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Cited by 5Obesity, Physical Activity, DietSleep and related disordersSchool Health and Nursing Education

Impact of delaying high school start times on weight and related behaviors - the START study

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Widome, Rachel, Erickson, Darin J., Laska, Melissa N., Berger, Aaron T., Lenk, Kathleen M., Iber, Conrad, Kilian, Gudrun, Lammert, Sara +1 more·2023·Preventive Medicine
DOI 10.1016/j.ypmed.2023.107548PMC PMC10319406
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Abstract

In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016-2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50-65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors - for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.

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  • Preliminary findings show better dietary quality and more healthful weight behaviors of students attending delayed-start schools compared to their peers.

    “the preliminary findings show better dietary quality and more healthful weight behaviors of students attending delayed-start schools compared to their peers [68,105,106].”

    From Later School Start Times as a Public Health Intervention to Promote Sleep Health in Adolescents (2023) · cites this paper as [105]

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Authors
Widome, R., Erickson, D. J., Laska, M. N., Berger, A. T., Lenk, K. M., Iber, C., Kilian, G., Lammert, S., & Wahlstrom, K. L.
Affiliations
University of Minnesota (US)
Corresponding author
Widome, Rachel
ORCID
Venue
Preventive Medicine
Publisher
Elsevier BV
Published
2023-07
Volume
172
Pages
107548
ISSN
0091-7435 (ISSN-L)
DOI
10.1016/j.ypmed.2023.107548
PMC
PMC10319406
OpenAlex
W4376638492
Cited by
5
References
19
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1
FWCI
1.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Preventive Medicine (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD088176)
  • Minnesota Population Center, University of Minnesota (P2C HD041023)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
Keywords
school start time, adolescent sleep, body mass index, adolescent obesity, weight-related behaviors, breakfast consumption, family meals, physical activity, fast food consumption, vegetable consumption, school policy
MeSH terms
Adolescent, Humans, Schools, Sleep, Time Factors, Health Behavior, Body Mass Index

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