJ/kg and 5.9 kJ/kg lower total daily energy expenditure in boys and girls, respectively (p < 0.001). Conclusions: This study found no evidence for a link between short sleep and low or reduced physical activity.

Tracking of BMI, fatness and cardiorespiratory fitness from adolescence to middle adulthood: the Zagreb Growth and Development Longitudinal Study.

Abstract Background: Effective intervention strategies aiming to improve cardiorespiratory fitness and to decrease body fatness are needed. However, long-term stability of these traits is not well understood. Aim: To assess long-term tracking of cardiorespiratory fitness and body fatness from late adolescence to middle adulthood. Subjects and methods: The sample consisted of 50 participants (31 boys) from the Zagreb Growth and Development Longitudinal Study who were followed up in adulthood (median age = 43). Fatness was evaluated through BMI and skin-folds, while cardiorespiratory fitness was assessed using a cardiopulmonary exercise test. Inter-age partial correlation coefficients were calculated to evaluate tracking. Results: Body mass index and skin-folds showed moderate tracking from age 15 years to middle adulthood (partial r = 0.55, p < 0.001 and partial r = 0.52, p < 0.001, respectively), while tracking of subcutaneous fat distribution was somewhat lower (partial r = 0.38, p < 0.01). At the same time, the observed tracking of peak oxygen uptake was low-to-moderate (partial r = 0.30, p = 0.03), while ventilatory aerobic and anaerobic thresholds did not show significant tracking. Conclusions: The results of this study indicate that preventive efforts aiming to increase cardiorespiratory fitness should include all adolescents, irrespective of their cardiorespiratory fitness status. Conversely, strategies aiming at obesity prevention should focus on high-risk groups of adolescents.

The Effect of Cigarette Smoking History on Muscular and Cardiorespiratory Endurance

The purpose of this study was to investigate the effect of cigarette smoking history on physical fitness in younger adults. Small, insignificant differences in BMI between non-smokers and smokers were shown regardless of cigarette smoking history duration. Although the differences in muscular endurance increased in the samples with progressing cigarette smoking history duration, a highly significant difference in aerobic endurance was observed between the group of non-smokers and smokers with a history of smoking up to 5 years and persisted at the same level in smokers with a history of smoking for longer than 10 years.

Which is more important for reducing the odds of metabolic syndrome in men: Cardiorespiratory or muscular fitness?

To examine combined associations of cardiorespiratory fitness (CRF) and muscular fitness (MF) with metabolic syndrome (MetSy) in a sample of young men.

School day and weekend patterns of physical activity in urban 11‐year‐olds: A cross‐cultural comparison

This multi‐center study was conducted to objectively evaluate energy expenditure and physical activity (PA) patterns on school days and weekends in urban 11‐year‐olds.

Anthropometry in cardio-metabolic risk assessment

Sažetak S visokom prevalencijom debljine i s njom povezanih kroničnih metaboličkih i srčano-žilnih bolesti aktualizirana je potreba primjene jednostavnih antropometrijskih pokazatelja u procjeni prekomjerne tjelesne mase i debljine i u primarnom probiru rizičnih skupina, najčešće ITM-om odnosno indeksom tjelesne mase. On se primjenjuje u epidemiološkim istraživanjima, ali i u svakodnevnom radu u primarnoj zdravstvenoj zaštiti, pri procjeni kardiovaskularnog rizika uz kliničku i laboratorijsku dijagnostiku, savjetovanju pravilne prehrane i praćenju učinaka dijetetskih mjera u prehrani te savjetovanju tjelesne aktivnosti i vježbanja. Međutim, s obzirom na to da nije pokazatelj tjelesnoga sastava, u individualnoj procjeni prekomjerne mase u mnogim slučajevima ne zadovoljava. To se osobito odnosi na procjenu tjelesno aktivnih osoba i sportaša s dobro razvijenom nemasnom tjelesnom masom, u kojih nalazimo prekomjernu tjelesnu masu, ali bez viška masti, kao i u osoba s normalnom tjelesnom masom i malom nemasnom masom i/ili gracilnim skeletom. Posljednjih desetljeća posebnu pozornost zaokuplja uloga različite raspodjele tjelesne masti u razvoju kroničnih metaboličkih i srčanožilnih bolesti. Najboljim antropometrijskim prediktorom kardiovaskularnog rizika smatra se opseg trbuha (OT). Neizravni je pokazatelj veličine nakupljanja visceralne masti. OT i omjer opsega struka i kukova dobri su pokazatelji distribucije tjelesne masti i kardio-metaboličkog rizika. Razmatra se varijabilnost i unutar skupine osoba s povećanim OT-om s obzirom na rizik od razvoja metaboličkog sindroma. Hipertrigliceridemija uz povećani OT smatra se prvim pokazateljem povećanog metaboličkog rizika. U radu su navedeni postupci analize tjelesnog sastava, posebno antropometrijski, koje se svrstava u skupinu jednostavnih i jeftinijih postupaka. Razvoj generaliziranih jednadžbi za procjenu gustoće tijela doveo je do uporabe antropometrije u analizi tjelesnog sastava u praktičnom radu. Summary High prevalence of obesity, as a major public health problem, is connected with chronic cardiovascular and metabolic diseases. That is why some simple anthropometric parameters were developed to estimate overweight and obesity, and in the primary screening of risk groups. In this field, body mass index (BMI) is the most frequent parameter, both in epidemiological research and in everyday practice. It is a part of the algorithm used in the early detection of overweight and obese persons. However, BMI does not provide any data on body composition. This is why it is particularly insufficient in estimating body mass in physically active persons and in athletes who are often overweight, with a higher proportion of lean body mass but without any excess fat, as well as in those with normal weight but lower than normal lean body mass and/ or gentle skeleton. Over the last few decades, attention has been especially directed to different body fat distribution in relation to chronic cardio-vascular and metabolic diseases. Waist circumference (WC) is the best anthropometric predictor of cardiovascular risk. It is considered an indirect parameter of visceral fat. WC and waist-to-hip ratio are good parameters showing body fat distribution and cardio-metabolic risk. Waist-to-height ratio is suggested by some authors to be an even better parameter of cardio-vascular risk and metabolic syndrome. Hypertriglyceridemia combined with increased WC is considered a marker of atherogenic metabolic risk. The paper also deals with procedures of body composition analysis. Anthropometric assessment of body composition analysis belongs to a group of simple and inexpensive procedures. Development of generalised equations for body density prediction introduced anthropometric methods in the analysis of body composition in everyday practice.

