The association of actigraphic sleep measures and physical activity with excess weight and adiposity in kindergarteners.

Insufficient sleep duration and physical activity (PA) are known risk factors for overweight and obesity in children; however, there are no studies on comprehensive associations of objectively-measured sleep parameters and PA with excess weight and excess adiposity in kindergarteners. Therefore, the aim of this study was to determine the associations between objectively measured sleep parameters and PA with excess weight and excess adiposity, defined as BMI ≥ 85th percentile and body fat percentage (BFP) ≥ 85th percentile, respectively. Sleep parameters and PA were measured in 676 subjects aged 5-6 years using accelerometers for 7 days, worn at the participant's hip. Bioelectrical impedance analysis was used to estimate BFP. In the total sample, lower sleep duration, sleep efficiency, vigorous PA and the number of steps per day were associated with excess weight. However, excess adiposity was associated with lower sleep duration, total PA, vigorous PA, moderate-to-vigorous physical activity (MVPA) and the number of steps per day. Logistic regression by the stepwise progressive method showed that the strongest predictor of excess adiposity in boys and girls was vigorous PA, while the strongest predictor of excess weight in boys was sleep efficiency. A holistic approach to health targeting all of these factors synergistically is needed to optimize the effectiveness of obesity prevention and treatment interventions.