Paths towards a healthier BMI among short and adequate sleepers: A pathway network analysis considering movement behaviors in low‐income preschoolers

Abstract

IntroductionShort sleep duration has been seen as a predictor of higher body mass index (BMI) in youth. Sleep duration varies substantially along early childhood, and the paths towards a healthier BMI, considering the other movement behaviors (physical activity‐PA and screen time) are unexplored in preschoolers.AimTo construct a sleep‐BMI model to capture the direct and indirect paths to intervening towards a healthier BMI, according to low‐income preschoolers´ compliance with the other movement behaviors.MethodsTwo hundred and seventy two preschoolers (4.5 ± 0.0; 138 boys) participated in the study. Sleep and screen time (ST) were assessed in a face‐to‐face interview with primary caregivers. PA was assessed using accelerometer (wGT3X‐BT). Preschoolers were categorized as compliant or not with sleep, screen time, total and moderate to vigorous PA recommendations. BMIz‐score was calculated according to preschoolers´ sex and age. All the assessed variables, besides sex and age were included in a Network Pathway Analysis (NPA) according to age as nodes.ResultsAt 3 years old, a direct and negative path between sleep‐BMIz score was observed. At four and 5 years old, this relationship became positive. Further, girls were more compliant with sleep, ST and total PA recommendations. Total PA (TPA) showed the highest expected influence value in the general, 3 and 4 years old NPA.ConclusionThe NPA analysis showed different directions for the relationship between sleep and BMIz score, according to age. Intervention strategies to a healthier BMI among preschoolers compliant or not with sleep recommendations should focus in increasing TPA.