Blunted rest-activity rhythms link to higher body mass index and inflammatory markers in children

Abstract

Study objectives: Disturbances of rest-activity rhythms are associated with higher body mass index (BMI) in adults. Whether such relationship exists in children is unclear. We aimed to examine cross-sectional associations of rest-activity rhythm characteristics with BMI z-score and obesity-related inflammatory markers in school-age children.

Methods: Participants included 411 healthy children (mean ± SD age 10.1 ± 1.3 years, 50.8% girls) from a Mediterranean area of Spain who wore wrist accelerometers for 7 consecutive days. Metrics of rest-activity rhythm were derived using both parametric and nonparametric approaches. Obesity-related inflammatory markers were measured in saliva (n = 121).

Results: In a multivariable-adjusted model, higher BMI z-score is associated with less robust 24-h rest-activity rhythms as represented by lower relative amplitude (-0.16 [95% CI -0.29, -0.02] per SD, p = 0.02). The association between BMI z-score and relative amplitude persisted with additional adjustment for sleep duration, and attenuated after adjustment for daytime activity level. Less robust rest-activity rhythms were related to increased levels of several salivary pro-inflammatory markers, including C-reactive protein, which is inversely associated with relative amplitude (-32.6% [-47.8%, -12.9%] per SD), independently of BMI z-score, sleep duration, and daytime activity level.

Conclusion: Blunted rest-activity rhythms are associated with higher BMI z-score and salivary pro-inflammatory markers already at an early age. The association with BMI z-score seem to be independent of sleep duration, and those with pro-inflammatory markers further independent of BMI z-score and daytime activity. Novel intervention targets at an early age based on improving the strength of rest-activity rhythms may help to prevent childhood obesity and related inflammation.

Clinical trials registration: NCT02895282.

Keywords: activity rhythm; body mass index; inflammation; rest; school-aged children.