Television viewing, reading, physical activity and brain development among young South Korean children

Vulnerabilities Prompting Use of Technology and Screen by Mothers of Autistic Children in India: Lived Experiences and Comparison to Scientific Literature

Technology and screen media has its place in every home, yet the influences of the same are less known. This research aims to explore the vulnerabilities that prompt the mothers to use screen media for their children, prior to a diagnosis of autism for their child. It also aims to explore literature the influence of screen media on speech and language development in children. This study combined semi-structured interviews with 16 mothers of autistic children in Southern India and a scoping literature review that resulted in 24 articles. The literature refers to a positive influence when co-viewing with the child, and it predominantly highlights improvements in speech and not in language. The interviews revealed that screens were used as a means of support, a language and learning development tool, or as a calming technique. Thus, the study shows that the mothers resorted to screen use for their children more out of helplessness, and not as an informed choice. Mothers of autistic children clearly express their vulnerabilities and indicate feelings of being lost without advice, with regard to use of screen-time. This suggests a need for more research into how they can be supported.

Reducing harm and promoting positive media use strategies: new perspectives in understanding the impact of preschooler media use on health and development

Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent's own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.

Primary Care Counseling of Parents Regarding Childhood Screen Media Use

Parental beliefs and motivation are instrumental in improving childhood digital media use (DMU). Parents (n = 611) completed questionnaires about childhood DMU assessing knowledge, interest in counseling, motivation to change, self-efficacy, and beliefs. Less than a third correctly recognized screen time limits. Twenty-seven percent received childhood DMU information from a doctor, while 46% stated they would like such information. Only 2% had a doctor-recommended DMU plan. Interest in DMU topics, motivation to improve, and management self-efficacy were moderate. Top negative beliefs were addiction to DMU (52%), sleep problems (39%), obesity (33%), social skills (33%), and inappropriate content (32%). Differences between age categories existed for social (48%, P = .01) and language (14%, P = .01) concerns (highest for toddlers), attention concerns (27%, P = .02; highest in preschoolers), and depression (13%, P < .001) and low self-esteem (8%, P = .04; highest in teens). Findings support further development of approaches to address DMU, tailored by age-specific common parental views.

Is vitamin D deficiency influenced by obesity during the first 5 years of life? A cross-sectional multicenter study

Evidence on the association of 25-hydroxyvitamin D (25[OH]D) and obesity during the first 5 years of life is limited in China. The objective of this study was to examine the associations between weight, weight for age z score (ZWAZ), weight for length/height z score (ZWHZ), and body mass index for age z score (ZBMI) and 25(OH)D. This was a large population-based cross-sectional multicenter study in which the children aged 0-5 years were recruited from 12 children's healthcare centers by a stratified cluster random-sampling method in 10 cities of the Jiangsu province, China. The 25(OH)D concentration was determined by ELISA. A total of 5289 children were investigated. For 0-71 months children with obesity and nonobesity, the prevalence of vitamin D deficiency was 36.0% and 29.8%, and the 25(OH)D level was 59.8 and 64.0 nmol/L, respectively, and there were all significant difference. Compared with children with nonobesity, children with obesity had higher risk of vitamin D deficiency (OR [95% CI]: 1.33 [1.02, 1.72], p < .05), and had lower 25(OH)D level (β = -3.84, 95% CI = -7.58, -0.09, p < .05). The results for children aged 24-71 months were similar to those for children aged 0-71 months. However, no significant difference was observed in children aged 0-23 months. Vitamin D deficiency was observed in children with greater adiposity during the first 5 years of life. However, the results mainly came from those in the age group of 2 to 5 years instead of the first 2 years in their lives.

