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BackgroundThe Prevention of Overweight in Infancy (POI) randomized controlled trial assessed the effect of a more conventional food, physical activity, and breastfeeding intervention, with a more novel sleep intervention on weight outcomes at 2 years of age. The trial had 58% uptake at recruitment, and retention was 86% at age 2 years, 77% at age 3.5 years, and 69% at age 5 years. Children who received the brief sleep intervention in infancy had just half the risk of obesity at 2 years of age compared to those who did not receive the sleep intervention. Importantly, this substantially reduced risk was still apparent at our follow-up at 5 years of age. ObjectiveThe primary aim of this follow-up at age 11 years is to determine whether differences in BMI z-score and obesity risk remain apparent now that it is at least 9 years since cessation of the sleep intervention. Several secondary outcomes of interest will also be examined including 24-hour movement patterns, mental health and wellbeing, and use of electronic media, particularly prior to sleep. MethodsWe will seek renewed consent from all 734 of the original 802 POI families who expressed interest in further involvement. Children and parent(s) will attend 2 clinics and 1 home appointment to obtain measures of anthropometry and body composition (dual-energy x-ray absorptiometry scan), 24-hour movement patterns (sleep, sedentary time, and physical activity measured using an AX3 accelerometer), mental health and wellbeing (validated questionnaires), family functioning (validated questionnaires), use of electronic media (wearable and stationary cameras, questionnaires), and diet and eating behaviors (24-hour recall, questionnaires). ResultsThis follow-up study has full ethical approval from the University of Otago Human Ethics Committee (H19/109) and was funded in May 2019 by the Health Research Council of New Zealand (grant 19/346). Data collection commenced in June 2020, and first results are expected to be submitted for publication in 2022. ConclusionsLong-term outcomes of early obesity intervention are rare. Despite the growing body of evidence linking insufficient sleep with an increased risk of obesity in children, interventions targeting improvements in sleep have been insufficiently explored. Our initial follow-up at 5 years of age suggested that an early sleep intervention may have long-term benefits for effective weight management in children. Further analysis in our now preteen population will provide much-needed evidence regarding the long-term effectiveness of sleep interventions in infancy as an obesity prevention approach. Trial RegistrationClinicalTrials.gov NCT00892983; https://tinyurl.com/y3xepvxf International Registered Report Identifier (IRRID)DERR1-10.2196/24968

BackgroundSarcopenia is the age-related loss of skeletal muscle mass and function and may exist in early middle age. Previous research in this area has focused on resistance training in older individuals; however, there is a lack of intervention trials in middle-aged adults with low relative appendicular lean soft tissue mass who may be at risk for sarcopenia in older age. ObjectiveThis randomized controlled trial aims to determine the effects of a high-intensity interval aerobic resistance training intervention on appendicular lean soft tissue mass in middle-aged adults with low relative appendicular lean soft tissue mass. MethodsWe will conduct a 40-week, single-blinded randomized controlled trial in 84 middle-aged adults with low appendicular lean soft tissue mass in the wider Dunedin area, New Zealand. We will randomly allocate participants to receive either a group-based, 20-week high-intensity interval aerobic resistance training intervention program or a single, 60-minute education session on current exercise recommendations. After the first 20 weeks, both groups will be given a 20-week home program. The study will assess primary and secondary outcome measures, including body composition (regional and whole-body lean soft tissue mass, fat mass, percentage body fat, measured by dual x-ray absorptiometry), blood biomarkers (cortisol, creatinine, C-reactive protein, lipid profile, hemoglobin), physical fitness (maximum oxygen consumption, blood pressure), physical activity (accelerometry), physical function (handgrip strength, sit-to-stand, gait speed, quadriceps strength), and self-reported questionnaires (health outcomes, self-efficacy, perceived enjoyment of physical activity, and multifactorial lifestyle), at baseline, 20 weeks, and 40 weeks. Physical function and self-reported questionnaires will also be measured at 10 weeks. We will assess the primary outcome measure, total body lean soft tissue mass, at baseline, 20 weeks, and 40 weeks. Analyses will be performed using intention-to-treat principles, comparing the outcomes resulting from the intervention, using linear mixed models. ResultsWe obtained ethical approval for this study from The University of Otago Human Ethics Committee on December 10, 2018. Participant recruitment started on February 11, 2019 and was completed on May 14, 2019. Data collection started on February 25, 2019 and was completed on February 28, 2020. We expect to publish the results in January 2021. ConclusionsHigh-intensity interval aerobic resistance training is a time-efficient form of exercise, enabling busy middle-aged adults to meet physical activity recommendations while maximizing training results. The findings can inform the development of future prevention-focused interventions aimed at counteracting the high prevalence of sarcopenia in the aging population. Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN12618001778279); https://tinyurl.com/y555z6fz. International Registered Report Identifier (IRRID)DERR1-10.2196/22989

Objective: The aim of this study was to determine which growth indicator (weight, weight‐for‐length, BMI) and time frame (6‐ or 12‐month intervals between 0 and 24 months) of rapid infant weight gain (RIWG) best predicted obesity risk and body composition at 11 years of age. Methods: RIWG (increase ≥0.67 z scores between two time points) was calculated from weight and length/height at birth, 0.5, 1, 1.5, and 2 years. The predictive value of each measure and time frame was calculated in relation to obesity (BMI ≥95th percentile) and body fat (fat mass index [FMI], dual‐energy X‐ray absorptiometry scan) at 11 years. Results: The sensitivity (1.5% to 62.1%) and positive predictive value (12.5% to 33.3%) of RIWG to predict obesity varied considerably. Having obesity at any time point appeared a stronger risk factor than any indicator of RIWG for obesity at 11 years. Obesity at any age during infancy consistently predicted a greater FMI of around 1.1 to 1.5 kg/m2 at 11 years, whereas differences for RIWG were inconsistent. Conclusions: A simple measure of obesity status at a single time point between 6 and 24 months of age appeared a stronger risk factor for later obesity and FMI than RIWG assessed by any indicator, over any time frame. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe how mild sleep deprivation in children changes time spent physically active and sedentary. Methods: In 2018 through 2020, children (n = 105) with normal sleep were randomized to go to bed 1 hour earlier (extension) or 1 hour later (restriction) than their usual bedtime for 1 week, each separated by a 1‐week washout. Twenty‐four‐hour movement behaviors were measured with waist‐worn actigraphy and expressed in minutes and proportions (percentages). Mixed‐effects regression models determined mean differences in time use (95% CI) between conditions. Time gained from sleep lost that was reallocated to other movement behaviors in the 24‐hour day was modeled using regression. Results: Children (n = 96) gained ~49 minutes of awake time when sleep was restricted compared with extended. This time was mostly reallocated to sedentary behavior (28 minutes; 95% CI: 19‐37), followed by physical activity (22 minutes; 95% CI: 14‐30). When time was expressed as a percentage, the overall composition of movement behavior remained similar across both sleep conditions. Conclusions: Children were not less physically active when mildly sleep deprived. Time gained from sleeping less was proportionally, rather than preferentially, reallocated to sedentary time and physical activity. These findings suggest that decreased physical activity seems unlikely to explain the association between short sleep and obesity in children. [ABSTRACT FROM AUTHOR]

The article presents results from New Zealand's 2018 Report Card on Physical Activity for Children and Youth. It mentions indicators on the basis of which grades are assigned including organized sport participation, active transportation, and sedentary behavior. The report card suggests that future initiatives should consider opportunities to build on the existing support systems and develop effective interventions to encourage PA, active transportation, and active play.