Lack of Sleep Increases Obesity and Body Fat in Children

Pediatrics has published a large study linking reduced sleep and childhood obesity.  The children who consistently received less than the recommended hours of sleep during infancy and early childhood had increases in both obesity and in adiposity or overall body fat at age 7.

Insufficient sleep was defined as less than 12 hours per day from ages 6 months to 2 years, less than 10 hours per day for ages 3 and 4, and less than 9 hours per day from age 5 to 7.

The results of the study indicated the following:

1. children with the lowest sleep scores had the highest levels of all body measurements for obesity and adiposity, including abdominal fat which is considered to be particularly hazardous.


2. association was consistent at all ages, indicting there was no critical period for the interaction between sleep and weight.

The researchers recommend that parents and children should be educated on good sleep habits.

Reference:  Medical Express.  Chronic insufficient sleep increases obesity, overall body fat in children. Retrieved from the web on 5/21/14 at http://medicalxpress.com/news/2014-05-chronic-insufficient-obesity-body-fat.html#nwlt.

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Autism Sleeps™ serves as a thorough resource of sleep sensory strategies and suggestions for preparing the “sleep environment”. Sample bedtime and wake-up routines are provided as templates, especially to guide parents of children with sleep difficulties.

Find out more at http://yourtherapysource.com/autismsleeps.html

Factors in the Home that Reduce Childhood Obesity

JAMA Pediatrics published research on in home interventions to reduce childhood obesity.  The children in the intervention group participated in a program called "Healthy Home Healthy Habits".  The parents were not told that it was to reduce the risk of the children becoming overweight. 

The interventions consisted of encouraging:

• regular family meals together
• adequate sleep for children
• limiting the time children spend watching television
• removing television from rooms where children sleep
• parenting practices such as role modeling and limit setting. 

At the end of 6 months, the results showed that the children in the intervention group were:

• sleeping 45 minutes more per night
• television watching dropped about an hour per day on the weekends (non intervention group increased tv viewing on the weekend)
• no change in family meals together
• overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. 

Reference: Haines J, McDonald J, O’Brien A, et al. Healthy Habits, Happy Homes: Randomized Trial to Improve Household Routines for Obesity Prevention Among Preschool-Aged Children. JAMA Pediatr. 2013;():-. doi:10.1001/jamapediatrics.2013.2356.  

Just 7 Minutes a Day...

Recent research published in the Archives of Pediatrics and Adolescent Medicine looked at the physical activity levels of 600 Canadian children ages 9-17.  The research indicated that children needed at least 7 minutes per day of vigorous physical activity to prevent weight gain and obesity.

The data indicated that the children spent 70% of their time doing sedentary activities, nearly 23% was light physical activity, almost 7% was moderate physical activity and 0.6% was vigorous physical activity. The more vigorous the physical activity was the less likely children were overweight.

The researchers also determined that the expected health benefits of mild to moderate physical activity were not observed. The key component was participating in vigorous physical activity.

Reference: Jacqueline Hay. Physical Activity Intensity and Cardiometabolic Risk in YouthPA Intensity and Cardiometabolic Risk in Youth. Archives of Pediatrics & Adolescent Medicine, 2012; : 1 DOI: 10.1001/archpediatrics.2012.1028  

Weight and Gross Motor Skills

Pediatric Physical Therapy published research on weight and gross motor skill development in young children.  Body mass index and gross motor skill level was determined for 4650 kindergarteners.  The results indicated that children with obesity exhibited decreased motor skills compared to their peers especially with respect to locomotor and balance skills.

Reference: Roberts, Dawn; Veneri, Diana; Decker, Robert; Gannotti, Mary. Weight Status and Gross Motor Skill in Kindergarten Children. Pediatric Physical Therapy. 24(4):353-360, Winter 2012. doi: 10.1097/PEP.0b013e3182680f19

BMI and Gross Motor Skills

Pediatric Physical Therapy published research on the relationship between body mass index (BMI) and gross motor skill level in children. Fifty typically developing 3-5 year old children were evaluated with the Peabody Developmental Motor Scales. Of those 50 children, 24% were overweight/obese with 54% scoring below average on the PDMS in that group. Whereas only 15% of the non overweight group scored below average on the PDMS. The researchers concluded that 3-5 year old children with a high BMI may have difficulties with gross motor skills. More research was recommended.

Reference: Nervik, Deborah PT, MHS, DPT, DHS, PCS; Martin, Kathy PT, DHS; Rundquist, Peter PT, PhD; Cleland, Joshua PT, PhD The Relationship Between Body Mass Index and Gross Motor Development in Children Aged 3 to 5 Years. Pediatric Physical Therapy:
Summer 2011 - Volume 23 - Issue 2 - p 144–148 doi: 10.1097/PEP.0b013e318218d356

Obesity, Gait Patterns and Vision

Gait and Posture published research comparing the walking patterns of normal weight children versus obese children. Gait analysis was performed on 32 children in light and dark conditions. Both groups of children exhibited changes in their walking patterns in the dark conditions. Although in the dark conditions, the obese group spent more time in the stance phase of walking. With the removal of vision, the obese children's gait patterns were affected more than their normal weight peers. The results indicated that obese children rely more on their vision to control walking.

