Is adherence to the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth associated with improved indicators of physical, mental, and social health?

Sleep health characteristics and positive mental health in Canadian youth: A cross-sectional analysis of the Health Behaviour in School-aged Children study

OBJECTIVES

This study investigated the associations between specific sleep health characteristics and indicators of positive mental health among Canadian youth in grades 6-10.

METHODS

We used cross-sectional data from the Canadian 2017/2018 Health Behaviour in School-aged Children study, a nationally representative sample of Canadian students. Our analyses included 14,868 participants (53.1% girls). We assessed the following self-reported characteristics of sleep health: nighttime insomnia symptoms, sleep duration, problems with daytime wakefulness, and weekend catch-up sleep. Positive mental health measures included self-reported life satisfaction, positive affect, self-efficacy, and self-confidence. Logistic regression models were used to assess associations while controlling for confounders.

RESULTS

Participants who had no or little nighttime insomnia symptoms, who met sleep duration recommendations, who had no or rare daytime wakefulness problems, and who had no or little weekend catch-up sleep were more likely to report high life satisfaction (range of adjusted odds ratios=1.29-2.50), high positive affect (range of adjusted odds ratios=1.35-3.60), high self-efficacy (range of adjusted odds ratios=1.22-2.54), and high self-confidence (range of adjusted odds ratios=1.28-2.31). Almost all of the associations remained significant in the gender- and age-stratified analyses.

CONCLUSION

The findings suggest that good sleep health is associated with higher odds of positive mental health among Canadian youth in grades 6-10. Further research is needed to understand the temporality of the associations and the underlying mechanisms.

Mapping the research using 24-h movement guidelines in children and adolescents: A bibliometric analysis

BACKGROUND

There are limited comprehensive bibliometric analyses that have examined research articles using the 24-h movement guidelines, which are necessary to evaluate the impact of the research field, map the scientific structure of the research landscape, and identify knowledge gaps.

OBJECTIVES

The aim of this study was to analyse the published research articles using the 24-h movement guidelines and assess their bibliometric characteristics.

METHODS

The search was conducted across all databases indexed in the Web of Science on March 6, 2024, and the bibliometric characteristics of studies published from 2016 onwards were analysed. Descriptive statistics and visualisations by the VOSviewer were used for the presentation of bibliometric characteristics.

RESULTS

120 studies using the 24-h movement guidelines in children and adolescents were included for analysis in this study. In general, number of the related publications using the 24-h movement guidelines increased from 2016 until now. 16 distinct clusters of author networking were displayed, of which the Canadian team was the strongest cluster with the highest research impacts. Of the included studies, cross-sectional studies accounted for the majority. North America and Europe were the leading two study locations across the included studies. Highly varied adherence rate to the 24-h movement guidelines across the included studies were observed. In terms of correlates and health outcomes of meeting the 24-h movement guidelines, separately, sociodemographic and health functioning characteristics were the most examined aspects.

CONCLUSIONS

This study provides a comprehensive scientific overview for research using the 24-h movement guidelines in children and adolescents, which may help guide potential research directions to improve the low compliance rates in this population.

Educating adolescents on preventing substance use: The role of 24-h movement behaviors ─ data from 2021 Youth Risk Behavior Surveillance

BACKGROUND

Little is known about how adhering to the health guidelines for physical activity (PA), screen time (ST), and sleep duration (SD) relates to substance use in adolescents. Thus, this study aims to explore the potential association between adherence to the 24-h movement behavior (24-h MB) guidelines and substance use among adolescents.

METHODS

Data from the 2019 Youth Risk Behavior Surveillance was analyzed. Participants reported their weekly PA, ST, SD, and substance use (alcohol and smoking) over the past 30 days. The mean age in the total participants was 15.56, and 48.03 % of the participants were females. Logistic regression was used in this study to explore the potential association between 24-h MB and substance use. Odds ratios (ORs) were reported alongside a 95 % confidence interval to enhance understanding of the observed association.

RESULTS

Only 2.22 % participants adhered to all three 24-h MB guidelines, while 47.99 % did not follow any guidelines. Notably, there was no significant difference in the odds of cigarette smoking between participants who followed none of the guidelines and those who followed some or all of them. Nevertheless, adherence to one or more guidelines was found to be associated with higher odds of abstaining from alcohol consumption compared to non-adherence (one guidelines: OR = 1.17 [1.08, 1.28], two guidelines: OR = 1.28 [1.13, 1.44]).

CONCLUSIONS

Adhering to 24-h MB guidelines may reduce adolescents' alcohol consumption, but the adherence was not significantly associated with smoking. Longitudinal studies are needed to confirm these findings. These results can inform adolescent health policies and interventions aimed at reducing substance use from the perspective of healthy time-use behaviors, which can be used for researchers and educator.

Physical Activity Habits and Sleep Duration According to Gender: A Cross-Sectional Study of Elementary School Children

(1) Background: The main goals of this study were to describe the physical activity (PA) and sleep habits of 8-12-year-old children according to their gender and to evaluate the relationship between PA and sleep habits (i.e., duration and timing). (2) Methods: A total of 236 children (114 boys and 122 girls) completed the Physical Activity Questionnaire for Older Children (PAQ-C) and an ad hoc sleep habits questionnaire. (3) Results: Boys were more physically active than girls (2.62 ± 0.51 vs. 2.46 ± 0.48, p = 0.026) and enacted higher PA levels in school recess (3.82 ± 1.36 vs. 3.56 ± 1.38, p = 0.003), during the afternoon (3.37 ± 1.20 vs. 2.89 ± 1.12, p = 0.003), and during weekends (3.54 ± 1.20 vs. 3.18 ± 0.48, p = 0.009). Per sleep habits, boys had a significantly later bedtime (21:53 ± 2:08 vs. 21:34 ± 2:14, p = 0.009) and a significantly smaller total sleep duration (9.64 ± 0.86 vs. 9.89 ± 0.87 h, p = 0.023) than girls. No significant correlations between PA and sleep habits were found. (4) Conclusions: We found differences in the PA and sleep habits between school-age boys and girls. Institutions and entities should consider designing specific interventions to improve PA and sleep habits according to gender.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents

PURPOSE

The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences.

METHODS

This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted.

RESULTS

The number of 24-HMB recommendations met was negatively associated with total difficulties (β estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (β estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: β estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: β estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: β estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: β estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls.

CONCLUSION

Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Suicidal Ideation and Attempts Among Youth With Physical-Mental Comorbidity in Canada: Proposal for an Epidemiological Study

BACKGROUND

Evidence suggests that having a chronic physical illness (CPI; eg, asthma, diabetes, and epilepsy) is an independent risk factor for suicidality (ie, suicidal ideation or attempts) among youth. Less is known about the mechanisms linking CPI and suicidality. Some evidence suggests that mental illness (eg, depression and anxiety) or neurodevelopmental disorder (eg, attention-deficit/hyperactivity disorder) mediates or moderates the CPI-suicidality association. Missing from the knowledge base is information on the association between having co-occurring CPI and mental illness or neurodevelopmental disorder (MIND) on youth suicidality.

OBJECTIVE

This study uses epidemiological data from the 2019 Canadian Health Survey of Children and Youth (CHSCY) to study the intersection of CPI, MIND, and suicidality in youth. We will estimate prevalence, identify predictors, and investigate psychosocial and service use outcomes for youth with CPI-MIND comorbidity versus other morbidity groups (ie, healthy, CPI only, and MIND only).

METHODS

Conducted by Statistics Canada, the CHSCY collected data from 47,850 children (aged 1-17 years) and their primary caregiving parent. Measures of youth CPI, MIND, family environment, and sociodemographics are available using youth and parent informants. Information on psychiatric services use is available via parent report and linkage to national administrative health data found in the National Ambulatory Care Reporting System and the Discharge Abstract Database, which allow the investigation of hospital-based mental health services (eg, emergency department visits, hospitalizations, and length of stay in hospital). Questions about suicidality were restricted to youths aged 15-17 years (n=6950), which form our analytic sample. Weighted regression-based analyses will account for the complex survey design.

RESULTS

Our study began in November 2023, funded by the American Foundation for Suicide Prevention (SRG-0-008-22). Access to the linked CHSCY microdata file was granted in May 2024. Initial examination of CHSCY data shows that approximately 20% (1390/6950) of youth have CPI, 7% (490/6950) have MIND, 7% (490/6950) seriously considered suicide in the past year, and 3% (210/6950) had attempted suicide anytime during their life.

CONCLUSIONS

Findings will provide estimates of suicidality among youth with CPI-MIND comorbidity, which will inform intervention planning to prevent loss of life in this vulnerable population. Modeling correlates of suicidality will advance understanding of the relative and joint effects of factors at multiple levels-information needed to target prevention efforts and services. Understanding patterns of psychiatric service use is vital to understanding access and barriers to services. This will inform whether use matches need, identifying opportunities to advise policy makers about upstream resources to prevent suicidality. Importantly, findings will provide robust baseline of information on the link between CPI-MIND comorbidity and suicidality in youth, which can be used by future studies to address questions related to the impact of the COVID-19 pandemic and associated countermeasures in this vulnerable population of youth.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/57103.