Home- and Community-Based Interventions for Physical Activity and Early Child Development: A Systematic Review of Effective Strategies

This systematic review examined the effects of home/family and community-based interventions on physical activity (PA) and developmental outcomes in early childhood. A search strategy was employed using four electronic databases (Academic Search Complete, CINAHL Complete, MEDLINE, and SPORTDiscus). Interventions investigating weight status (i.e., BMI), physical activity, sedentary behavior, and/or motor proficiency that took place in home, family, or community settings were assessed. Studies were eligible if they were peer-reviewed, available in English, published between 2011 and 2021, and if samples consisted of healthy young children (2-5 years old). There were 24 studies retained (8351 participants) spanning from the United States (n = 12), Australia (n = 3), Canada (n = 2), Switzerland (n = 2), Finland (n = 2), Netherlands (n = 1), and other Eastern European countries (n = 2). There were 19 studies that incorporated home/family-based approaches and 14 studies that incorporated community-based approaches. Studies ranged in intervention duration from 6 weeks to 24 months. It suggests that improving PA participation in young children was especially challenging to solicit improvement (only 25% of all studies found significant improvement in PA after intervention). Distributing educational material to parents/families, consistent, direct contact with parents, and encouraging community engagement were identified as effective strategies to promote physical activity, healthy weight status, and motor skills in young children.

Global Prevalence of Meeting Screen Time Guidelines Among Children 5 Years and Younger: A Systematic Review and Meta-analysis

IMPORTANCE

Pediatric guidelines suggest that infants younger than 2 years avoid screen time altogether, while children aged 2 to 5 years receive no more than 1 hour per day. Although these guidelines have been adopted around the world, substantial variability exists in adherence to the guidelines, and precise estimates are needed to inform public health and policy initiatives.

OBJECTIVE

To derive the pooled prevalence via meta-analytic methods of children younger than 2 years and children aged 2 to 5 years who are meeting guidelines about screen time.

DATA SOURCES

Searches were conducted in MEDLINE, PsycINFO, and Embase up to March 2020.

STUDY SELECTION

Studies were included if participants were 5 years and younger and the prevalence of meeting (or exceeding) screen time guidelines was reported.

DATA EXTRACTION AND SYNTHESIS

Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive the mean prevalence rates.

MAIN OUTCOMES AND MEASURES

Prevalence of meeting screen time guidelines.

RESULTS

From 63 studies, 95 nonoverlapping samples with a total of 89 163 participants were included. For children younger than 2 years, the pooled prevalence of meeting the screen time guideline (0 h/d) was 24.7% (95% CI, 19.0%-31.5%). Moderator analyses revealed that prevalence of meeting screen time guidelines varied as a function of year of data collection (increased over time), measurement method (higher when questionnaires compared with interview), and type of device use (higher when a combination of screen use activities compared with television/movies only). For children aged 2 to 5 years, the mean prevalence of meeting the screen time guideline (1 h/d) was 35.6% (95% CI, 30.6%-40.9%). Moderator analyses revealed that the prevalence of meeting screen time guidelines varied as a function of type of device use (higher when screen time was television/movies only compared with a combination of screen use activities).

CONCLUSIONS AND RELEVANCE

The findings of this meta-analysis indicate that only a minority of children 5 years and younger are meeting screen time guidelines. This highlights the need to provide support and resources to families to best fit evidence-based recommendations into their lives.

The Short-Term Impact of Animation on the Executive Function of Children Aged 4 to 7

Research has shown that animation plays an important role in the development of children's executive function (EF), and the development of EF components, inhibitory control, working memory, and cognitive flexibility, is asynchronous. Thus, this study explores the developmental trajectories and animation features (fantasy and pacing) that influence each EF component, by examining 218 children aged 4-7. Pretest information, mainly the childhood EF inventory, was provided by parents: child's age, age of first exposure to animation, animation viewing time on weekdays and weekends, family income, and parents' education. The children in each age group were randomly divided into four groups to watch animations comprised of different animation features. After watching, their EF were measured by a day-night task, backward digit-span task, and flexible item-selection task. The results showed that the children's inhibitory control, working memory and cognitive flexibility levels all improved with age. Highly fantastical animations weakened children's performance on each subsequent EF task. Pacing had no effect on any of the components of children's EF. An interactive effect on inhibitory control was only found with fantasy in younger children; specifically, high-fantastical animations had a more pronounced short-lived weakening effect on inhibitory control in younger children (4-6 years) compared with low-fantastical animations. Future research should explore the long-term impact of content rather than the form of animation on younger children's EF.

