Identification of lifestyle patterns, including sleep deprivation, associated with insulin resistance in children: the Healthy Growth Study

BACKGROUND/OBJECTIVES: Although diet, physical activity (PA), sedentary behavior and sleep deprivation are factors that have been individually associated with insulin resistance (IR) in childhood, the combined effect of these lifestyle behaviors has not been examined yet. The current study aimed to examine the association of lifestyle patterns with IR, combining all these indices, in children. SUBJECTS/METHODS: Socio-economic, demographic, anthropometric (body weight, height and waist circumference), biochemical (plasma glucose and serum insulin), clinical (pubertal stage) and lifestyle (dietary intake, PA level and sleeping habits) data were collected from a representative sample of 2026 children (50.1% girls) aged 9-13 years in Greece. Homeostasis model assessment (HOMA-IR) was calculated, and principal component analysis was used to identify lifestyle patterns, combining all these lifestyle indices. RESULTS: In multivariable regression analyses, the lifestyle pattern characterized by more screen time, shorter sleep duration and higher consumption of sugared beverages was positively associated with HOMA-IR (beta = 0.043; P = 0.040), whereas the pattern characterized by more time spent on moderate-to-vigorous PA (MVPA) and more frequent eating occasions was inversely associated with HOMA-IR (beta = - 0.061; P = 0.003). In logistic regression analyses, children with 72.2 min/day of MVPA and 5.05 eating occasions/day and children with 141.8 min/day of MVPA and 5.22 eating occasions/day were less likely of being insulin resistant based on HOMA-IR, compared with children with 20.0 min/day of MVPA and 4.09 eating occasions/day. CONCLUSIONS: A lifestyle pattern of >72 min of MVPA and 5 eating occasions/day was associated with reduced likelihood of IR in children.