Chronotype in bipolar disorder: Differences in sleep quality, social jet lag, physical activity, and diet / Cronotipo en trastorno bipolar: Diferencias en la calidad de sueño, jet lag social, actividad física y dieta

Abstract Introduction People with bipolar disorder are at a higher risk of metabolic morbidity and mortality. Chronotype may play a significant role due to its effect on sleep quality, eating patterns, and physical activity. Objective To compare sleep quality, social jetlag, physical activity, and diet, depending on the chronotype of people with bipolar disorder, and to determine the association between these variables. Method Cross-sectional, comparative, correlational study. The sociodemographic and clinical characteristics of subjects were assessed. Chronotype was determined using the Composite Scale of Morningness while sleep quality was evaluated through the Pittsburg Sleep Quality Index. Social jet lag was calculated through the absolute difference between the midpoint of sleep on weekends and workdays. Physical activity was measured through the Bouchard Activity Record and diet was evaluated through a food frequency questionnaire. Comparative analyses were performed between chronotype categories and the association between variables was measured. Results 116 subjects were included. Subjects with evening chronotype reported poorer sleep quality than those with morning chronotype. Eveningness was associated with lower sleep quality scores and more hours of sleep on workdays, as well as with higher consumption of cold meats, calories, and sodium. Trends indicate greater social jet lag and low physical activity levels among evening chronotypes. Discussion and conclusion The effects of chronotype on study variables require further research to clarify this complex relationship and develop educational strategies to promote sleep hygiene, physical activity, and a healthy diet.

Resumen Introducción Las personas con trastorno bipolar corren mayor riesgo de presentar morbimortalidad metabólica. El cronotipo podría desempeñar un rol importante por su efecto sobre la calidad de sueño, los patrones de alimentación y la actividad física. Objetivo Comparar la calidad de sueño, el jet lag social, la actividad física y la dieta en función del cronotipo de personas con trastorno bipolar, así como determinar la asociación entre estas variables. Método Estudio transversal, comparativo y correlacional. Se evaluaron las características sociodemográficas y los antecedentes clínicos de los participantes. El cronotipo se determinó con la Escala Compuesta de Matutinidad y la calidad de sueño con el Índice de Calidad de Sueño Pittsburg. El jet lag social se calculó como la diferencia absoluta entre el punto medio de sueño en días libres y de trabajo. La actividad física se midió con el registro de Bouchard y la dieta con un cuestionario de frecuencia de consumo de alimentos. Se realizaron análisis comparativos entre categorías de cronotipo y se evaluó la asociación entre variables. Resultados Se incluyeron 116 participantes. Las personas de cronotipo vespertino reportaron menor calidad de sueño en comparación con las del cronotipo matutino. La vespertinidad se asoció a puntuaciones de menor calidad de sueño y más horas para dormir en días de trabajo, así como a mayor consumo de embutidos, calorías y sodio. Las tendencias indican mayor jet lag social y bajo nivel de actividad física entre cronotipos vespertinos. Discusión y conclusión Los efectos del cronotipo sobre las variables de estudio requieren más investigación, que aclare esta compleja relación, para desarrollar estrategias educativas de higiene de sueño, actividad física y dieta saludable.

Ingesta alimentaria y composición corporal asociadas a síndrome metabólico en estudiantes universitarios / Dietary intake and body composition associated with metabolic syndrome in university students

Resumen El objetivo de este estudio fue conocer la relación de la ingesta alimentaria (IA) y la composición corporal (CMC) con el síndrome metabólico (SM) entre estudiantes universitarios. Participaron 50 alumnos (56% mujeres) de entre 19 y 25 años de edad (M = 20.58, DE = 1.86), quienes completaron un cuestionario dirigido a evaluar IA, además se recabaron parámetros bioquímicos y de CMC. De acuerdo con el porcentaje de grasa corporal (PG), se identificó una alta ocurrencia de sobrepeso (22%) y obesidad (38%). Además, la grasa visceral incrementó conforme aumentó el PG. En ambos sexos existió un consumo bajo de hidratos de carbono y alto en lípidos, mayormente de origen animal, así como alto consumo de grasas saturadas, pero bajo de omegas 3 y 6. El SM fue identificado en 20% de la muestra, principalmente mujeres. El criterio de riesgo más frecuente fue los bajos niveles séricos de colesterol HDL, seguido de la obesidad abdominal; en tanto que la dislipidemia más frecuente fue la hipertrigliceridemia. En este estudio, aunque no se encontró relación directa entre IA y SM, si de éste con indicadores de CMC. Resulta inminente la necesidad de implementar estrategias que permitan a los estudiantes universitarios adquirir hábitos alimentarios y de actividad física saludables.

Abstract The objective of this study was to know the relationship between dietary intake (DI) and body composition (BC) with the metabolic syndrome (MS) among university students. A total of 50 students (56% female) among 19 and 25 years of age (M = 20.58, SD = 1.86), completed a questionnaire aimed at assessing DI, in addition biochemical and BC parameters were collected. According to the percentage of body fat (BF), a high prevalence of overweight (22%) and obesity (38%) was identified. In addition, visceral fat increased as the BF increased. In both sexes, there was a low consumption of carbohydrates and high in lipids, mostly of animal fat as well as high consumption of saturated fats, but low omegas 3 y 6. The MS was identified in 20% of the sample, mainly in women. The most frequently risk criteria were low levels of HDL cholesterol, followed by abdominal obesity; whereas the most frequent dyslipidemia was hypertriglyceridemia. In this study, although no direct relationship was found between DI and MS, it was found between MS and BC indicators. It is imminent the need to implement strategies that allow university students to acquire healthy eating and physical activity habits.

Equations based on anthropometry to predict body fat measured by absorptiometry in schoolchildren and adolescents / Equações com base na antropometria para prever a gordura corporal medida por absorciometria em crianças em idade escolar e adolescentes

Abstract Objective: To develop and validate equations to estimate the percentage of body fat of children and adolescents from Mexico using anthropometric measurements. Methods: A cross-sectional study was carried out with 601 children and adolescents from Mexico aged 5-19 years. The participants were randomly divided into the following two groups: the development sample (n = 398) and the validation sample (n = 203). The validity of previously published equations (e.g., Slaughter) was also assessed. The percentage of body fat was estimated by dual-energy X-ray absorptiometry. The anthropometric measurements included height, sitting height, weight, waist and arm circumferences, skinfolds (triceps, biceps, subscapular, supra-iliac, and calf), and elbow and bitrochanteric breadth. Linear regression models were estimated with the percentage of body fat as the dependent variable and the anthropometric measurements as the independent variables. Results: Equations were created based on combinations of six to nine anthropometric variables and had coefficients of determination (r2) equal to or higher than 92.4% for boys and 85.8% for girls. In the validation sample, the developed equations had high r2 values (≥85.6% in boys and ≥78.1% in girls) in all age groups, low standard errors (SE ≤ 3.05% in boys and ≤3.52% in girls), and the intercepts were not different from the origin (p > 0.050). Using the previously published equations, the coefficients of determination were lower, and/or the intercepts were different from the origin. Conclusions: The equations developed in this study can be used to assess the percentage of body fat of Mexican schoolchildren and adolescents, as they demonstrate greater validity and lower error compared with previously published equations.

Resumo Objetivo: Desenvolver e validar equações para estimar o percentual de gordura corporal (%GC) de crianças e adolescentes do México com medidas antropométricas. Métodos: Foi feito um estudo transversal com 601 crianças e adolescentes do México cinco e 19 anos. Os participantes foram divididos aleatoriamente nos seguintes dois grupos: a amostra de desenvolvimento (n = 398) e a amostra de validação (n = 203). A validade das equações publicadas anteriormente (por exemplo, Slaughter) também foi avaliada. O %GC foi estimado por absorciometria de dupla energia de raios X (raios X de dupla energia [DXA]). As medidas antropométricas incluíram estatura, altura sentado, peso, circunferências da cintura e do braço, dobras cutâneas (tríceps, bíceps, subescapular, suprailíaca e panturrilha) e larguras do cotovelo e bitrocantérica. Os modelos de regressão linear foram estimados com o %GC, a variável dependente e as medidas antropométricas como as variáveis independentes. Resultados: As equações foram criadas com base nas combinações de seis a nove variáveis antropométricas e apresentaram coeficientes de determinação (r2) iguais ou superiores a 92,4% para meninos e 85,8% para meninas. Na amostra de validação, as equações desenvolvidas apresentaram altos valores de r2 (≥ 85,6% em meninos e ≥ 78,1% em meninas) em todos os grupos, baixo nível de erros padrão (EP ≤ 3,05% em meninos e ≤ 3,52% em meninas) e os interceptos não foram diferentes da origem (p > 0,050). Com as equações publicadas anteriormente, os coeficientes de determinação foram menores e/ou os interceptos foram diferentes da origem. Conclusões: As equações desenvolvidas neste estudo podem ser usadas para avaliar o %GC das crianças em idade escolar e adolescentes mexicanos, pois têm uma maior validade e menor erro em comparação com as equações publicadas anteriormente.