Physical Activity, Fitness, School Readiness, and Cognition in Early Childhood: A Systematic Review

BACKGROUND

Early childhood is an important age for brain and cognitive development. Given the support of physical activity and fitness on cognition and academic performance in older children, more research has emerged recently focusing on younger children. In this systematic review, the authors review the relations between physical activity/fitness and academic-related (ie, school readiness and cognitive) outcomes in early childhood.

METHODS

A search was conducted from PubMed, PsycINFO, Web of Science, ERIC databases, and reference lists for articles that had participants aged less than 6 years were written in English, and were in peer-reviewed journals. Articles were excluded if the design was a case study or case series report. The Grading Recommendations Assessment, Development and Evaluation framework was followed to assess the quality of evidence by study design.

RESULTS

Sixty-eight articles reporting on 72 studies (29 observational and 43 experimental) were included. The majority of study effects were mixed, and the quality of evidence varied from very low to low.

CONCLUSIONS

A clear consensus about the role of physical activity and fitness on academic-related outcomes in early childhood is still lacking given the high heterogeneity in methodological approaches and overall effects. Additional high-quality studies are needed to determine what specific dosages of physical activity are impactful at this age.

Measurement of screen time among young children aged 0-6 years: A systematic review

The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.

Levels and correlates of physical activity and screen time among early years children (2-5 years): Cross-cultural comparisons between Canadian and South Korean data

BACKGROUND

Cross-cultural research can provide insight into whether levels and correlates of movement behaviours among early years children vary across different cultural contexts. This study (1) compared children's physical activity (PA) and screen time (ST) and parental and environmental correlates of PA and ST between samples of Canadian and South Korean (Korean thereafter) early years children (2-5 years) and (2) investigated parental and environmental correlates of PA and ST and whether country moderates the relationships.

METHODS

Cross-sectional data from 121 Canadian children (3.4 years; 49.6% girls) and 101 Korean children (3.4 years; 54.9% girls) who participated in the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) study were used. Demographic information, children's PA, ST, PA- or ST-specific parental cognitions and behaviours, and home and neighbourhood environments were measured using a proxy-reported questionnaire. Two-tailed independent samples T test or Mann Whitney U test, chi-square tests, linear regression and moderation analyses were performed.

RESULTS

Canadian children spent more time in non-organized PA compared to Korean children (111 vs. 63 min/day), whereas time spent in organized PA was higher in Korean children than Canadian children (25 vs. 9 min/day). Canadian children had more ST than Korean children (159 vs. 110 min/day). Similarly, Canadian parents reported higher screen (142 vs. 116 min/day) and sitting time (317 vs. 286 min/day) than Korean parents. Though children's behaviours, as well as parental cognitions and behaviours, varied between the two samples, similar correlates of children's PA and ST were observed. The relationship between presence of electronics in children's bedrooms and children's ST was moderated by country, with Canadian children showing a stronger relationship than Korean children.

CONCLUSIONS

Supporting parents to adopt cognitions and behaviours that are conducive to healthy PA and ST patterns of their own and their early years children may be important for both Canada and Korea.

Vitamin D status and its dietary and lifestyle factors in children during the first 5 years of life: A cross-sectional multicentre Jiangsu bone study

BACKGROUND

To explore the vitamin D status with its demographic and lifestyle factors including dietary, supplementation, and physical activity in 0-5 years old children.

METHODS

This was a large population-based cross-sectional multicentre study in which the children were recruited from 12 Children's Health Care Centers by a stratified cluster random-sampling method in 10 cities in Jiangsu Province, China.

RESULTS

A total number of 5289 children were investigated. The prevalence of vitamin D deficiency was 30.1%. The concentration of 25 hydroxyvitamin D was 64.0 (46.3-83.0) nmol mL^-1 after adjustment for covariates. Children with higher risk of vitamin D deficiency were more likely to be at older age, girls, survey conducted in spring, location in southern Jiangsu province, residence in urban, outdoor activity < 2 h day^-1 (all p < 0.05). Moreover, those with lower risk were more likely to be the number of parity ≥ 2 times, vitamin D supplementation from birth to 6 months, the initial time of vitamin D supplementation after birth ≤ 1 months, vitamin D and calcium supplementation in the last 3 months, and dose of vitamin D supplementation > 400 IU day^-1 (all p < 0.05). Children with preferences for sweets, meat consumption > 150.0 g day^-1 , milk consumption < 250 mL day^-1 , time of sleeping < 10 h day^-1 had higher risks of vitamin D deficiency. However, these relationships were affected by demographics.

