This study aimed to compare sedentary time (SED) and intensity‐specific physical activity (PA) estimates and the associations of SED and PA with body mass index (BMI) and waist circumference (WC) using three different sets of cut‐points in preschool‐aged children. A total of 751 children (4.7 ± 0.9 years, boys 52.7%) wore an ActiGraph GT3X+BT accelerometer on their hip for 7 days (24 h). Euclidean norm −1 G with negative values rounded to zero (ENMO) and activity counts from vertical axis (VACounts) and vector magnitude (VMCounts) were derived. Estimates of SED and light, moderate, vigorous, and moderate‐to‐vigorous PA (MVPA) were calculated for commonly used cut‐points by Hildebrand et al., Butte et al., and Evenson et al. Furthermore, the prevalence of meeting the PA recommendation, 180 min/day of which at least 60 min/day being MVPA, were assessed for the cut‐points. Multilevel mixed analysis was used to examine associations of SED and PA with BMI and WC. In accordance with the results, SED and PA intensity estimates differed largely across cut‐points (i.e., SED = 22–341 min/day; light PA = 52–257 min/day; moderate PA = 5–18 min/day; vigorous PA = 7–17 min/day; MVPA = 13–35 min/day), and the prevalence of children meeting the PA recommendation varied from 4% to 70%. Associations of SED and PA with BMI or WC varied between the cut‐points. Our results indicate that SED and PA estimates in preschool‐aged children between studies using these cut‐points are poorly comparable. Methods facilitating accelerometer‐derived PA estimate comparison between studies are highly warranted.

Summary: This study compared weekday and weekend actigraphy‐measured and parent‐reported sleep in relation to weight status among preschool‐aged children. Participants were 3–6 years old preschoolers from the cross‐sectional DAGIS‐study with sleep data for ≥2 weekday and ≥2 weekend nights. Parents‐reported sleep onset and wake‐up times were gathered alongside 24 h hip‐worn actigraphy. An unsupervised Hidden‐Markov Model algorithm provided actigraphy‐measured night time sleep without the guidance of reported sleep times. Waist‐to‐height ratio and age‐and‐sex‐specific body mass index characterised weight status. Comparison of methods were assessed with consistency in quintile divisions and Spearman correlations. Associations between sleep and weight status were assessed with adjusted regression models. Participants included 638 children (49% girls) with a mean ± SD age of 4.76 ± 0.89. On weekdays, 98%–99% of actigraphy‐measured and parent‐reported sleep estimates were classified in the same or adjacent quintile and were strongly correlated (r_s = 0.79–0.85, p < 0.001). On weekends, 84%–98% of actigraphy‐measured and parent‐reported sleep estimates were respectively classified and correlations were moderate to strong (r_s = 0.62–0.86, p < 0.001). Compared with actigraphy‐measured sleep, parent‐reported sleep had consistently earlier onset, later wake‐up, and greater duration. Earlier actigraphy‐measured weekday sleep onset and midpoint were associated with a higher body mass index (respective β‐estimates: −0.63, p < 0.01 and −0.75, p < 0.01) and waist‐to‐height ratio (−0.004, p = 0.03 and −0.01, p = 0.02). Though the sleep estimation methods were consistent and correlated, actigraphy measures should be favoured as they are more objective and sensitive to identifying associations between sleep timing and weight status compared with parent reports.

Objective: As a pilot trial under the Games of Food consortium, this study assessed the effectiveness of an educational escape game alongside a self-study method as a nutrition knowledge intervention. Furthermore, this study explored the use of an escape game as an educational tool for young adolescents.Materials and Methods: Altogether three schools participated, one from Finland and two from the UK. Baseline questionnaires assessing knowledge were administered before intervention day. Participants from each class were randomly allocated by the researchers into either the escape game condition, where participants played a nutrition education escape game with a focus on plant-based protein sources, or the self-study condition, where participants received an educational leaflet with identical content. In addition to the knowledge post-assessment, the educational escape game condition answered an enjoyment and intrinsic motivation questionnaire to evaluate the game experience. Paired t-tests were used to determine significant changes within intervention conditions and ANCOVA was used to estimate the differences in knowledge.Results: The participants were 130 children (11–14 years), divided into educational escape game (n = 68) and self-study (n = 62) conditions. Both the educational escape game (20.7 vs. 23, p < 0.001) and self-study (21.1 vs. 23.1, p = 0.002) had improved overall knowledge scores. No significant differences in gained knowledge existed between groups. Of the educational escape game participants, 60% reported the game as mostly enjoyable and 46% reported added use and value for learning.Conclusion: The educational escape game condition was comparable to the self-study method for nutrition education in adolescents. However, since the educational escape game provides an enjoyable experience that may enhance intrinsic motivation to promote learning and possible behavior change, the use of escape games for nutrition education warrant further investigation.