Reference: Eva D’Hondt et al. The role of vision in obese and normal-weight children's gait control Gait & Posture Volume 33, Issue 2, February 2011, Pages 179-184

Reading Changes Body Mass Index in Girls

This study in Pediatrics is very creative and intriguing. Thirty one of 81 girls, ages 9-13, were randomly assigned to read an intervention novel which was a story about an overweight girl who discovers improved health and self worth. Thirty three girls read a control novel and 17 girls read no novel. Follow up occurred 1-2 months later with the girls who read the intervention novel showing a significant greater reduction in body mass index (BMI) compared to the control group. Girls in both the intervention and control group had a significantly lower BMI change than the girls who read no book. The authors concluded that more research is needed to see if this would help other overweight and obese girls.

I equate this to being similar to a more mature social story combined with positive affirmations. Seems like a great, simple way to empower girls to change their lifestyle habits independently.

Reference: Bravender, Terrill, Russell, Alexandra, Chung, Richard J., Armstrong, Sarah C. A "Novel" Intervention: A Pilot Study of Children's Literature and Healthy Lifestyles Pediatrics 2010 125: e513-e517

Higher Academic Scores for Physically Fit Children

The New York City Department of Health recently reviewed academic and fitness records of public school children in Grades K-8. This records review revealed the following:
1. More than 20% of the students were obese and 18% are overweight totaling 38% of all students.
2. Boys were more likely to be obese than girls (except among black students).
Twenty nine percent of Hispanic boys were obese.
3. The overweight and obese children were less physically fit.
4. Students who were more physically fit had higher academic test scores.
5. Academic test scores increase consistently with increasing fitness levels for all students.

The Department of Health recommends that parents, schools and health care providers should help all children be fit through daily physical activity. In addition, adults should help children develop healthy eating habits.

Here are some suggested activity books from Your Therapy Source, Inc. to encourage daily physical activity in children:
50 Sensory Motor Activities for Kids!
Mini Movement Breaks
Motor Magic Sensory Motor Group Activities A to Z
Sidewalk Chalk Fun and Games

Reference: Egger JR, Bartley KF, Benson L, Bellino D, Kerker B. Childhood Obesity is a Serious Concern in New York City: Higher Levels of Fitness Associated with Better Academic Performance. NYC Vital Signs 2009, 8(1): 1-4.

Musculoskeletal Problems in Obese Children

Annals of Family Medicine published research on self reported musculoskeletal problems in obese and overweight children. They studied 2459 children ages 2-11 years old of which 4.1% were overweight or obese. The overweight and obese children self reported significantly more musculoskeletal problems than normal weight peers. The musculoskeletal problems included back/neck pain and lower extremity pain (ankle/foot problems more than hip/knee problems). There was no difference between the two groups for reports of upper extremity musculoskeletal pain. In addition, children who were 12 years and older consulted a physician more often than normal weight peers for musculoskeletal problems.

Reference: Krul, Marjolein, van der Wouden, Johannes C., Schellevis, Francois G., van Suijlekom-Smit, Lisette W. A., Koes, Bart W. Musculoskeletal Problems in Overweight and Obese Children Ann Fam Med 2009 7: 352-356

Get children moving with sensory motor activities from Your Therapy Source Inc.

Obesity and Motor Skills

Here is another interesting topic to me. Just read some research from 2008 Neuroscience Letters indicating that obese and overweight children had decreased fine motor control when compared to normal weight peers. Fine motor skills were decreased more when postural challenges were present (standing on balance beam while doing peg activity.

In addition, Adapted Physical Activity Quarterly reports on recent research that concluded obese children scored significantly less than overweight or normal peers on the MABC in ball skills, balance and manual dexterity.

Pondering today if therapists consider this when evaluating overweight and obese children. If using standardized testing to determine eligibility, should it be taken into account that it may be "normal" for overweight children to score below age level? If motor skill deficits are noted along with decreased muscle strength, functional deficits, sensory issues and more how much motor skill gains can we expect if the obesity is not addressed simultaneously?


Reference: Eva D'Hondt, Benedicte Deforche, Ilse De Bourdeaudhuij, Matthieu Lenoir Relationship Between Motor Skill and Body Mass Index in 5- to 10-Year-Old Children
APAQ, 26(1), January 2009

Reference: Eva D’Hondt, Benedicte Deforchea, Ilse De Bourdeaudhuija and Matthieu Lenoira (2008) Childhood obesity affects fine motor skill performance under different postural constraints Neuroscience Letters
Volume 440, Issue 1, 25 July 2008, Pages 72-75