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Licensed Unlicensed Requires Authentication Published by De Gruyter November 16, 2020

Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth

Ana P. Sehn, Anelise R. Gaya, Caroline Brand, Arieli F. Dias, Roya Kelishadi, Silvia I. R. Franke, Jane D. P. Renner and Cézane P. Reuter



The combination of sleep duration, television (TV) time and body mass index (BMI) may be related to the alteration of cardiometabolic risk. However, there are few studies that use these variables grouped, and showing the moderating role of age. This study aimed to verify if the combination of sleep duration, TV time and BMI is associated with cardiometabolic risk and the moderating role of age in this relationship in youth.


Cross-sectional study conducted with 1411 adolescents (611 male), aged 10–17 years. Sleep duration, TV time and BMI were assessed and grouped into eight categories. Cardiometabolic risk was assessed by a continuous metabolic risk score, including the following variables: low HDL-cholesterol, elevated triglycerides, dysglycemia, high systolic blood pressure, high waist circumference and low cardiorespiratory fitness. Generalized linear models were used to test moderation of age in the relationship between the eight categories of sleep duration/television time/BMI with cardiometabolic risk.


Cardiometabolic risk factor showed association with all overweight or obesity independent of sleep time and TV time. Age moderated the relationship between sleep duration/television time/BMI with cardiometabolic risk. This association was stronger in younger adolescents (11 and 13 years), indicating that individuals with inadequate sleep, prolonged TV time and overweight/obesity present higher cardiometabolic risk values when compared to 15-year-old adolescents.


Overweight/obesity, independently of sleep duration and TV time, is the main risk factor for cardiometabolic disorders in adolescence. When moderated by age, younger adolescents that presented the combination of risk factors had higher cardiometabolic risk.

Corresponding author: Dra. Cézane Priscila Reuter, Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Av. Independência, 2293 - Universitário, 96815-900, Santa Cruz do Sul, RS, Brazil, Phone: +055 (51) 3717 7300, E-mail:

Funding source: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior


We thank the collaboration of the schools, our research group from Health Research Laboratory (LAPES), Professor Miria Suzana Burgos (in memoriam), who contributed to this study and for all her dedication to the research “Schoolchildren’s health”, as well as all the support of the University of Santa Cruz do Sul – UNISC and Higher Education Personnel Improvement Coordination - Brazil (CAPES).

  1. Research funding: This work was carried out with the support of the Higher Education Personnel Improvement Coordination - Brazil (CAPES) - Financing Code 001.

  2. Authors contributions: APS, CPR, JDPR participated in data organization and designed the study. APS, ARG, AFD, CB, JDPR and CPR performed the statistical analysis. All the authors contributed to the elaboration of the manuscript with critical comments about it.

  3. Competing interests: The authors declare no conflict of interest.

  4. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. In addition, this study has been conducted in accordance with Resolution 466/2012 of the National Council of Health in Brazil. Informed consent was obtained from all individual participants included in the study. The study was approved by the Research Ethics Committee of the University of Santa Cruz do Sul (UNISC) under Opinion No. 2936223.


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Supplementary Material

The online version of this article offers supplementary material (

Received: 2020-07-03
Accepted: 2020-10-16
Published Online: 2020-11-16
Published in Print: 2021-01-27

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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