Association between meeting 24-h movement guidelines and health in children and adolescents aged 5-17 years: a systematic review and meta-analysis

Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one's lifespan. Consistent with movement behaviors, several countries have formulated and published 24-h movement guidelines. This review summarized the studies related to 24-h movement guidelines among children and adolescents from six databases (MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, and SPORTDiscus). In a total of 61 studies that discussed compliance with 24-h movement guidelines, the overall adherence rate was very low (7.1%), with boys exceeding girls, children surpassing adolescents, and regional differences. A total of 39 studies examined the associations between 24-h movement guidelines and health indicators. Findings indicated that meeting all three guidelines was favorably associated with adiposity, cardiometabolic health, mental and social health, physical fitness, health-related quality of life, academic achievement, cognitive development, perceived health, dietary patterns, and myopia. Future research should utilize longitudinal and experimental designs to enhance our understanding of the associations between 24-h movement guidelines and health indicators, thereby aiding the formulation and refinement of such guidelines.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, CRD42023481230.

Cross-sectional association between 24-hour movement guidelines and depressive symptoms in Chinese university students

Background

The world's first 24-h movement guidelines for adults were released on 15 October 2020 in Canada, though evidence of their associations with health indicators in young adults is sparse. This study aimed to report the prevalence of meeting the 24-h movement guidelines and associations with depressive symptoms in a sample of Chinese university students.

Methods

Cross-sectional data from 1,793 Chinese university students (mean age = 20.7 years, 63.6% female) were used. Sociodemographic information, movement behaviors (physical activity, sedentary behavior, and sleep duration), and depressive symptoms were collected using a self-reported questionnaire.

Results

The prevalence of meeting the 24-h movement guidelines was 27.8% in Chinese university students. Logistic regression results show that compared to those who met the 24-h movement guidelines, odds ratio (OR) for depressive symptoms in those who met fewer recommendations contained in the 24-h movement guidelines were significantly higher (OR for none = 3.4, 95% CI [2.1-5.5], p < 0.001; OR for one = 2.7, 95% CI [2.0-3.8], p < 0.001; OR for two = 1.5, 95% CI [1.1-2.1], p = 0.013).

Conclusion

The prevalence of meeting the 24-h movement guidelines in Chinese university students was relatively low and should be enhanced through multiple strategies. Meeting the 24-h movement guidelines was associated with lower risk for depression in Chinese young adults. It is suggested that moving more, sitting less and sleeping well in this population may reduce the occurrence of depression.

Associations Between Changes in 24-Hour Movement Behaviors in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Mediation-Based Meta-Analysis

BACKGROUND

Although 24-hour movement behaviors are known to be interconnected, limited knowledge exists about whether change in one behavior during the COVID-19 pandemic (eg, increased screen time) was associated with change in another (eg, reduced physical activity or sleep). This review estimates mediational associations between changes in children's physical activity, screen time, and sleep during the COVID-19 pandemic.

METHODS

We included studies published between January 1, 2020 and June 27, 2022, in the PubMed/MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science databases. Summary data were extracted from included studies and analyzed with random-effects meta-regression.

RESULTS

This review included 26 studies representing 18,959 children across 18 mid-high-income countries (53% male; mean age, 11.5 [2.9] y). There was very good evidence of decreased total daily physical activity (factor change, 0.62; 90% CI, 0.47-0.81) and strong evidence of increased screen time (1.56; 90% CI, 1.38-1.77). There was very good evidence of decreased moderate to vigorous physical activity (0.75; 90% CI, 0.62-0.90) and weak evidence of increased sleep (1.02; 90% CI, 1.00-1.04). Mediational analysis revealed strong evidence that most of the reduction in total daily physical activity from before, to during, the pandemic was associated with increased screen time (0.53; 90% CI, 0.42-0.67). We observed no further mediational associations.

CONCLUSION

Increased reliance on and use of screen-based devices during the COVID-19 pandemic can be linked with reduced child and adolescent physical activity. This finding links COVID-related restrictions to potential displacement effects within child and adolescent 24-hour movement behavior.

Examining the relationship between meeting 24-hour movement behaviour guidelines and mental health in Chinese preschool children

Background

Limited research has explored the relationship between adhering to 24-h Movement Behaviour guidelines and mental health in Chinese preschool children. The objectives of this study encompassed two primary goals: (1) to investigate the adherence of preschool children in China to the 24-h Movement Behaviour guidelines; and (2) to analyze the relationship between fulfilling various combinations of these guidelines and mental health, identifying the most advantageous combination.

Methods

Utilizing a convenience sampling approach, this study included 205 preschool children (117 boys and 88 girls, average age 4.8 ± 0.51 years) from five kindergartens in Hengyang, Hunan Province. The physical activity (PA) and sedentary behaviour of preschool children were objectively assessed using waist-worn accelerometers, while sleep duration and screen time were reported by the children's parents. To evaluate mental health, the parent version of the internationally validated Strength and Difficulties Questionnaire (SDQ) was employed, which measures externalizing problems, internalizing problems, and prosocial behaviour. Employing Mplus 8.0 for Structural Equation Modeling analysis, while controlling for demographic variables, the study explored the connection between preschool children's mental health and their adherence to the 24-h Movement Behaviour guidelines.

Results

Worryingly, merely 14.6% of preschoolers met the recommended guidelines for all three aspects (PA, sleep duration, and screen time). Positive correlations were identified between meeting PA guidelines and displaying prosocial behaviour (β = 0.184; p < 0.05), while screen time adherence exhibited a negative correlation with externalizing problems (β = -0.207; p < 0.05). Similarly, there was a negative association between sleep duration adherence and externalizing problems (β = -0.191; p < 0.05). Meeting all three recommended guidelines was notably linked to enhanced prosocial behaviour (β = 0.464; p < 0.05), while following the screen time and sleep duration guidelines was negatively associated with externalizing problems (β = -0.246; p < 0.05).

Conclusion

This study underscores the limited adherence of Chinese preschoolers to the comprehensive 24-h Movement Behaviour guidelines. Noteworthy findings include the positive influence of PA on prosocial behaviour, alongside the significant roles that sleep duration and screen time play in mitigating externalizing problems within this age group. Alignment with the 24-h Movement Behaviour guidelines is associated with more favorable mental health indicators in preschoolers.

Adherence to 24-hour movement guidelines and their association with depressive symptoms in adolescents: Evidence from Bangladesh

Healthy movement behaviours are associated with various physical and mental wellbeing; however, little is known about such associations in low- and middle-income countries. The aim of this study was to examine adherence to 24-hour (h) movement guidelines and their relationship with depressive symptoms in adolescents. Data were from 312 Bangladeshi adolescents aged 13-17 years (42% female). Meeting the guidelines was defined as: energy expenditure for physical activity (PA) ​≥ ​1 680 Metabolic Equivalent of Task (MET)-min/week, ≤ 2 ​h/day of recreational screen time (ST), and 8-10 ​h/night of sleep. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) with a score of 10 or more indicating high depressive symptoms. Percentage of adolescents meeting the three recommendations was 2.2%, with 17.6% meeting two, and 31.2% meeting one recommendation. Generalized estimating equations showed that odds of having high depressive symptoms was a third (odds ratio [OR] ​= ​0.35, 95% confidence interval [CI], 0.19-0.57) for meeting the PA guidelines, and about a half (OR = 0.47, 95%CI, 0.18-0.87) for meeting the sleep guidelines. Odds of depressive symptoms reduced significantly for meeting PA and sleep (OR = 0.20, 95%CI, 0.09-0.59), or PA and ST (OR ​= ​0.24, 95%CI, 0.08-0.55) guidelines. About half of the adolescents did not meet any recommendations, which underscores the need for public health campaigns to promote adherence to the movement guidelines in this pediatric population. Further longitudinal research with larger sample size is recommended to explore the inter-relationships of these behaviours and their impact on health and wellbeing outcomes of adolescents in Bangladesh.

24-H movement behaviors and visual impairment among Chinese adolescents with and without obesity

BACKGROUND

Previous studies have identified obesity, sleep patterns, screen time, and physical activity as independent risk factors for the visual health of adolescents. However, our understanding of how these factors interact and contribute to visual impairment remains limited. This study aimed to investigate the relationship between adherence to the 24-h movement guidelines (24-HMG) and visual impairment in adolescents with and without obesity.

METHODS

We analyzed data from the 2014-2015 China Education Panel Survey. Participants provided self-reported information on their screen time, sleep duration, and physical activity levels. The data on weight, height, and visual acuity were obtained from school health examination reports. Logistic regression analysis was conducted to assess the association between 24-h movement behaviors and visual impairment, reported as odds ratios (ORs) with a 95 % confidence interval (CI).

RESULTS

After controlling for covariates such as sex and age, it was found that adolescents with obesity who adhered to the sleep guidelines had a lower risk of visual impairment compared with adolescents without obesity who did not adhere to the 24-HMG (OR = 0.84, 95 % CI: 0.75-0.94, P = 0.003). Additionally, adolescents who adhered to both the physical activity and sleep guidelines had an even lower risk of visual impairment (OR = 0.58, 95 % CI: 0.42-0.79, P = 0.001).

CONCLUSIONS

Adhering to the Sleep and physical activity + Sleep recommendations in the 24-HMG could significantly reduce the risk of visual impairment in adolescents without obesity. No significant relationship was observed between adherence to 24-HMG and the risk of visual impairment in adolescents with obesity.