Is School Type Associated with Objectively Measured Physical Activity in 15-Year-Olds?

The main aims of this study were: (1) to determine the objectively assessed physical activity (PA) patterns in urban 15-year-old male and female adolescents according to school type and (2) to assess the differences in PA between school days and weekend days. In this cross-sectional study, participants were 187 secondary-school male and female adolescents (61.4% females) attending grammar and vocational schools. Patterns of PA were objectively evaluated using a multi-sensor body monitor for 5 consecutive days. Confounders assessed included biological age, socio-economic status, sum of 4 skinfolds, maximal temperature and the amount of rainfall. Males and females from grammar schools achieved higher total daily energy expenditure (TEE) and active energy expenditure (AEE) compared to their peers from vocational schools (TEE: 50 ± 12 kcal/kg/day vs. 47 ± 12 kcal/kg/day, p = 0.02; AEE: 23 ± 5 kcal/kg/day vs. vocational = 21 ± 6 kcal/kg/day, p = 0.04). No differences in time spent in light (LPA), moderate (MPA) or vigorous (VPA) physical activity were noted between the two groups (p = 0.16–0.43). Next, a significant decline in TEE and MPA between school days and weekends was observed (p< 0.001 and p = 0.02, respectively), while VPA remained the same throughout the week (p = 0.76). Weekly patterns of PA did not show differences by school type or gender (p for interactions = 0.21–0.50). In addition, significantly lower amount of MPA was accumulated during weekends compared to school days, resulting in lower TEE, regardless of school type or gender. Policies and strategies on PA in adolescents should focus vocational schools and weekend days.

One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS)

Abstract Background Little is known about the concurrent change in physical activity (PA), sedentary behavior (SB) and sport participation (SP) during adolescence. The main purpose of this prospective and partly objective study was to simultaneously investigate PA, SBs and SP changes between the 1st and 2nd grades of high school in urban adolescents. Methods In this 1-year follow-up study, the participants were 81 secondary-school students (28 boys and 53 girls) aged 15.5 years at the baseline. PA was assessed with the SenseWear Armband multi-sensor activity monitor, while SBs were assessed by using School Health Action, Planning and Evaluation System (SHAPES) PA questionnaire. The SHAPES questionnaire was supplemented with two questions inquiring about SP in organized sports in school and outside of school. Results PA decreased markedly in both genders between the 1st and 2nd grades of high school. Total energy expenditure (TEE) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls (p for both <0.001), while mean daily active energy expenditure (AEE) decreased by 7 kcal/kg/day (p < 0.001) and 3 kcal/kg/day (p = 0.04) in boys and girls, respectively. Similarly, the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls (p for both <0.001). At the same time vigorous PA was cut by 14 min/day (p < 0.001) and 3 min/day (p = 0.003) in boys and girls, respectively. Conversely, time spent in SBs did not show any change. Conclusion In conclusion, a decline in PA between the 1st and 2nd grades of high school was marked but was not accompanied with an increase in SBs. Policies aimed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA.