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Aim: As retinal microvasculature (RMV) can be assessed non-invasively, it presents an opportunity to examine the health and disease of the human microcirculation, as RMV alterations have been recognised as one of the earliest signs of cardiovascular risk. This review summarises current literature on the associations between physical activity (PA), sedentary behaviour (SB) and/or adiposity and RMV in children and adolescents aged 0-18 years., Methods: Six databases were searched (MEDLINE, Scopus, Web of Science, ScienceDirect, PsycINFO and CINAHL), through to December 11, 2019. English, Portuguese, French, Spanish or Dutch were the languages searched. Meta-analyses were performed using the meta-analyst software., Results: A total of 6796 studies were screened, and 26 studies were included, representing 24 448 participants, from 12 different countries. Studies reporting results on weight status were twenty-three, PA was assessed in six studies, and SB was assessed in three studies. Four studies examined weight status and PA/SB. Meta-analysis was performed for two studies and showed that children with obesity have smaller retinal arterioles (-2.38 µm difference, 95% CI 0.62, 4.15 µm) and larger retinal venules (2.74 µm difference, 95% CI -4.78, -0.72 µm) than children without obesity., Conclusion: Results showed that adiposity was associated with microvascular alterations in children and adolescents. Increased adiposity, lack of PA and high levels of SB were negatively correlated with vessel width parameters., (© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Background: The associations between sleep characteristics and adiposity in children under three years are not fully understood yet., Objective: The objective of the study is to examine the cross-sectional and prospective associations between sleep characteristics and adiposity in toddlers over a 12-month period., Methods: Participants were 202 toddlers from the GET-UP!, Study: Sleep duration, sleep timing, and sleep variability were assessed using 24-hour accelerometry for seven consecutive days. Height and weight were measured, and BMI z scores were calculated. Linear mixed models were performed to examine the cross-sectional and prospective associations between sleep characteristics and adiposity, with adjustments for clustering effects and demographic factors., Results: Total sleep duration was negatively associated with higher adiposity cross-sectionally (B = -0.12; 95% CI: -0.23, -0.01; .033) but not prospectively (B = 0.01; 95% CI: -0.13, 0.10; .843). Nap duration was prospectively associated with higher levels of adiposity (B = 0.41; 95% CI: 0.14, 0.68; .003). Sleep variability and sleep timing were not associated with concurrent or subsequent adiposity., Conclusion: Although sleep duration is an important factor associated with obesity in toddlerhood, the potential effects of different types of sleep duration may vary. While longer total sleep duration may protect children from increasing adiposity, longer nap duration seems to be risk factor. As evidence in this age group is scarce, more research is needed to confirm this finding., (© 2019 World Obesity Federation.)

Background: In youth, research on the health benefits of breaking up sitting time is inconsistent. Our aim was to explore the association between the number of breaks in sitting time and adiposity in Australian toddlers., Methods: This study comprised 266 toddlers (52% boys), aged 19.6 ± 4.2 months from the GET-UP! Study, Australia. Body mass index (BMI) was calculated and z-scores by age and sex were computed for waist circumference (WC). Participants were classified as overweight according to the WHO criteria for BMI. For WC, participants with a z-score≥1SD were considered overweight. Sitting time was assessed with activPALs during childcare hours and participants were classified by tertiles of the number of breaks/h in sitting time: <26 breaks/h; 26-39 breaks/h, and >39 breaks/h. Logistic regression assessed odds ratios for non-overweight (BMI or waist circumference categories) by number of breaks in sitting time/h, controlling for age, sex, and socioeconomic status., Results: The number of breaks in sitting time significantly predicted a lower weight status (non-overweight) according to WC values (P for trend = 0.032) after adjustments., Conclusions: Breaking up sitting time was positively associated with toddlers' waist circumference. Future studies are needed to determine whether breaking up sitting time is a protective for cardiometabolic health in toddlers., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Study Objective: This study aimed to examine the direct effects of environmental characteristics of early childhood education and care (ECEC) centres on adiposity, and the indirect effects through daily movement behaviours (physical activity, sedentary time and naps)., Methods: 274 children (average age 19.73 ± 4.15 months) from 27 ECEC centres participated in this study. Environmental characteristics of ECEC centres were rated using the Infant/Toddler Environment Rating Scale-revised edition (ITERS-R). Daily movement behaviours were assessed using 24-h accelerometry. Body mass index z-scores were used to indicate adiposity., Results: There were no significant direct effects or indirect effects of environmental characteristics on toddlers' adiposity through daily movement behaviours. However, the environmental characteristics of "personal care routine" (B=0.72, p = 0.041) and "activity" (B = 0.87, p < 0.050) were positively associated with the percentage of time these toddlers spent in moderate-to-vigorous physical activity (MVPA). "Listening and talking" was also positively associated withnap(s) durations (B = 4.08 p = 0.001)., Conclusion: The relationships between environmental characteristics of ECEC centres and adiposity in toddlers, as well as, the mediating roles of daily movement behaviours still need confirmation by future longitudinal and experimental studies with long follow-up periods. At the same time, a broader spectrum of environmental characteristics of these settings needs to be examined with toddlers' adiposity in future studies; other potential mediators may also need to be taken into considerations., (Copyright © 2018 Elsevier Ltd. All rights reserved.)