Adherence to 24-h movement behaviour guidelines in families with multiple children

BACKGROUND

In 2019, the World Health Organization (WHO) launched the first global movement guidelines for children that combined sleep, physical activity and screen time. Our previous research showed that adherence to age-specific guidelines for screen time was challenging for families with children in different age groups. We aimed to determine whether families with children in different age-based movement guideline categories have poorer adherence to the broader 24-h movement guidelines than those with all children in the same age category.

METHODS

Data were from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health (seventh survey, 2015) and the women's three youngest children (aged ≤12) (Mothers and their Children's Health sub-study, 2016/2017). The sample was 1787 women (families) with 4064 children (mean age 7.2 [SD 2.9]). Whether children in the family were in the same or different age-based category was determined by matching children's ages in a family against age-based guideline categories for the 24-h movement behaviours. The association between children in the family being in the same or different age-based guideline category on adherence to 24-h movement guidelines, both collectively and individually, was analysed by adjusted logistic regression (binary and multinomial).

RESULTS

Families with children in the same age guideline categories had double the odds of having all children meet 24-h movement guidelines (adjusted odds ratio [OR] 1.95 [95% confidence interval, CI: 1.32, 2.86]). Families with children in the same age categories on the screen guideline had higher odds of all children meeting (2.25 [1.73, 2.93]) and lower odds of some meeting/some failing the screen guideline (0.18 [0.14, 0.25]), than families with all children in different age categories. Families with children in the same age categories on the physical activity guideline had lower odds of all children meeting (0.57 [0.43, 0.75]) or some meeting/some failing the physical activity guideline (0.08 [0.06, 0.12]). No associations were found for sleep guidelines.

CONCLUSIONS

Families with multiple children may need practical advice and strategies on how to adhere to guidelines when children span age categories. This could form part of public health strategies that raise awareness of the guidelines and may improve guideline adherence.

Association between meeting the 24-h movement guidelines and psychosocial health in children: A cross-sectional study

OBJECTIVE

Emerging evidence suggests that meeting the 24-h movement guidelines is associated with optimal mental health. However, there remains some uncertainty regarding this association in children. Therefore, this study aimed to examine the association between meeting the 24-h movement guidelines and psychosocial health in children.

METHODS

A cross-sectional study design was employed to investigate 2005 children aged 9-12 years from four districts of Shanghai, China. The 24-h movement behaviours were assessed using selected items from the Health Behaviour in School-aged Children (HBSC) survey questionnaire. Children's self-rated psychosocial health was evaluated using the Strengths or Difficulties Questionnaire (SDQ). Generalised Linear Models with the ordinal logistic module were employed to analyse the association between meeting the 24-h movement guidelines and psychosocial health.

RESULTS

The overall prevalence of meeting all three 24-h movement recommendations was 10.2%. Among children, 7.9% of them exhibited abnormal total difficulties, with a notable difference between sex (boys: 11.2%, girls: 7.0%, p = 0.001). Meeting all three 24-h movement behaviour recommendations was associated with reduced total difficulties, emotional symptoms, conduct problems, hyperactivity and peer problems. Furthermore, a dose-response association was observed, indicating that meeting a greater number of 24-h movement behaviour recommendations was associated with enhanced psychosocial health, particularly in boys.

CONCLUSION

The findings of this study highlight the positive association between meeting the 24-h movement guidelines and psychosocial health in children. Notably, meeting more of these recommendations was associated with a lower likelihood of experiencing psychosocial problems, with greater benefits observed in boys compared with girls.

24-Hour movement behaviours research during the COVID-19 pandemic: a systematic scoping review

OBJECTIVES

Many studies examining 24-hour movement behaviours based on the 24-Hour Movement Guidelines (24HMG) have been published during the COVID-19 pandemic. However, no comprehensive reviews summarized and synthesized the evidence concerning studies using 24HMG. The aim of this scoping review was to synthesize the evidence from the 24HMG studies published during the pandemic.

METHODS

Three electronic databases (Web of Science, PubMed, EBSCO) were utilized to conduct a literature search. The search procedure adhered to the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a total of 1339 research articles published in peer-reviewed journals were screened. After eliminating 461 duplicates, 878 articles remained. The titles and/or abstracts of these articles were then cross-checked, and 25 articles were included. Subsequently, two authors independently assessed full-text of articles based on the pre-defined inclusion and exclusion criteria, resulting in the final selection of 16 articles that met the inclusion criteria. Study characteristics (e.g., study population, study design, measurement) were extracted and then summarized. According to the Viable Integrative Research in Time-use Research (VIRTUE) epidemiology, the included studies were further classified into different but interrelated study domains (e.g., composition, determinants, health outcomes).

RESULTS

The majority of included articles focused on children and adolescents as study population. This study primarily demonstrated that a low prevalence of meeting the 24HMG among children and adolescents during the COVID-19 pandemic. There has been a decline in the percentage of individuals meeting the 24HMG compared to the pre-COVID-19 period. The majority of included studies focused on sociodemographic factors when examining the correlates of meeting the 24HMG, while a few studies assessed factors of other domains, such as social, cultural, and environmental aspects.

CONCLUSION

The COVID-19 pandemic had an impact on healthy 24-hour movement behaviours in children and adolescents. In conjunction with the studies conducted during the COVID-19 pandemic, more studies were encouraged to explore the correlates of meeting the 24HMG and the associated health benefits in wider ranges of populations.

Prospective associations between adherence to 24-hour movement guidelines and mental well-being in Chinese adolescents

Most evidence regarding the relationships between adherence to 24-hour movement guidelines and adolescent mental health have been derived from cross-sectional studies or have ignored positive mental health indicators. The current prospective study examined the associations between adherence to 24-hour movement guidelines and changes in mental well-being among Chinese adolescents over three months. 816 Chinese adolescents (Mage = 14.76 years; SD = 0.81) completed baseline and follow-up scales of 24-hour movement behaviours, mental well-being, and covariates. Linear mixed-effects models were used for data analyses, with adjustments for covariates and mental well-being at baseline. There was a significant improvement in mental well-being across the three months, and the improvement in mental well-being was positively associated with meeting any single guidelines and both physical activity and sleep guidelines but not adherence to all three guidelines. Meeting both physical activity and sleep recommendations appears to exert more significant benefits on mental well-being than meeting one or two other recommendations. An integrative approach to mental health promotion by focusing on 24-hour movement behaviours (at least physical activity and sleep) may be more effective than focusing on a single behaviour alone.

Socioeconomic position as a predictor of youth's movement trajectory profiles between ages 10 and 14 years

BACKGROUND

Combinations of movement behaviors (i.e., physical activity, sedentary behavior, sleep) are associated with health and developmental outcomes in youth. Youth vary in how they accumulate these behaviors, both in volume and specific domains (e.g., sedentary time spent on recreational screen activities vs homework). The aim of this study was to examine how youth's combined general and domain-specific movement trajectories differ by socioeconomic position.

METHODS

We conducted a longitudinal, group-based multi-trajectory analysis to identify general and domain-specific movement trajectory profiles for 2457 youth from age 10 to 14 years from the Longitudinal Study of Australian Children from 2014-2018. We used multinomial logistic regression to test if socioeconomic position predicted profile membership.

RESULTS

We identified three general movement trajectory profiles for both sexes, four domain-specific profiles for males, and five for females. For general movement trajectories, females from lower socioeconomic positions were more likely to be a combination of less active and more sedentary than females from higher socioeconomic positions. Males across socioeconomic positions spend similar amounts of time in physical activity, sedentary time, and sleep. For domain-specific movement trajectories, youth from lower socioeconomic positions were likely to spend a combination of less time in education-based sedentary behavior and more time in recreational screen activities than their higher socioeconomic position peers.

CONCLUSION

Our results indicate that socioeconomic position predicted in which domains youth accumulate their movements. Future observational research and interventions targeting different socioeconomic groups should therefore consider domain-specific movement trajectories.

Associations between physical activity, screen time, sleep time and selected academic skills in 8/9-year-old children

BACKGROUND

High levels of physical activity (PA), low levels of screen time, combined with sufficient sleep time, provide better health benefits. However, few studies have examined the association of these behaviours with academic skills. Therefore, this study aims to determine how PA, screen time, and sleep time are related to selected academic skills of 8/9-year-old children while examining compliance with the guidelines on PA, sedentary behaviour, and sleep among this population group.

METHODS

This cross-sectional study included 114 primary school children (50% girls) aged 8-9years old from 2nd grade. The levels of PA, screen time, and sleep were assessed using self-reported questionnaires. The selected academic skills (based on reading and writing) were assessed by a battery of methods designed to diagnose the causes of school failure in students aged 7-9. Non-linear regression was applied to build multivariate models aimed at finding the most significant predictors for the selected academic skills separately.

RESULTS

Sixty-seven percent of children met the sleep guidelines, 22% met the screen time guidelines, and only 8% met PA guidelines. In terms of screen time, boys spent more time playing games than girls (p = .008). Moderate to vigorous intensity physical activity (MVPA) was associated with higher/better scores of the visual-auditory integration (B = -0.07, p = .040). Not meeting the sleep guidelines was associated with lower scores in visual-auditory integration among children (B = 0.12, p = .042). Children who did not meet the screen time guidelines had lower scores in perceptual-motor integration (B = -0.09, p = .040).