El auto-reporte de actividad física y comportamientos sedentarios no concuerda con la acelerometría en escolares mexicanos / Accelerometry does not match with self-reported physical activity and sedentary behaviors in Mexican children

Resumen: Introducción: La evaluación precisa de la actividad física (AF) en escolares es necesaria para implementar estrategias que favorezcan estilos de vida activos. El objetivo del presente estudio fue evaluar la validez de un cuestionario autoadministrado de AF y actividades sedentarias y ligeras (ASL) desarrollado para escolares mexicanos, analizando las diferencias en la validez de acuerdo con el estado de nutrición. Métodos: Escolares de 8-12 años de edad contestaron un cuestionario autoaplicable en el cual se evaluaron las ASL y AF moderada y vigorosa (AFMV). Se determinaron los minutos a la semana dedicados a ASL y AFMV en niños que portaron un acelerómetro triaxial. La concordancia entre los dos métodos para detectar el tiempo que los niños invierten en ver televisión se evaluó mediante coeficientes de correlación intraclase y el método de Bland-Altman. Resultados: La estimación de AFMV por cuestionarios fue mayor que la de acelerometría por 117.6 min/semana, mientras que la estimación de ASL fue menor por 1,924.7 min/semana. No se detectó correlación entre el tiempo evaluado con acelerómetros y el reportado en el cuestionario para las ASL y AFMV. En niños con índice de masa corporal normal, se detectó una correlación baja entre el tiempo reportado y el medido por acelerometría para jugar videojuegos con las actividades sedentarias (ric = 0.29, p = 0.031). Conclusiones: Los escolares sobreestiman las AFMV y subestiman las ASL. El peso corporal puede ser un factor que influya en dichos sesgos.

Abstract: Background: An accurate assessment of physical activity in schoolchildren is necessary to implement strategies that promote active lifestyles. The objective of this study was to validate a self-administered questionnaire to assess physical activity and sedentary behaviors and to analyze differences in the validity according to nutritional status in Mexican schoolchildren. Methods: Schoolchildren of 8-12 years of age answered a self-report physical activity and sedentary behaviors questionnaire to evaluate sedentary and light physical activity (SLPA) and moderate to vigorous physical activity (MVPA). The data of children who wore a triaxial accelerometer days was analyzed. Concordance between both methods to determine the time schoolchildren spend watching television was assessed using intraclass correlation coefficients and Bland-Altman method. Results: The estimation of MVPA by questionnaires was higher than that of accelerometers by 117.6 minutes per week, and the estimation of SLPA was lower by 1,924.7 minutes per week. No correlation between the time assessed by accelerometers and the time reported in the questionnaires for SLPA and MVPA was detected. In normal-weighted children, a low correlation between the time dedicated to play videogames with sedentary activities (ric =0.29, p=0.031) assessed by accelerometers was observed. Conclusions: Schoolchildren over-estimate MVPA and under-estimate SLPA. Body weight can be a factor influencing such bias.

Actividad física en un grupo de escolares de la Ciudad de México: factores asociados y puntos de corte utilizando acelerometría / Physical activity in a group of school children in Mexico City: associated factors and cutoff points measured by accelerometry

Introducción. A cualquier edad, la actividad física (AF) es fundamental para mantener la salud. Se han formulado diferentes directrices de AF para mejorar la salud de niños y adolescentes. Los objetivos de este trabajo fueron analizar las diferencias que existen en los niveles de AF en escolares a lo largo del día y por los días de la semana y conocer si las dos formas de implementar las recomendaciones de AF (frecuencia y duración versus duración acumulada) permiten identificar diferencias en condición física y adiposidad. Métodos. Participaron 71 escolares que portaron un acelerómetro triaxial por siete días consecutivos. Se estimaron los minutos dedicados a la actividad física moderada o vigorosa (AFMV). Se utilizaron dos criterios para definir si un niño era activo: ≥60 minutos de AFMV/día y 300 minutos de AFMV/semana. El estado de nutrición fue evaluado con el índice de masa corporal (IMC) y la condición física según el protocolo FITNESSGRAM®. Resultados. El 12.5% de los escolares fueron activos de acuerdo al criterio de 60 min AFMV/día y 55.5% con el criterio de 300 min AFMV/semana. Los escolares fueron más activos en el recreo y en la tarde entre semana y en la tarde y noche los fines de semana. Los hombres fueron más activos que las mujeres. El tiempo dedicado a AF vigorosa y moderada se correlacionó positivamente con la condición aeróbica. Existió correlación positiva entre el tiempo dedicado a las actividades sedentarias y la grasa corporal, y negativa con la AF ligera y moderada. Los niños clasificados como activos según el criterio de 300 minutos de AFMV/semana mostraron mejor capacidad aeróbica. Conclusiones. La proporción de niños activos difiere según el criterio de AF. Se mostró que la AF varió por sexo y hora del día. El tiempo dedicado a actividades de mayor intensidad parece influir en la capacidad aeróbica de los escolares.