CONCLUSIONS

Vitamin D status during the first five years of life was suboptimal and was associated with demographic and lifestyle determinants including milk, meat, sweets, vitamin D and calcium supplementation, sleeping and outdoor activity.

A Review of Evidence on the Role of Digital Technology in Shaping Attention and Cognitive Control in Children

The role of digital technology in shaping attention and cognitive development has been at the centre of public discourse for decades. The current review presents findings from three main bodies of literature on the implications of technology use for attention and cognitive control: television, video games, and digital multitasking. The aim is to identify key lessons from prior research that are relevant for the current generation of digital users. In particular, the lack of scientific consensus on whether digital technologies are good or bad for children reflects that effects depend on users' characteristics, the form digital technologies take, the circumstances in which use occurs and the interaction between the three factors. Some features of digital media may be particularly problematic, but only for certain users and only in certain contexts. Similarly, individual differences mediate how, when and why individuals use technology, as well as how much benefit or harm can be derived from its use. The finding emerging from the review on the large degree of heterogeneity in associations is especially relevant due to the rapid development and diffusion of a large number of different digital technologies and contents, and the increasing variety of user experiences. We discuss the importance of leveraging existing knowledge and integrating past research findings into a broader organizing framework in order to guide emerging technology-based research and practice. We end with a discussion of some of the challenges and unaddressed issues in the literature and propose directions for future research.

Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis

Importance

There is considerable public and scientific debate as to whether screen use helps or hinders early child development, particularly the development of language skills.

Objective

To examine via meta-analyses the associations between quantity (duration of screen time and background television), quality (educational programming and co-viewing), and onset of screen use and children's language skills.

Data Sources

Searches were conducted in MEDLINE, Embase, and PsycINFO in March 2019. The search strategy included a publication date limit from 1960 through March 2019.

Study Selection

Inclusion criteria were a measure of screen use; a measure of language skills; and statistical data that could be transformed into an effect size. Exclusion criteria were qualitative studies; child age older than 12 years; and language assessment preverbal.

Data Extraction and Synthesis

The following variables were extracted: effect size, child age and sex, screen measure type, study publication year, and study design. All studies were independently coded by 2 coders and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Main Outcomes and Measures

Based on a priori study criteria, quantity of screen use included duration of screen time and background television, quality of screen use included co-viewing and exposure to educational programs, and onset of screen use was defined as the age children first began viewing screens. The child language outcome included assessments of receptive and/or expressive language.

Results

Participants totaled 18 905 from 42 studies included. Effect sizes were measured as correlations (r). Greater quantity of screen use (hours per use) was associated with lower language skills (screen time [n = 38; r = -0.14; 95% CI, -0.18 to -0.10]; background television [n = 5; r = -0.19; 95% CI, -0.33 to -0.05]), while better-quality screen use (educational programs [n = 13; r = 0.13; 95% CI, 0.02-0.24]; co-viewing [n = 12; r = 0.16; 95% CI, 0.07-.24]) were associated with stronger child language skills. Later age at screen use onset was also associated with stronger child language skills [n = 4; r = 0.17; 95% CI, 0.07-0.27].

Conclusions and Relevance

The findings of this meta-analysis support pediatric recommendations to limit children's duration of screen exposure, to select high-quality programming, and to co-view when possible.