CONCLUSIONS

Participating in PA, limiting screen time and sufficient sleep time may benefit/support academic skills in children.

Association of screen time and physical activity with health-related quality of life in college students

OBJECTIVE

To determine the association between screen time and physical activity with quality of life among Chilean university students.

METHODS

Cross-sectional and analytical study conducted on 726 first-year university students who replied three questionnaires: Youth Risk Behavior Survey, WHO Quality of Life-BREF scale, and the International Physical Activity Questionnaire.

RESULTS

There were differences in overall quality of life (p < .001) and level of satisfaction in health (p < .01) according to screen exposure time. These results follow a linear trend for all the quality of life domains (p < .01), and they indicate that there is an inverse association between screen time and quality of life.

CONCLUSION

There is an inverse association between screen time and quality of life in university students. Students with a longer screen exposure time showed a lower quality of life, specifically in the domains of social relationships and psychological health, regardless of sex, physical activity, or socioeconomic level.

The link between unhealthy lifestyle behaviors and emotional and behavioral problems in children and adolescents: a latent class analysis

Unhealthy lifestyle behaviors (ULBs) in children and adolescents are relatively common. Previous studies have shown an association between a single ULBs and emotional and behavioral problems (EBPs); however, few studies have explored the connection between multiple behavioral patterns and EBPs in children and adolescents. Hence, we aimed to investigate the link between ULBs clusters and EBPs among Chinese children and adolescents. From April to May 2019, we used cluster sampling to investigate children and adolescents in grades 1-12 from 14 schools located across six streets of Bao'an District in the city of Shenzhen. We measured emotional and behavioral problems using the Strengths and Difficulties Questionnaire (SDQ). ULBs included the consumption of sugar-sweetened beverages, takeaway and fast food consumption, lack of sleep, low outdoor activity, and excessive screen time. We performed clustering of ULBs using the regression hybrid modeling method of latent class analysis (LCA). We analyzed the association between ULBs and EBPs using logistic regression. In total, 30188 children and adolescents remained for analysis, with an average age of 12.44 ± 3.47 years. The LCA revealed four distinct patterns of ULBs: (1) lowest risk; (2) high-risk unhealthy lifestyle behaviors; (3) high-risk dietary unhealthy lifestyle behaviors; and (4) highest risk. Compared to ULBs with the lowest risk, high-risk ULBs, high-risk dietary ULBs, and highest risk ULBs were positively correlated with EBPs, with an adjusted odds ratio (aOR) (95% confidence interval [CI]) of 1.27, 1.34 and 2.05, respectively. Children and adolescents who reported engaging in multiple ULBs were also more likely to have poorer EBPs status. This implies that school administrations should pay more attention to the management of dietary and lifestyle behaviors to prevent EBPs in children and adolescents. Our findings highlight the need to focus on multiple clusters of ULBs among adolescents in a preventive care system and to validate EBP that may occur in children who are exposed to ULBs.

Cross-sectional and longitudinal associations of adherence to the 24-hour movement guidelines with mental health problems among Chinese adolescents

OBJECTIVE

This study aimed to examine the cross-sectional and longitudinal associations between meeting the 24-Hour Movement Guidelines (recommendations for the optimal amount of moderate-to-vigorous physical activity, screen time, and sleep duration per day) and mental health problems among Chinese adolescents.

METHODS

A two-wave longitudinal survey was conducted in Huizhou, Guangdong province. A total of 906 junior high school students were recruited in the six-month follow-up survey. Moderate-to-vigorous physical activity, screen time, sleep duration, anxiety symptoms (GAD-7 score), and depressive symptoms (PHQ-9 score) were measured using a self-administered questionnaire. At baseline, participants were classified as meeting: 1) no recommendation, 2) one recommendation, 3) two recommendations, or 4) all three recommendations.

RESULTS

Overall, the proportions of adolescents meeting moderate-to-vigorous physical activity, screen time, and sleep recommendations at T₁ were 33.3%, 68.2%, and 64.7%, respectively. Cross-sectionally, the severity of anxiety and depressive symptoms at T₁ significantly decreased as the number of recommendations met increased (adjusted regression coefficients [95% CI] for three recommendations met versus none: -2.80 [-4.05, -1.55] and - 3.42 [-4.85, -1.99], respectively). Longitudinally, adolescents who met three recommendations at T₁ displayed lower anxiety and depressive symptoms six months later than those who did not (adjusted regression coefficients [95% CI]: -1.00 [-1.98, -0.02] and - 1.43 [-2.53, -0.32], respectively). Furthermore, meeting three recommendations was associated with the alleviation of depressive symptoms (adjusted OR [95% CI]: 0.39 [0.17, 0.90]).

CONCLUSIONS

Promoting adolescents to adhere to the 24-Hour Movement Guidelines could be considered an intervention target for mental health problems at a population level.

Adherence to 24-hour movement guidelines in children with mental, behavioral, and developmental disorders: Data from the 2016-2020 National Survey of Children's Health

BACKGROUND

Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens. However, the lifestyles of children with mental, behavioral, and developmental disorders (MBDDs) remains under-described within the literature of public health field. This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.

METHODS

Data were from the 2016-2020 National Survey of Children's Health-A national, population-based, cross-sectional study. We used the data of 119,406 children aged 6-17 years, which included 38,571 participants with at least 1 MBDD and 80,835 without. Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity, screen time, and sleep duration.

RESULTS

Among children with MBDDs, 20.3%, 37.0%, 60.7%, and 77.3% met the physical activity, screen time, sleep, and at least 1 of the 24-hour movement guidelines. These rates were lower than those in children without MBDDs (22.8%, 46.2%, 66.7%, and 83.4%, respectively; all p < 0.001). Children with MBDDs were less likely to meet these guidelines (odds ratio (OR) = 1.21, 95% confidence interval (95%CI): 1.13-1.30; OR = 1.37, 95%CI: 1.29-1.45; OR = 1.29, 95%CI: 1.21-1.37; OR = 1.45, 95%CI: 1.35-1.56) than children without MBDDs. Children with emotional disorders had the highest odds of not meeting these guidelines (OR = 1.43, 95%CI: 1.29-1.57; OR = 1.48, 95%CI: 1.37-1.60; OR = 1.49, 95%CI: 1.39-1.61; OR = 1.72, 95%CI: 1.57-1.88) in comparison to children with other MBDDs. Among children aged 12-17 years, the difference in proportion of meeting physical activity and screen time guidelines for children with vs. children without MBDD was larger than that among children aged 6-11 years. Furthermore, the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.

CONCLUSION

Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs. In educational and clinical settings, the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs; and specifically for white children who have MBDDs, increasing physical activity may help.

Combinations of Physical Activity, Sedentary Behavior, and Sleep Duration and Their Associations With Physical, Psychological, and Educational Outcomes in Children and Adolescents: A Systematic Review

We conducted a systematic review to evaluate combinations of physical activity, sedentary behavior, and sleep duration (defined as "movement behaviors") and their associations with physical, psychological, and educational outcomes in children and adolescents. MEDLINE, CINAHL, PsychInfo, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Included studies needed to 1) quantitatively analyze the association of 2 or more movement behaviors with an outcome, 2) analyze a population between 5 and 17 years of age, and 3) include at least an English abstract. We included 141 studies. Most studies included the combination of physical activity and sedentary behavior in their analyses. Sleep was studied less frequently. In combination, a high level of physical activity and a low level of sedentary behavior were associated with the best physical health, psychological health, and education-related outcomes. Sleep was often included in the combination that was associated with the most favorable outcomes. Sedentary behavior had a stronger influence in adolescents than in children and tended to be associated more negatively with outcomes when it was defined as screen time than when defined as overall time spent being sedentary. More initiatives and guidelines combining all 3 movement behaviors will provide benefit with regard to adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.

Adherence to 24-h movement guidelines and cognitive difficulties in adolescents

BACKGROUND

Studies have identified sleep, screen time, and physical activity as independent risk factors for cognitive impairment in adolescents. However, little is known about how these factors interact to contribute to cognitive difficulties. This study aimed to investigate the association between 24-h movement guidelines and cognitive difficulties in adolescents.

METHODS

Data from the 2019 Youth Risk Behaviour Surveillance was used for analysis. Participants self-reported their screen time, sleep, and physical activity levels, and cognitive difficulty was assessed using a standardized protocol with a binary response (Yes or No). Logistic regression analysis was used to evaluate the association between 24-h movement behaviours and cognitive difficulty, with results reported as the odds ratio (OR) with a 95% confidence interval (CI).

RESULTS

After controlling for covariates (e.g., sex, age), compared to adolescents not adhering to none of the 24-h movement guidelines, adhering to the screen time (OR = 1.68, 95%CI: 1.37-2.05) and sleep guidelines (OR = 1.32, 95%CI: 1.08-1.61) were more likely to report no cognitive difficulties in adolescents, respectively. Adhering to all the 24-h movement guidelines was also likely to increase the odds of reporting no cognitive difficulties (OR = 3.38, 95%: 2.15-5.30).

CONCLUSIONS

The study findings suggest that promoting better 24-h movement behaviours could be an effective approach to reducing cognitive difficulties in adolescents. Future studies should use improved study designs to confirm or refute these results.