Background. At any age, physical activity (PA) is critical to maintaining health. Different PA guidelines have been formulated to improve the health of children and adolescents. We undertook this study to analyze the difference in physical activity levels in school children during the day and week and to determine whether two recommendations of physical activity (frequency and duration vs. accumulated duration) in school children identify difference in physical fitness and fatness. Methods. Seventy-one school children participated. A tri-axis accelerometer (ActiGraph) was used for 7 consecutive days. Minutes spent on moderate or vigorous physical activity (MVPA) were estimated. Two criteria were used to define whether a child is active: ≥60 min of MVPA/day and 300 min of MVPA/week. Nutritional status was assessed using the body mass index (BMI) and physical fitness with the FITNESSGRAM® protocol. Results. It was shown that 12.5% of school children were active according to 60 min MVPF/day criterion and 55.5% with 300 min MVPF/week criteria. School children were more active during school recess and afternoons on weekdays and afternoons and nights on weekends. Boys were more actives than girls. The time spent on vigorous and moderate activities was positively correlated with aerobic fitness (r =0.23, p =0.057 and r =0.32, p =0.007, respectively). There was a positive correlation between the time spent on sedentary activities and body fat (r =0.343, p =0.003) and negative with light and moderate activities (r =-0.249, p =0.003; r =-0.249, p =0.013, respectively). School children classified as active according to 300 min of MVPA/week criteria showed better aerobic capacity. Conclusions. The proportion of active school children differs according to the physical activity criterion. It was shown that physical activity varied according to gender and time of day. The time spent on high intensity activities appears to have an influence on aerobic fitness of school children.

Tejido adiposo intra-abdominal: crecimiento, evaluación y su asociación con el desarrollo de problemas metabólicos en niños y adolescentes / Intra-abdominal adipose tissue: growth, assessment and association with the development of metabolic alterations in children and adolescents

La presente revisión tiene como objetivo mostrar el incremento del tejido adiposo intra-abdominal (TAIA) durante la etapa de crecimiento, los métodos de medición del TAIA, y su posible asociación con el desarrollo de problemas metabólicos durante la niñez y adolescencia. El TAIA se caracteriza por tener alta actividad lipolítica y secreción de adipocinas que favorecen el desarrollo de resistencia a la insulina, dislipidemias e hipertensión arterial. El TAIA aumenta de manera natural durante la etapa de crecimiento; sin embargo, se observa una amplia variación en la cantidad de TAIA entre niños y jóvenes. La resonancia magnética y tomografía axial computarizada (TAC) son los métodos más exactos para medir el TAIA, pero el costo de estos métodos limita su uso a nivel poblacional. No es recomendable usar la TAC para medir el TAIA en niños sanos por la exposición a radiaciones. Hasta el momento no se han establecido métodos alternativos para medir con precisión este tejido. El TAIA presenta una asociación positiva con la presión arterial, las concentraciones de insulina, de triglicéridos y de lipoproteínas de baja densidad (LDL), y con la disminución del tamaño de las partículas de LDL; además de una asociación negativa con las concentraciones de lipoproteínas de alta densidad (HDL).

The aim of the present review is to demonstrate the increase of intra-abdominal adipose tissue (IAAT) during growth and development and to describe methods to assess IAAT and the possible association with the development of metabolic alterations during childhood and adolescence. IAAT is characterized to have a high lipolytic activity and adipocytokine secretion that favor the development of insulin resistance, dyslipidemia and hypertension. IAAT naturally increases during growth in childhood; however, there is a wide variation in the amount of IAAT between children and adolescents. Magnetic resonance imaging and computerized axial tomography (CAT) are the most accurate methods to assess IAAT, but the cost of these methods limits their use at the population level. It is not recommended to use CAT to assess IAAT in healthy children due to radiation exposure. Currently, alternative methods have not been established to accurately assess this tissue. IAAT presents a positive association with blood pressure, insulin concentration, triglycerides and low-density lipoproteins (LDL), a decrease in the size of LDL particles, and a negative association with the concentrations of high-density lipoproteins.