Nature visits and nature exposure have been shown to be favorably associated with children’s health and development, but the research regarding their associations with children’s lifestyle habits is limited. The current study aimed to investigate the associations between the frequency of parent–child nature visits and sleep, moderate-to-vigorous physical activity (MVPA) and weight status among three- to six-year-old Finnish preschoolers. Parents and their children (n = 864) participated in a cross-sectional DAGIS (increased health and wellbeing in preschools) study, which was conducted between 2015 and 2016 in Finland. In total, 798 parents answered a questionnaire on the frequency of parent–child nature visits, which also included questions on sociodemographic factors and their children’s sleep habits. Parents also reported children’s bedtimes and wake-up times and children wore an accelerometer for seven days. Trained researchers measured children’s weight and height. Linear and logistic regression analyses were conducted. More frequent parent–child nature visits were associated with children’s longer sleep duration at night, higher amounts of MVPA outside preschool time and, among girls, good sleep consistency. The frequency of parent–child nature visits was not significantly associated with whether children were overweight or obese or not. Promoting parent–child nature visits could be a cost-effective way to increase young children’s MVPA and enhance night-time sleep.

Evidence suggests that adolescents and adults with a later chronotype have poorer sleep habits and are more susceptible to unhealthy behaviors, but, little is known about these associations in younger children. The objective of the study was to 1) identify and compare individual chronotype tendencies among preschool-aged children and 2) investigate associations of sleep dimensions and chronotype with diet. Participants were 636 3–6-years-old (mean±sd age: 4.74±0.89 years, 49%girls) preschoolers from the cross-sectional DAGIS study in Finland. Sleep duration, sleep variability (in duration and midpoint), social jetlag, and midsleep on weekends adjusted for sleep debt (MSWEadj) was measured with 7-day actigraphy. Morning, intermediate, and evening chronotype tendencies were defined based on the lowest and highest 10^th percentile cutoffs of MSWEadj. Food, energy, and macronutrient intake were assessed from 3-day records. Associations between sleep dimensions and diet were assessed with regression models. MSWEadj was 1:13±14min for morning (n=64), 2:25±28min for intermediate (n=560) and 3:38±15min for evening (n=64) chronotype tendency. Children with an evening chronotype tendency had greater social jetlag and sleep variability. Having an evening chronotype tendency was associated with higher added sugar, higher sugary food consumption, and lower vegetable consumption compared to intermediate tendency types. A later chronotype (MSWEadj) was associated with higher sugary food consumption, as well as lower vegetable and fiber intake. Sleep duration, social jetlag, and sleep variability were not associated with diet. Several less healthy sleep and diet behaviors were observed among children with later chronotypes. Future public health interventions aimed towards children would benefit from taking into account chronotype.

Background/Objectives: Circadian health plays an important role in overall well-being. The objective of this study was to examine whether potential indicators of circadian disruption, such as exhibiting a later chronotype or greater social jetlag, in preschool-age could predict dietary habits or BMI z-scores in an eight-year follow-up. Subjects/Methods: Our data included 210 children who participated in the DAGIS Survey in 2015–2016 (baseline, mean [SD] age: 4.69 [0.89] years) and DAGIS Next in 2023 (follow-up, age: 12.03 [0.90] years). Chronotype and social jetlag were calculated from baseline sleep measures assessed from 7-day actigraphy. Diet was assessed at follow-up with a Food Frequency Questionnaire, which evaluated the weekly consumption frequency of (1) fruits and vegetables and (2) sugary foods and drinks. BMI z-score based on Finnish growth references was calculated from height and weight measures from baseline and follow-up. Associations were analyzed with linear regression models. Results: Follow-up BMI z-score was predicted by both preschool-aged chronotype (β-est: 0.22 [95% CI: 0.01, 0.42] p = 0.03) and social jetlag (β-est: 0.33 [95% CI: 0.02, 0.65], p = 0.04) after covariate adjustment. No associations were observed between preschool-aged chronotype or social jetlag and preadolescent fruit and vegetable or sugary food and drink consumption. Conclusions: Having a later chronotype and greater social jetlag during preschool age predicted a higher preadolescent weight outcome. Obesity prevention initiatives should include efforts to reduce the risk of circadian disruption among young children, by accounting for chronotype and aiming to reduce social jetlag in interventions.