Twenty-four-hour movement guidelines during adolescence and its association with obesity at adulthood: results from a nationally representative study

To determine the association between adherence to the 24-h movement guidelines during adolescence with obesity at adulthood 14 years later in a nationally representative cohort. We analyzed data from 6984 individuals who participated in Waves I (1994-1995) and IV (2008-2009) of the National Longitudinal Study of Adolescent Health (Add Health) in the USA. Obesity was defined by the International Obesity Task Force cut-off points at Wave I and adult cut-points at Wave IV (body mass index [BMI]≥30 kg/m2 and waist circumference [WC]≥102 cm in male and 88 cm in female). Physical activity, screen time and sleep duration were self-reported. Adolescents who met screen time recommendation alone (β = -1.62 cm, 95%CI -2.68 cm to -0.56), jointly with physical activity (β = -2.25 cm, 95%CI -3.75 cm to -0.75 cm), and those who met all three recommendations (β = -1.92 cm, 95%CI -3.81 cm to -0.02 cm) obtained lower WC at Wave IV than those who did not meet any of these recommendations. Our results also show that meeting with screen time recommendations (IRR [incidence rate ratio] = 0.84, 95%CI 0.76 to 0.92) separately and jointly with physical activity recommendations (IRR = 0.86, 95%CI 0.67 to 0.97) during adolescence is associated with lower risk of abdominal obesity at adulthood. In addition, adolescents who met all 24-h movement recommendations had lower risk of abdominal obesity later in life (IRR = 0.76, 95%CI 0.60 to 0.97).

CONCLUSION

Promoting the adherence to the 24-h movement guidelines from adolescence, especially physical activity and screen time, seems to be related with lower risk of abdominal obesity later in life, but not for BMI.

WHAT IS KNOWN

• Some studies have shown a relationship between adherence to 24-h movement guidelines and adiposity or obesity markers in youth. However, most of these studies have a cross-sectional design or a short follow-up.

WHAT IS NEW

• This is the first study which determined the association between adherence to the 24-h movement guidelines during adolescence with obesity at adulthood 14 years later in a nationally representative US cohort. • Meeting the 24-h movement guidelines from adolescence seems to be related with lower risk of abdominal obesity later in life, but not for body mass index.

Accelerometer-measured physical activity, sedentary behavior, and sleep in children with cerebral palsy and their adherence to the 24-hour activity guidelines

AIM

To measure and describe the 24-hour activities (i.e. physical activity, sedentary behavior, and sleep) and to examine adherence to the 24-hour activity guidelines among children with cerebral palsy (CP) using actigraphy.

METHOD

Children's 24-hour activities were recorded over 7 days using hip- and wrist-worn ActiGraph wGT3X-BT accelerometers.

RESULTS

In total, 362 days and 340 nights from 54 children with CP (Gross Motor Function Classification System [GMFCS] levels I-III; 44% females; median age [range] 6 years 6 months [3-12 years]) were included. Mean (SD) daily wear time was 746.2 (48.9) minutes, of which children spent on average 33.8% in light physical activity (251.6 [58.7] minutes per day), 5.2% in moderate-to-vigorous physical activity (38.5 [20.1] minutes per day), and the remaining 61.1% being sedentary (456.1 [80.4] minutes per day). Physical activity decreased while sedentary behavior increased with increasing GMFCS level. In total, 13% of all children met the physical activity recommendations, and 35% met the age-appropriate sleep duration recommendation. The proportion of children meeting the combined 24-hour guidelines for physical activity and sleep was low (5.9%), especially in those classified in GMFCS level III (0%).

INTERPRETATION

The observed low 24-hour guideline adherence rates emphasize the importance of considering the entire continuum of movement behaviors in the care of children with CP, in efforts to promote healthy lifestyle behaviors and prevent negative health outcomes.

The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Mental Health in Adolescents-Cross Sectional Evidence from China

(1) Background: This study determined the prevalence of adolescents that meet 24-HMGs alone and in combination, and their association with the risk of developing adolescent anxiety and depression. (2) Methods: Participants were drawn from 9420 K8 grade adolescents (age 14.53 ± 0.69 years; 54.78% boys) from the China Education Tracking Survey (CEPS) 2014-2015 tracking data. Data on depression and anxiety were collected from the results of the questionnaire in the CEPS for the adolescent mental health test. Compliance with the 24-HMG was defined as: physical activity time (PA) ≥ 60 min/day was defined as meeting the PA. Screen time (ST) ≤ 120 min/day was defined as meeting the ST. Adolescents aged 13 years achieved 9-11 h of sleep per night and adolescents aged 14-17 years achieved 8-10 h of sleep per night, defined as meeting sleep. Logistic regression models were used to examine the association between meeting and not meeting the recommendations and the risk of depression and anxiety in adolescents. (3) Results: Of the sample studied, 0.71% of adolescents met all three recommendations, 13.54% met two recommendations and 57.05% met one recommendation. Meeting sleep, meeting PA+ sleep, meeting ST + sleep, and meeting PA + ST + sleep were associated with a significantly lower risk of anxiety and depression in adolescents. Logistic regression results showed that differences in the effects of gender on the odds ratio (ORs) for depression and anxiety in adolescents were not significant. (4) Conclusions: This study determined the risk of developing depression and anxiety in adolescents who met the recommendations for 24-HMG alone and in combination. Overall, meeting more of the recommendations in the 24-HMGs was associated with lower anxiety and depression risk outcomes in adolescents. For boys, reducing the risk of depression and anxiety can be prioritised by meeting PA + ST + sleep, meeting ST + sleep and meeting sleep in the 24-HMGs. For girls, reducing the risk of depression and anxiety may be preferred by meeting PA + ST + sleep or meeting PA+ sleep and meeting sleep in 24-HMGs. However, only a small proportion of adolescents met all recommendations, highlighting the need to promote and support adherence to these behaviours.

Proportion of Chinese Children and Adolescents Meeting 24-Hour Movement Guidelines and Associations with Overweight and Obesity

Background: Since there is little knowledge about the 24-hour movement behaviors of Chinese children and adolescents, the purposes of this study were to investigate the proportion of Chinese children and adolescents meeting the 24-Hour Movement Guidelines and to further evaluate its relationship with overweight and obesity. Methods: A total of 440 children and adolescents aged 7−18 years from 7 cities in China were selected to measure physical activity using accelerometers, and sleep (SLP) and screen time (ST) using questionnaires. The data were analyzed with the independent T-test, Mann−Whitney U test, Cox−Stuart test, chi-square test, and logistic regression. Results: The proportion of Chinese children and adolescents meeting the overall 24-Hour Movement Guidelines was 7.3%. Boys (11.8%) were higher than girls (3.4%) (p < 0.001) and showed a downward trend with age (Ptrend = 0.03). The rates of overweight and obesity among children and adolescents who met the ST, MVPA + ST, ST + SLP, and MVPA + SLP + ST guidelines were 39%, 15%, and 36%, and 25% did not meet any guidelines. The rates of overweight and obesity among those who met 1, 2, and 3 guidelines were lower than the rate among those who did not meet any guidelines (odds ratio (OR) = 0.51, 95% confidence interval (CI): 0.22−1.17; OR = 0.32, 95% CI: 0.13−0.77; OR = 0.23, 95% CI: 0.07−0.81) and showed a decreasing trend (Ptrend = 0.006). Conclusions: The proportion of Chinese children and adolescents meeting the overall 24-Hour Movement Guidelines was low. The rate of overweight and obesity among children and adolescents who met the overall 24-Hour Movement Guidelines was the lowest compared with the rates among those who met any one or two. There was a dose−response relationship between the number of guidelines met and the overweight and obesity rate.

Differential Associations Between Meeting 24-Hour Movement Guidelines With Mental Wellbeing and Mental Illness Among Chinese Adolescents

PURPOSE

Contemporary mental health models simultaneously consider psychological distress and wellness. Researchers have proposed that adhering to the 24-hour movement guidelines (24-HMG) contributes to mental health. 24-HMG integrates recommendations of time distribution among sleep, screen use, and moderate to vigorous physical activity (MVPA). Yet, there are few studies on the relationship between meeting 24-HMG and mental health, especially mental wellbeing. This study aimed to examine the associations between adherence to 24-HMG with mental wellbeing and mental illness among Chinese adolescents.

METHODS

Cross-sectional data of 67,281 Chinese adolescents aged 10-17 years (mean age = 13.0 years, 51.9% males) were collected by sending online questionnaires to local primary and middle schools in Shenzhen in 2021. We used multilevel generalized linear models to analyze associations between meeting 24-HMG with mental wellbeing (subjective wellbeing, resilience, and positive youth development) and mental illness (depression and anxiety).

RESULTS

Only 1.7% of participants met recommendations for all three behaviors (sleep, screen use, and MVPA). Compared with meeting none of the recommendations, participants who met one or more recommendations reported significantly better performance in mental wellbeing (all p < .001); on the contrary, meeting one or more recommendations (except for only meeting the MVPA recommendation) were significantly related to lower severity of mental illness (all p < .001). The relationship between the number of recommendations met with mental well-being and mental illness indicators presented a dose-response pattern (all p < .001).

DISCUSSION

Meeting 24-HMG was associated with superior mental health, including a higher propensity for mental wellbeing and a lower risk of mental illness. The importance of limiting screen time and getting enough sleep should be highlighted in promoting mental health in adolescents.

Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth

PURPOSE OF REVIEW

Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep.

RECENT FINDINGS

Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.

Sociodemographic and mental health characteristics associated with changes in movement behaviours due to the COVID-19 pandemic in adolescents

Objectives

Control measures enacted to control the spread of COVID-19 appear to have impacted adolescent movement behaviours. It remains unclear how these changes relate to sociodemographic characteristics and indicators of mental health. Understanding these relationships can contribute to informing health promotion efforts. The purpose of this study is to examine sociodemographic and mental health characteristics associated with changes in movement behaviours (physical activity, screen time, sleep duration) due to the COVID-19 pandemic among adolescents.

Methods

This cross-sectional study used May-June 2020 survey data and included 7349 students from Quebec, Ontario, and British Columbia (Canada). ANOVA, χ2 tests, and estimation of effect sizes using Cohen's d and h tests were performed between self-reported perceived changes (increase; decrease; no change) to physical activity, TV watching, social media use, and sleep duration as a result of the COVID-19 pandemic and gender, age, race/ethnicity, income, depression and anxiety symptoms, flourishing-languishing, and self-rated mental health.

Results

Over half of students reported increases in TV viewing and social media use and approximately 40% reported decrease in physical activity and increase in sleep duration due to the COVID-19 pandemic. More females (68.9%) than males (54.3%) reported increase in social media use (Cohen's h ≥ 0.2-0.5). No change from pre-COVID-19 social media use and sleep duration were associated with fewer depression and anxiety symptoms and better self-rated mental health compared to reports of an increase or decrease. These effect sizes ranged from small-to-moderate to moderate-to-large (Cohen's d/h ≥ 0.2-0.8). Decreased physical activity and sleep duration were associated with better psychological functioning with effects sizes of small-to-moderate. Compared to an increase or no change, decreased sleep had the largest effect size of less frequent depression symptoms (Cohen's d ≥ 0.5-0.8).

Conclusion

Maintaining pre-COVID-19 screen time and sleep duration during early stages of the COVID-19 lockdown was generally beneficial to mental health, with sleep being particularly important in regards to symptoms of depression. Psychological functioning was more related to physical activity and sleep than screen time during the pandemic.

Examining Relationships among Chinese Preschool Children's Meeting 24-Hour Movement Guidelines and Fundamental Movement Skills

Background: Few studies have investigated associations between meeting 24-Hour Movement Guidelines and preschool children’s fundamental movement skills (FMS). This study aimed to investigate the associations between Chinese preschoolers meeting various combinations of the Guidelines and FMS, as well as examining gender differences across those outcomes. Methods: A total of 322 preschool children (181 boys and 141 girls) aged 3−6 years old were recruited from five early-childhood education and care services in China. Children’s 7-day physical activity (PA) was assessed using accelerometry, and screen time (ST) and sleep duration were reported by their parents. FMS were assessed by Test of Gross Motor Development 3. Descriptive statistics and gender differences in children’s meeting the Guidelines and FMS were calculated using t-tests for continuous variables and Chi-square tests for categorical variables. Results: Most preschoolers met the sleep and ST guidelines, but only 22.3% met the PA guidelines; 4% of preschoolers did not meet any of the recommendations, while 9.3% met all three recommendations. Boys reported significantly higher compliance with all combined recommendations. There were positive associations between meeting the PA guidelines and both locomotor (β = 0.49; p < 0.001) and object control skills (β = 0.21; p < 0.001). A significantly positive relationship was identified between meeting PA + sleep guidelines and locomotor skills (β = −0.16; p = 0.02). A significantly negative association was observed between preschoolers’ meeting sleep + ST guidelines and locomotor skills (β = 0.31; p = 0.001). Conclusion: Few preschoolers met all three movement behavior guidelines. The findings suggest that PA levels, especially MVPA, are important for the promotion of FMS. Meanwhile, the impacts of ST and sleep on motor development cannot be neglected.

Consensus statement on Singapore integrated 24-hour activity guide for children and adolescents

INTRODUCTION

Lifestyle activities, such as regular physical activity, are important for good metabolic health and the prevention of non-communicable diseases. Epidemiological studies highlight an increase in the proportion of overweight children in Singapore. A workgroup was formed to develop recommendations to encourage children and adolescents (aged 7-17 years) to adopt a holistic approach towards integrating beneficial activities within a daily 24-hour period for good metabolic and general health.

METHODS

The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision framework was employed to formulate the public health question, assess the evidence and draw conclusions for the guide. The evidence for international 24-hour movement guidelines, and guidelines for physical activity, sedentary behaviour, and sleep and eating habits were reviewed. An update of the literature review from August 2018 to end of September 2020 was conducted through an electronic search of Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.

RESULTS

Ten consensus statements were developed. The statements focused on the overall aim of achieving good metabolic health through integration of these activities and initiatives: light and moderate- to vigorous-intensity physical activity on a regular basis; muscle- and bone-strengthening activities; limiting sedentary behaviour; regular and adequate sleep; good eating habits and choosing nutritionally balanced foods and drinks; practise safety in exercise; and aiming to achieve more or all aforementioned recommendations for the best results.

CONCLUSION

This set of recommendations provides guidance to encourage Singapore children and adolescents to adopt health-beneficial activities within a 24-hour period.

Physical activity, screen time, and sleep: do German children and adolescents meet the movement guidelines?

The interactions between physical activity (PA), screen time, and sleep affect the health of children and adolescents. This study described the national prevalence estimates of German youth aged 9 to 18 years who meet PA, screen time, and sleep guidelines alone and in combination and examined the associations of demographic and personal characteristics with adherence to guidelines. Data from a 2019-2020 German student survey were used (n = 15,786). The target population consisted of children and adolescents enrolled in grades 5-10, with a mean age of 13.0 years (SD = 1.8) and an equal gender distribution (male: 50%). The levels of PA, screen time, and sleep were assessed by self-reports (online questionnaires). The prevalence rates of meeting each guideline individually and in different combinations were calculated, and multilevel logistic regression models were used to examine the associations of demographic and personal characteristics with meeting versus not meeting guidelines. Overall, 9.7% of the respondents met all three guidelines combined, and approximately 25% did not meet any of the guidelines. Half of the participants (50%) met the sleep guidelines, and approximately one third met the screen time (35%) and PA (37%) guidelines alone. Demographic characteristics associated with adherence to meeting all three movement guidelines included younger age, male gender, higher self-reported socioeconomic status, and school type. Personal characteristics related to adherence to meeting all three movement guidelines included better subjective school performance, less frequent attention deficit hyperactivity disorder (ADHD), lower levels of depressive symptoms, lower body mass index (BMI), and not using substances in the past 30 days.

CONCLUSION

A low percentage of German children and adolescents met the movement guidelines. With increasing age, the proportion of young people who follow the recommendations decreases. There is an urgent need for health interventions devoted to youth behavior as a whole.

WHAT IS KNOWN

• High levels of PA, low levels of screen time, and optimal sleep duration provide enhanced health benefits in comparison to the adoption of just one of these behaviors. • Evidence shows that movement behaviors interact throughout the day and should be studied concurrently.

WHAT IS NEW

• Approximately 10% of German children and adolescents met the recommendations on PA, screen time, and sleep, while 25% did not meet any guidelines. • Meeting all guidelines was associated with less frequent ADHD and depressive symptoms, lower BMI, and less frequent substance use in the past 30 days.

Canadian 24-h Movement Guidelines, Life Stress, and Self-Esteem Among Adolescents

Background

Adolescence is often considered a period of heightened stress, and healthy active living behaviors may help those experiencing it to better cope with life stressors and increase their self-esteem. The 24-h movement guidelines for children and adolescents recommend ≥60 min per day of moderate-to-vigorous physical activity, ≤ 2-h per day of recreational screen time, and 9–11-h of sleep per night for school-aged children or 8–10-h per night for adolescents. The objective of this study was to examine the association of meeting the 24-h movement guidelines with life stress and self-esteem among students in Ontario, Canada.

Methods

Self-reported data on movement behaviors, life stress and self-esteem were derived from the 2019 cycle of the Ontario Student Drug Use and Health Survey, a cross-sectional and province-wide survey of students in grades 7–12 aged 11 to 20 years (N = 6,932). Multivariable ordered logistic regression analyses were adjusted for the complex sample design of the survey and for important covariates.

Results

Overall, meeting all combinations of movement behavior recommendations were associated with lower life stress and better self-esteem compared with meeting none of the recommendations, except meeting the physical activity only or screen time only recommendations that were not associated with lower life stress. Meeting all 3 recommendations was associated with lower life stress (OR: 0.40; 95 CI: 0.30–0.53) and better self-esteem (OR: 0.29; 95% CI: 0.21–0.40). There was a dose-response gradient between the number of recommendations met (3 > 2 > 1) and lower life stress (p < 0.001) and higher self-esteem (p < 0.001), with meeting all 3 recommendations being the best combination.

Conclusions

These findings suggest that meeting the recommendations of the 24-h movement guidelines is associated with lower life stress and better self-esteem among adolescents.