Immediate impact of fantastical television content on children's executive functions

Recent research has suggested that particular content of television programmes, such as watching fantastical scenes, can have negative consequences on cognitive functions in young children. We examined the effects of watching fantastical programmes on executive functions measured at both pre- and post-television viewing. Eighty 5- to 6-year-old children participated and were randomized into either fantastical or non-fantastical conditions. They completed inhibition, working memory, cognitive flexibility, and planning tasks both before and after watching either the brief fantastical or non-fantastical television clip. Whilst there were no differences between the groups at pre-test on any of the cognitive measures, children in the fantastical condition were poorer on inhibition, working memory, and cognitive flexibility tasks at the post-test session. Watching fantastical television content, even briefly, seems to disrupt cognitive function performance in young children across a broad range of aspects of executive function. Statement of contribution What is already known on this subject? Exposure to fantastical content within a television programme may impair executive functions in young children. What does this study add? Exposure to fantastical content within television programmes impairs executive functions in children of early primary school age. Impairment extends to all three core aspects of executive functions. Watching fantastical clips slows down planning performance without improving accuracy.

Adiposity is not beneficial to bone mineral density in 0-5 year old Chinese children: The Jiangsu bone health study

OBJECTIVE

Data on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD.

SUBJECTS AND METHODS

This was a large population-based multicenter study in which the representative children aged 0-5 years were recruited from 13 Children's Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson's correlation and further tested using partial correlation in the additive model.

RESULTS

A total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r=0.711, P<0.001; r=0.727, P<0.001; r=-0.318, P<0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2kg, but started to gain slowlyand even decreased when the weight was over 21.2kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P<0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (β=-47.45, 95%CI=-85.07, -9.83, P=0.013).

CONCLUSIONS

Adiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.

The effects of fantastical television content on Chinese preschoolers' executive function

Literature has indicated the mixed impact of television content on the executive function (EF) of preschoolers. This study investigated the short-term impact of TV fantastical events on children's EF performance and whether these impacts were different between boys and girls. This study included 143 preschoolers (M_age  = 5.88 years, SD_age  = 0.32 years) and their parents. Participating children were randomly assigned to three groups to watch cartoons of high-fantasy, mid-fantasy, and low-fantasy, and then requested to perform on a series of EF tasks. The results revealed the nonlinear pattern for the effects of fantasy on inhibitory control and cognitive flexibility. Specifically, children in the mid-fantasy group did worst on inhibitory control and cognitive flexibility and no significant group differences were found in working memory. However, no conclusive evidence existed to prove the moderating role of gender on the relationship between fantastical events and EF. Finally, the implications of the findings and future directions are discussed.

Results from South Korea's 2018 Report Card on physical activity for children and youth

Background/Objective

South Korea's 2018 Report Card on Physical Activity for Children and Youth is the second comprehensive evaluation of physical activity and the sources of influence based on the 10 core indicators provided by the Active Healthy Kids Global Alliance. It will serve as an advocacy tool to promote physical activity among children and youth.

Methods

Three national surveillance data (i.e., 2017 Korea Youth Risk Behavior Web-based Survey, 2016 Korea National Health and Nutrition Examination Survey, 2016 Physical Activity Promotion System) were used as main sources to evaluate the indicators. Descriptive statistics were performed to obtain prevalence estimates of physical activity-related indicators. In addition, expert opinions as well as the most recently available published or unpublished relevant sources were synthesized.

Results

South Korea's 2018 Report Card, compared to the 2016 Report Card, showed favourable changes in the Active Transportation (B+), Organized Sports Participation (C), Sedentary Behaviours (D), and School (D+) indicators, while unfavourable changes were shown in Overall Physical Activity (F) and Government (D). Physical Fitness was graded as D+. In parallel with the 2016 Report Card, Active Play, Family and Peers, and Community and Environment remain ungraded due to insufficient data.

Conclusions

Successes as well as gaps and research needs were identified in the 2018 Report Card. Though some indicators have shown improvement, most children and youth continue to be insufficiently physically active with overall poor grades (Average of D+). To achieve substantial improvement in all grades in future Report Cards, more institutional and governmental support and investment is needed to promote physical activity. Furthermore, effort should be made to generate data pertaining to the indicators that were ungraded.

Physical activity, sedentary behaviour, and psychosocial well-being among young South Korean children

OBJECTIVE

To examine associations between television (TV) viewing, reading, physical activity (PA), and psychosocial well-being among a representative sample of young South Korean children aged 0-5 years.

