Associations between the Chronotypes and Eating Habits of Hong Kong School-Aged Children.

Later chronotypes have been found to be associated with unhealthy diets in adolescents and adults, but no study has been conducted in children. The aim of this study was to investigate the associations between the chronotypes and dietary patterns of school-aged children. Children aged 7-11 and their parents were recruited from five mainstream schools in Hong Kong. The parents were told to complete questionnaires on the children's circadian preferences, food frequency, and dietary behaviors. All of the questionnaires were distributed and collected by schoolteachers. No gender differences in chronotype were observed (all p > 0.05). The evening-type was associated with significantly greater odds of viewing television (TV) during meals (adjusted odds ratios (OR) = 5.62 in boys and 5.39 in girls). Evening-oriented boys were prone to skipping breakfast (adjusted OR = 14.78), whereas evening-oriented girls were at risk of consuming fast food (adjusted OR = 7.74). There are indications of some gender differences in chronotype-related eating patterns. Sleep duration and screen time significantly mediated the associations between later chronotypes and unhealthy eating habits. Individualized dietary recommendations in accordance with circadian preferences may be effective at promoting healthy and nutritious diets for school-aged children.

Self-administered acupressure for knee osteoarthritis in middle-aged and older adults: a pilot randomized controlled trial.

OBJECTIVE: To test the acceptability and feasibility of self-administered acupressure as an intervention for knee pain among middle-aged and older adults with knee osteoarthritis (KOA). METHODS: In this pilot randomized controlled trial, 35 participants with KOA were randomized to receive self-administered acupressure (n = 17, two self-administered acupressure training sessions followed by self-practice for 6 weeks) or knee health education (n = 18, two health education sessions about KOA management followed by self-care for 6 weeks). Current pain intensity (primary outcome) was measured using a Numeric Rating Scale (NRS) at baseline and weeks 1, 2, 4 and 6 (post-intervention). Secondary outcome measures included worst and least pain intensity, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM) of the knee joints and Short-Form Six-Dimension (SF-6D) scores for health-related quality of life. RESULTS: Participants in both groups attended all training sessions. In the self-administered acupressure group, all subjects mastered the acupressure technique and passed a consistency check. Both groups showed a decreasing trend in current knee pain intensity measured using NRS post-intervention. A medium between-group effect size (0.40) was found, but between-group differences were not statistically significant. The other secondary outcome measures were also comparable between both groups post-intervention (all p > 0.05). CONCLUSION: A two-session self-administered acupressure training was acceptable to and feasible in participants with KOA. The data generated allowed for calculation of a sample size for a definitive randomized controlled trial (RCT) to confirm whether self-acupressure is effective for pain management in KOA. Furthermore trials with adequate power and longer follow-up periods are warranted.

Validation of the Chinese Version of the Children's ChronoType Questionnaire (CCTQ) in school-aged children.

The Children's ChronoType Questionnaire (CCTQ) is a valid and reliable measure for assessing prepubertal children aged 4-11 years. The CCTQ is a parent-reported, 27-item questionnaire consisting of sleep-wake parameters for scheduled and free days (16 items), a morningness/eveningness scale (M/E, 10 items), and a five-point, single-item, chronotype score. The CCTQ has been translated into different languages, but a Chinese version is not available. In the present study, we aimed to produce a Chinese version of the CCTQ and test its validity and reliability on school-aged children. A total of 555 children aged 7-11 years were recruited from five primary schools. The parents were told to complete the CCTQ and record their child's sleep pattern in a 7-day sleep diary. Sixty-six children and their parents were invited to participate in determining the test-retest reliability of the CCTQ over a 2-week interval, and their sleep patterns were assessed using a sleep diary. The internal consistency of the Chinese CCTQ M/E score as measured by Cronbach's alpha was acceptable (0.74). Regarding the test-retest reliability of the instrument, moderate to strong Spearman's correlation coefficients were found for most of the CCTQ - sleep-wake items (ρ = 0.52-0.86) and for the CCTQ-M/E total score (ρ = 0.78). For the concurrent validity, Spearman's correlations between the sleep-wake parameters of the CCTQ and the sleep diary were moderate to high on both the scheduled days (ρ = 0.54 to 0.87) and free days (ρ = 0.36 to 0.60). For the correlations measured with actigraphs, significant correlations were found in the CCTQ sleep-wake parameters, including bedtime, get-up time, sleep latency, sleep period, time in bed, and mid-sleep point on both the scheduled (ρ = 0.31 to 0.76) and free days (ρ = 0.27 to 0.52), but not in sleep latency and sleep period on free days. The results of the present study suggest that the Chinese version of the CCTQ is a reliable and valid tool for assessing chronotypes in Chinese school-aged children in Hong Kong.