Meeting the 24-Hour Movement Guidelines and Outcomes in Adolescents with ADHD: A Cross-Sectional Observational Study

According to the 24-Hour Movement Guidelines, meeting daily recommendations for physical activity, sleep, and screen time is important for obtaining optimal health benefits. This cross-sectional observational study aimed to examine (a) the prevalence of meeting the movement guidelines; and (b) the associations between meeting the guidelines and selected outcomes in adolescents with attention-deficit/hyperactivity disorder (ADHD). Data from the 2018–2019 National Survey for Children’s Health dataset was used. Participants were adolescents (10–17 years) with ADHD and without other chronic conditions. Outcomes were flourishing, school engagement, and body weight status. Exposures of interest were adherence to the movement guidelines. The frequency of the participants’ adherence to the guidelines was estimated, and regression analyses were conducted to examine the associations between adherence to the guidelines and outcomes, adjusting for potential confounders. Complete observations were available for 634 adolescents with ADHD. Overall, 46.8% of the participants met at least one movement guideline, but only 6.5% met all three. The number of guidelines met had a significant and positive association with flourishing and school engagement (β = 0.21/0.17, p_trend < 0.001). Compared with meeting all three guidelines, significant associations with lower flourishing levels were found in participants who met none, sleep only, and sedentary time only (β = −0.38–−0.13, p < 0.05). Similar findings were identified in the school engagement outcome. Adherence to the guidelines was, however, not significantly associated with the odds of being overweight or obese. Collectively, the findings suggest the movement guidelines may be appropriate for extending to adolescents with ADHD and there is a need to increase adherence to the guidelines in this group.

Different Types of Screen Behavior and Depression in Children and Adolescents

The purpose of this study was to examine the associations between different types of screen behavior and depression, taking into account exercise and sleep among children and adolescents. A total of 23,573 Japanese children and adolescents (aged 8-15 years) participated in this cross-sectional study. Different types of screen behavior, weekly exercise time, sleep duration, and prevalence of depression were assessed using a questionnaire. Independent associations between various types of screen behavior and prevalence of depression were examined using logistic regression analyses after adjusting for age, school, sleep duration, exercise time, and other screen behavior types. A two-way analysis of covariance was conducted to examine whether exercise and sleep can attenuate the negative effects of screen behavior. The associations between screen behavior and depression varied by screen behavior types and participant characteristics. More time spent engaging in newer types of screen behavior, including social media, online games, and online videos, was associated with a higher prevalence of depression. In contrast, more time spent on TV was associated with a lower prevalence of depression. Sufficient exercise can lower the prevalence of depression, regardless of the length of time and content of the screen, and its associations were particularly significant for junior high school girls. Sleep was not associated with the prevalence of depression among any participant group except elementary school boys. Our findings suggest that age- and sex-specific intervention strategies that also consider screen-based behavior can effectively lower the risk of depression in children and adolescents.

Prevalence and trends in Australian adolescents' adherence to 24-hour movement guidelines: findings from a repeated national cross-sectional survey

BACKGROUND

24-hour movement guidelines recommend a healthy balance of high levels of physical activity, low levels of sedentary behaviour and appropriate sleep duration each day. At present, surveillance data on how Australian adolescents are performing against these guidelines are lacking. This study aims to describe the extent to which Australian secondary school students are adhering to the physical activity, sedentary recreational screen time and sleep duration recommendations outlined in the national 24-hour movement guidelines for children and young people. It also examines whether there are socio-demographic differences in levels of compliance and if there have been significant changes in these behaviours over time.

METHODS

A repeated national cross-sectional survey of students in grades 8 to 11 (ages 12-17 years) was conducted in 2009-2010 (n=13,790), 2012-2013 (n=10,309) and 2018 (n=9,102). Students' self-reported physical activity, screen time and sleep behaviours were assessed using validated instruments administered in schools via a web-based questionnaire.

RESULTS

In 2018, around one in four students (26%) did not meet any of the 24-hour movement guidelines, while only 2% of students met all three. Adherence to the sleep duration recommendation was highest (67%), with substantially smaller proportions of students meeting the physical activity (16%) and screen time (10%) recommendations. Differences in adherence by sex, grade level and socio-economic area were apparent. Students' compliance with the screen time recommendation has declined over time, from 19% in 2009-2010 to 10% in 2018. However, there has been no significant change in the proportion meeting the physical activity (15% in 2009-2010 cf. 16% in 2018) and sleep duration (69% in 2009-2010 cf. 67% in 2018) recommendations. Compliance with all three guidelines has remained very low (<3%) across each survey round.

CONCLUSIONS

There is considerable scope to improve Australian adolescents' physical activity and sedentary behaviours in line with the national 24-hour movement guidelines. Policy proposals and environmental interventions, particularly those focused on replacing sedentary screen time with physical activity (e.g. promotion of active commuting to/from school), are needed to better support Australian adolescents in meeting the 24-hour movement guidelines.

A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep

Abstract

Background

In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process.

Methods

The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines.

Results

Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years).

Conclusions

To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01236-2.

Impact of the COVID-19 pandemic on elementary schoolers' physical activity, sleep, screen time and diet: A quasi-experimental interrupted time series study

BACKGROUND

COVID-19 school closures pose a threat to children's wellbeing, but no COVID-19-related studies have assessed children's behaviours over multiple years .

OBJECTIVE

To examine children's obesogenic behaviours during spring and summer of the COVID-19 pandemic compared to previous data collected from the same children during the same calendar period in the 2 years prior.

METHODS

Physical activity and sleep data were collected via Fitbit Charge-2 in 231 children (7-12 years) over 6 weeks during spring and summer over 3 years. Parents reported their child's screen time and dietary intake via a survey on 2-3 random days/week.

RESULTS

Children's behaviours worsened at a greater rate following the pandemic onset compared to pre-pandemic trends. During pandemic spring, sedentary behaviour increased (+79 min; 95% CI = 60.6, 97.1) and MVPA decreased (-10 min, 95% CI = -18.2, -1.1) compared to change in previous springs (2018-2019). Sleep timing shifted later (+124 min; 95% CI = 112.9, 135.5). Screen time (+97 min, 95% CI = 79.0, 115.4) and dietary intake increased (healthy: +0.3 foods, 95% CI = 0.2, 0.5; unhealthy: +1.2 foods, 95% CI = 1.0, 1.5). Similar patterns were observed during summer.

CONCLUSIONS

Compared to pre-pandemic measures, children's PA, sedentary behaviour, sleep, screen time, and diet were adversely altered during the COVID-19 pandemic. This may ultimately exacerbate childhood obesity.

Associations between 24-hour movement guideline adherence and mental health disorders among young people with active and inactive epilepsy

OBJECTIVE

(1) Examine 24-hour movement guideline adherence among young people with active and inactive epilepsy compared to population norms. (2) Investigate associations between 24-hour movement guideline adherence and mental health disorders among these subpopulations.

METHODS

Cross-sectional data from the 2016 to 2019 cycles of the National Survey of Children's Health were used. Parental/caregiver reports of movement behaviors (physical activity, screen time, sleep, and sport participation) were used to determine adherence to the 24-hour movement guidelines and associations with mental health disorders for young people with active (n = 663) and inactive epilepsy (n = 526) as well as population norms (n = 49,067) between 6 and 17 years old. Multivariate logistic regression analyses were conducted.

RESULTS

Young people with active epilepsy were less likely to meet the 24-hour movement guidelines than population norms, largely driven by below average levels of physical activity guideline adherence. Sport participation was lower among both young people with active and inactive epilepsy; seizure severity and health-related limitations played an influential role. Beneficial associations were generally observed between 24-hour movement guideline adherence and mental health disorders, although for young people with active and inactive epilepsy, there was considerable variability among these relationships.

CONCLUSIONS

Further dissemination of the International League Against Epilepsy's Task Force on Sports and Epilepsy report can help improve promotion of physical activity and sport participation among young people with active and inactive epilepsy. The relationship between 24-hour movement guideline adherence and mental health disorders is complex among young people with epilepsy and longitudinal research is needed to determine causal links.

Associations of 24-Hour Movement Behavior with Depressive Symptoms and Anxiety in Children: Cross-Sectional Findings from a Chinese Sample

This study examined the associations between adherence to 24-hour movement behavior guidelines (24-HMB) and the mental-health-related outcomes of depressive symptoms and anxiety in Chinese children. Data on movement behavior from 5357 children (4th and 5th grades), including physical activity, recreational screen time and sleep, were self-reported using the Health Behavior School-Aged Children Survey. Depressive symptoms and anxiety were self-reported using the Chinese version of the nine-item Patient Health Questionnaire and the Generalized Anxiety Disorder Scale, respectively. Depressive symptoms and anxiety were treated as categorical variables. Only 3.2% of the participants met physical activity, screen time, and sleep 24-HMB guidelines. Ordinal logistic regressions showed that, compared with participants who met the 24-HMB guidelines, participants who met none (odds ratio (OR) = 2.62, 95% CI: 1.76-3.90) or any one of the guidelines (OR = 1.88, 95% CI: 1.27-2.77) had higher odds of depressive symptoms. Similarly, there were higher odds of anxiety in participants who met none (OR = 2.32, 95% CI: 1.45-3.70) or any one of the recommendations (OR = 1.62, 95% CI: 1.03-2.57) compared with participants who met all the 24-HMB guidelines. Meeting the 24-HMB guidelines is associated with better mental-health-related outcomes in Chinese children. Because of the low prevalence of Chinese children meeting the 24-HMB recommendations, the present findings highlight the need to encourage children to regularly engage in physical activity, decrease their time spent sitting, and improve their sleep patterns.

