Sleep Duration, Sedentary Behaviors, and Physical Activity across Weight Status in Hispanic Toddlers’ Participants of the WIC Program

Abstract

Objective: To describe physical activity, sedentary behaviors and sleep duration in toddlers' participants of the WIC program in Puerto Rico and assess its association with excessive weight.Methods: This was a cross-sectional analysis of data gathered in the follow-up visit (12 months later) of a longitudinal study among toddlers 12-36 months old participants of the WIC program. In this follow-up visit, a Sleep, Sedentary Behaviors and Physical Activity Questionnaire was included.Results: From the 213 eligible participants for the follow-up visit, 76 completed the follow-up visit. Most were girls (52.6%), with median age 21 months and most were categorized as healthy weight (76.3%). In general, toddlers spent a total median of 142 min/d in sedentary behaviors, 300 min/d in physical activities and 690 min/d sleeping. There was a higher duration of physical activities among overweight/obese compared to healthy weights (p<0.05) but similar duration of sedentary behaviors and sleep by weight status (p>0.05). There was a greater proportion of overweight/obese toddlers meeting the screen time recommendation (88.9%) compared to healthy weight toddlers (62.1%; p<0.05). Also, there was a significant positive age-adjusted correlation between time spent in unstructured physical activity (R=0.23, p<0.05) with weightfor-length z-score. Infant weight status was not significantly correlated to parent's perception or knowledge of physical activity or sleep in toddlers (p>0.05). Conclusion:Most toddlers studied met the recommendations for duration of sleep, sedentary behaviors, and physical activity. Overweight/obese toddlers engage in more physical activities than those with a healthy weight status. These findings could be due to educational interventions by the WIC program to promote physical activities, as these toddlers are active WIC participants.

Intervention to promote physical activation and improve sleep and response feeding in infants for preventing obesity early in life, the baby-act trial: Rationale and design

“…Although the current WIC curriculum has improved breastfeeding practices among their participants (31% breastfeeding in 2015), only 13% were exclusively breastfed [19]. In our studies among WIC infants and toddlers in Puerto Rico, we have shown low breastfeeding rates, early introduction of complementary foods and juices, low diet quality (particularly after 12 months of age), low compliance to sleep and physical activity and other non-healthy feeding practices [5,20,21]. Therefore, this program needs complementary approaches using technology to continue improving feeding practices as well as including other components that have been shown to be important for preventing obesity.…”

“…We are also assessing the estimated time the infant spends in physical activities, sedentary behaviors and sleep using questionnaires; this is our secondary assessment of the infant activation. For this, we are using a questionnaire developed by our group and successfully implemented during the follow-up phase of a cohort study in 77 infants, 12 to 36 months of age in PR WIC [21].This instrument includes questions related to the time and frequency the infant spends sleeping, in sedentary behaviors, and in physical activities. In addition, we have incorporated the Brief Infant Sleep Questionnaire (BISQ) to this assessment so that this aspect of the study is comparable to the Environmental Influences on Child Health Outcomes (ECHO)-wide cohorts.…”