METHODS

Findings are based on 1,774 children who participated in the Korea Children and Youth Survey. All measures were questionnaire-derived. Psychosocial well-being included social, interactive, and emotional skills (α = .7-.9), and the top quartile denoted high psychosocial well-being. Multiple logistic regressions were performed to examine relationships after controlling for several confounders.

RESULTS

Compared to children who participated in PA for <1 hr/week, those who participated in PA for 1- <3 hr/week were more likely to show high emotional skills (odds ratio [OR]: 1.40, 95% confidence interval [CI] [1.02, 1.93]), and those who participated ≥3 hr/week were more likely to show high social (OR: 2.01, 95% CI [1.45, 2.78]) and interactive skills (OR: 1.39, 95% CI [1.01, 1.92]). During weekdays, children who read 1- <3 hr/day and ≥3 hr/day, compared to <1 hr/day, were more likely to show high social (OR: 1.61, 95% CI [1.20, 2.16] and OR: 2.47, 95% CI [1.31, 4.67]) and emotional skills (OR: 1.57, 95% CI [1.16, 2.13] and OR: 2.58, 95% CI [1.34, 4.98]). In addition, children who read 1- <3 hr/day, compared to <1 hr/day, were more likely to show high interactive skills (OR: 1.44, 95% CI [1.08, 1.92]). Similar findings for reading on weekends were observed. TV viewing was not associated with social skills or interactive skills. TV viewing for 1- <3 hr/day, compared to <1 hr/day, was associated with increased odds of high emotional skills (OR: 1.71, 95% CI [1.28, 2.27] on weekdays; OR: 1.90, 95% CI [1.39, 2.61] on weekends).

CONCLUSION

PA and reading primarily showed favourable associations with psychosocial well-being, whereas TV viewing did not; thus, PA or reading may be a better option over TV viewing for optimal psychosocial well-being among young South Korean children. These findings should be confirmed with stronger study designs.

Meeting new Canadian 24-Hour Movement Guidelines for the Early Years and associations with adiposity among toddlers living in Edmonton, Canada

BACKGROUND

Canada has recently released guidelines that include toddler-specific recommendations for physical activity, screen-based sedentary behaviour, and sleep. This study examined the proportions of toddlers meeting the new Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) and associations with body mass index (BMI) z-scores in a sample from Edmonton, Canada.

METHODS

Participants included 151 toddlers (aged 19.0 ± 1.9 months) for whom there was complete objectively measured physical activity data from the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) project. Toddlers' physical activity was measured using ActiGraph wGT3X-BT monitors. Toddlers' screen time and sleep were measured using the PREPS questionnaire. Toddlers' height and weight were objectively measured by public health nurses and BMI z-scores were calculated using World Health Organization growth standards. Meeting the overall 24-Hour Movement Guidelines was defined as: ≥180 min/day of total physical activity, including ≥1 min/day of moderate- to vigorous-intensity physical activity; no screen time per day (for those aged 12-23 months) or ≤1 h/day of screen time per day (ages 24-35 months); and 11-14 h of sleep per 24-h period. Frequency analyses and linear regression models were conducted.

RESULTS

Only 11.9% of toddlers met the overall 24-Hour Movement Guidelines, but this finding was largely driven by screen time. The majority of toddlers met the individual physical activity (99.3%) and sleep (82.1%) recommendations, while only 15.2% of toddlers met the screen time recommendation. No associations were observed between meeting specific and general combinations of recommendations within the guidelines and BMI z-scores.

CONCLUSIONS

Most toddlers in this sample were meeting physical activity and sleep recommendations but were engaging in more screen time than recommended. Consequently, only a small proportion of toddlers met the overall guidelines. Based on the findings of this study, identifying modifiable correlates of screen time to inform appropriate strategies to reduce screen time appears key for increasing the proportion of toddlers meeting the 24-Hour Movement Guidelines for the Early Years. Future research should examine the associations between meeting the new guidelines and other health indicators. Furthermore, future high-quality studies examining dose-response relationships between movement behaviours and health indicators are needed to inform guideline updates.