Asia-Pacific Consensus Statement on integrated 24-hour activity guidelines for children and adolescents

Non-communicable diseases (NCDs) constitute a significant public health challenge and pose a great burden on health and social systems throughout the world. The Asia-Pacific region is in a vulnerable position as the prevalence of NCDs will inevitably increase with rapid socioeconomic transitions; yet it is ill prepared for this public health challenge as Asian children are among the most physically inactive in the world. Aligned with the WHO's global strategy to control NCDs via preventive measures and health promotion policies, representatives from the Asia-Pacific region came together to develop consensus statement on integrated 24-hour activity guidelines for children and adolescents. These guidelines apply to children and adolescents, aged 5-18 years, in the Asia-Pacific region, regardless of gender, cultural background or socioeconomic status. These guidelines aim to provide the latest evidence-based recommendations, taking a holistic approach to lifestyle activities and adopting a practical perspective by framing these activities within a 24-hour period. Eating and dietary elements were incorporated as they closely influence the energy balance of the movement behaviours and vice versa. By investing in the younger generations through advocacy for healthier lifestyles, we aim to reduce the burden of NCDs in the Asia-Pacific region.

Movement Behaviors and Mental Wellbeing: A Cross-Sectional Isotemporal Substitution Analysis of Canadian Adolescents

Background: Studies have shown reallocating screen time for healthy movement behaviors such as physical activity and sleep can provide important benefits for mental health. However, the focus on positive aspects of mental health such as wellbeing has received limited attention, particularly among adolescents. The purpose of this study was to examine the effects of reallocating physical activity, screen time, and sleep on mental wellbeing in adolescents.

Methods: This study involved cross-sectional analysis of data from Wave 1 of the ADAPT study. A total of 1,118 Canadian adolescents enrolled in grade 11 classes (M_AGE = 15.92; 54.5% female) self-reported their movement behaviors using the International Physical Activity Questionnaire – Short Form to assess moderate-to-vigorous physical activity and daily recall questionnaires to assess recreational screen time and sleep. Participants also completed three measures of mental wellbeing: the Flourishing Scale, Rosenberg Self-Esteem Scale, and a brief Resiliency scale from the Canadian Campus Wellbeing Survey.

Results: Isotemporal substitution analysis revealed replacing 60 min of screen time with either moderate-to-vigorous physical activity or sleep has significant benefits for mental wellbeing. Comparatively, reallocating 60 min between moderate-to-vigorous physical activity and sleep does not impact mental wellbeing.

Discussion: Findings suggest healthy movement behaviors confer similar beneficial effects for adolescent’s mental wellbeing. Health promotion campaigns targeted toward adolescents should consider highlighting that reallocation of screen time to either sleep or moderate-to-vigorous physical activity may provide important benefits for mental wellbeing.

Implications of Disability Severity on 24-Hour Movement Guideline Adherence Among Children With Neurodevelopmental Disorders in the United States

BACKGROUND

Research has established beneficial associations between 24-hour movement guideline adherence and several health outcomes in typically developing (TD) children, but these relationships are poorly understood in children with neurodevelopmental disorders (NDD). This study examined (1) 24-hour movement guideline adherence, (2) the influence of disability severity, and (3) associations between guideline adherence and health outcomes of TD children and children with NDD.

METHODS

This cross-sectional study used data from the 2018 and 2019 cycles of the US National Survey of Children's Health. Parental/caregiver reports of movement behaviors (physical activity, screen time, and sleep), disability severity (limitations to daily activities), and health outcomes (general health status, anxiety, and depression) were provided for 8554 children with NDD and 19,669 TD children aged 6-17 years.

RESULTS

Children with NDD had significantly lower odds of meeting each movement behavior guideline compared to TD children; these effects were most pronounced for those who experienced consistent limitations to daily activities. Meeting at least 2 guidelines significantly lowered the odds for anxiety and depression, and increased the odds for better general health for children with NDD.

DISCUSSION

These findings suggest that degree of disability severity has a strong influence on adherence to 24-hour movement guidelines among children with NDD.

Sleep as a Priority: 24-Hour Movement Guidelines and Mental Health of Chinese College Students during the COVID-19 Pandemic

Research on the combined role of 24-hour movement behaviors (sleep, sedentary behavior [SB], and physical activity) in adult mental health, though important, is in its infancy. In the context of Canadian 24-hour movement guidelines integrating quantitative recommendations for sleep, SB, and moderate-to-vigorous physical activity (MVPA), this study aimed to examine the associations between meeting guidelines and mental health among college students. The study used a cross-sectional sample of 1846 Chinese college students surveyed online in August 2020. Through network analysis and multivariate analysis of covariance, the individual and combined associations between meeting 24-hour movement guidelines and the levels of depression and anxiety after adjusting sociodemographic factors were analyzed. Results indicated that meeting the sleep guideline had stronger associations with depression and anxiety than meeting the SB or MVPA guideline. Specifically, compared to meeting no guidelines, meeting the sleep guideline (alone or in combination with other guidelines) was associated with significantly lower levels of depression and anxiety; meeting both SB and MVPA guidelines was also associated with a significantly lower level of depression. Hence, meeting more guidelines, especially adhering to a healthy sleep routine, may play an important role in promoting the mental health of young adults.

Health Promotion through Movement Behaviors and Its Relationship with Quality of Life in Spanish High School Adolescents: A Predictive Study

A growing number of studies have highlighted the health benefits of high physical activity, low screen time, and optimal sleep duration among school-age children and adolescents. Objective: The present study proposes to examine the individual and combined association between movement behaviors (physical activity, screen time, and sleep time) and quality of life in boys and girls. Method: A total of 319 Spanish primary and secondary school students participated in the study. Physical activity, screen time, sleep duration, and quality of life were evaluated. Results: Descriptive, correlation, and regression analyses were carried out in order to improve knowledge about health-related behaviors for all participants. The results found significant positive associations between physical activities and sleep time with quality of life. Finally, the regression models showed that physical activity scores predict quality of life, especially in children. It is concluded that movement behaviors are important in association with quality of life. Likewise, the impact of physical activity on the quality of life is highlighted as the main behavior in the prediction of the quality of life for a population of school adolescents.

The 24-Hour Movement Guidelines and Body Composition Among Youth Receiving Special Education Services in the United States

BACKGROUND

The purposes of this study were to examine the proportions of youth receiving special education services in the United States who individually and jointly met physical activity, screen time, and sleep duration guidelines, and to examine the impact of meeting none, one, two, and three of the guidelines on overweight and obesity.

METHODS

This cross-sectional analysis utilized data from the 2016 to 2017 National Survey for Children's Health data set on 3582 youth aged 10-17 years who received special education services. The frequency of the participants' compliance with the 24-hour movement guidelines and body weight status (based on the age- and sex-specific percentile cutoffs) were estimated. Meeting guidelines was defined as: 9-11 hours/night (5-13 y) or 8-10 hours/night (14-17 y) of sleep, ≤120 minutes per day of screen time, and ≥60 minutes per day of moderate to vigorous physical activity. A multinomial logistic regression analysis was conducted to estimate the impact of meeting none, one, two, or three guidelines on body weight status, adjusted for potential confounders.

RESULTS

Overall, 8.1% of youth met all three guidelines, 42.0% met two guidelines, 38.0% met one guideline, and 11.9% did not meet any guideline. Meeting all three guidelines was associated with an approximately 50% decreased likelihood of overweight than meeting no guideline, or sleep or screen time guidelines independently.

CONCLUSIONS

This study extends the 24-hour movement framework to children receiving special education services and should prompt the continued study of its utility for understanding health disparities experienced by this population.

24-Hour Movement Behaviors and Internalizing and Externalizing Behaviors Among Youth

PURPOSE

The Canadian 24-Hour Movement Guidelines for Children and Youth (≥60 minutes of moderate-to-vigorous physical activity per day, ≤2 hours of recreational screen time per day, and 9-11 hours of sleep per night for 5-13 years old) are associated with better physical health, but less is known about how these behaviors are related to mental health. This study examined the association of meeting these guideline recommendations with internalizing and externalizing behaviors among youth.

METHODS

A large and broadly representative cross-sectional sample of 9- to 11-year-old U.S. youth (N = 11,875) from the Adolescent Brain and Cognitive Development study was analyzed. Internalizing and externalizing behaviors were measured using the Child Behaviour Checklist. Associations were examined using negative binomial regression adjusted for several confounders.

RESULTS

Compared to meeting none of the recommendations, meeting recommendations for screen time and sleep but not physical activity was associated with a lower prevalence ratio of total, internalizing, and externalizing behaviors. Meeting two or all three recommendations was more strongly associated with these outcomes than meeting one recommendation or none. The prevalence ratio of the group meeting all three recommendations was .77 (95% confidence interval [CI]: .68-.86) for total problem scores, .78 (95% CI: .68-.89) for internalizing problem scores, and .79 (95% CI: .68-.91) for externalizing problem scores.

CONCLUSIONS

Meeting the 24-hour movement guidelines was associated with a lower risk of internalizing and externalizing behaviors in youth. These associations were mainly explained by meeting the screen time and sleep duration recommendations.