Associations between meeting sleep, physical activity or screen time behaviour guidelines and academic performance in Australian school children

Meeting 24-h movement behavior guidelines is associated with academic engagement, social-emotional functioning in obese/overweight youth

BACKGROUND

The 24-h movement behavior (24-HMB) guidelines suggest that the integration of adequate sleep (SL), increased physical activity (PA), and limited screen time (ST) has general health benefits. However, associations of meeting integrated guidelines with academic engagement and social-emotional functioning among obese/overweight youth have yet to be fully examined. Thus, we aimed to investigate the associations between meeting 24-HMB guidelines and the above-presented outcome measures among this unique group.

METHODS

In this cross-sectional study, 2800 children and adolescents (youth aged 6-17 years old) that were retrieved from the National Survey of Children's Health (NSCH) were included for data analysis. Exposure of interests included adherence to 24-HMB guideline(s), while indicators of academic engagement and social-emotional functioning were operationalized. Furthermore, multiple logistic regression was conducted while adjusting for social-demographic variables including age, sex, ethnicity, household income, parental education level and mental health status.

RESULTS

The percentages of meeting 24-HMB guidelines varied greatly across different combinations: 1399 participants (49.96 %) met 1 of the 3 guidelines, 580 participants (20.91 %) met 2 guidelines, while only 91 participants (2.94 %) met all 3 guidelines. Meeting integrated guidelines was selectively associated with higher odds of indicators (showing interest/curiosity in learning, caring about school performance, and completing all required homework) of academic engagement. Additionally, Meeting SL + ST guideline (OR = 0.52, 95%CI: 0.29-0.93, p < 00.05) was associated with lower odds of serious difficulty in concentrating, remembering, and making decisions, while meeting ST + SL guideline (OR = 1.67, 95%CI: 1.03-2.69, p < 00.05) was more likely to be good at making and keeping friendships. Furthermore, meeting all 3 guidelines was associated with less argumentative behaviors (OR = 0.58, 95%CI: 0.33-0.99, p < 00.05) and a higher level of resilience (OR = 3.51, 95%CI: 1.88-6.54, p < 00.01), while meeting any two integrated guidelines was associated with a higher level of resilience (OR = 1.72, 95%CI: 1.09-2.71, p < 00.05).

CONCLUSION

Findings have indicated the role of meeting 24-HMB guidelines, especially integrated guidelines in the healthy development of obese/overweight youth. Policymakers should implement a long-term plan for this unique group to engage in physical activity, achieve enough sleep, and limit screen time.

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.

Is adherence to the 24-h movement guidelines associated with greater academic-related outcomes in children and adolescents? A systematic review and meta-analysis

The purpose of this systematic review was to synthesise the evidence for the association of adherence to the 24-h movement guidelines with academic-related outcomes in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. PubMed, PsycINFO, Scopus, WOS, SPORTDiscus, and EMBASE were searched from their inception to 12 December 2023. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias of included studies. In total, 4326 records were identified through database searches; 10 articles met the inclusion criteria and were included in this systematic review. There were eight cross-sectional studies and two longitudinal studies; the main academic-related outcomes were academic achievement and cognitive function. A small association between adherence to all three recommendations and academic achievement (k = 5, r = 0.17, 95% CI = 0.10-0.24, I2 = 49%) was found compared to those who did not adhere to any recommendations.   Conclusion: Findings from this systematic review and meta-analysis reveal a small association between adherence to all three recommendations and greater academic achievement in children and adolescents. Nevertheless, it is imperative to underscore the need for more studies to establish robust evidence underpinning this relationship.   Trial registration: PROSPERO (CRD42021295403). What is Known: • Regular physical activity, reduced screen time, and optimal sleep duration are independently associated with improved academic-related outcomes in children and adolescents. • The associations between adherence to the 24-h movement guidelines and academic-related outcomes in children and adolescents have not been quantitatively synthesised. What is New: • There is a small but positive association between adherence to all three recommendations of the 24-h movement guidelines and greater academic achievement in children and adolescents. • Further well-designed research is needed to focus on academic achievement, cognitive function and classroom behaviours in young individuals.

Predictors for achieving optimal sleep in healthy children: Exploring sleep patterns in a sleep extension trial

STUDY OBJECTIVES

Earlier bedtimes can help some children get more sleep, but we don't know which children, or what features of their usual sleep patterns could predict success with this approach. Using data from a randomized crossover trial of sleep manipulation, we sought to determine this.

METHODS

Participants were 99 children aged 8-12years (49.5% female) with no sleep disturbances. Sleep was measured by actigraphy at baseline and over a restriction or extension week (1 hour later or earlier bedtime respectively), randomly allocated and separated by a washout week. Data were compared between baseline (week 1) and extension weeks only (week 3 or 5), using linear or logistic regression analyses as appropriate, controlling for randomization order.

RESULTS

One hour less total sleep time than average at baseline predicted 29.7 minutes (95% CI: 19.4, 40.1) of sleep gained and 3.45 (95% CI: 1.74, 6.81) times higher odds of successfully extending sleep by >30 minutes. Per standardized variable, less total sleep time and a shorter sleep period time were the strongest predictors (significant odds ratios (ORs) of 2.51 and 2.28, respectively). Later sleep offset, more variability in sleep timing and lower sleep efficiency also predicted sleep gains. The sleep period time cut-point that optimized prediction of successful sleep gains was <8 hours 28 minutes with 75% of children's baseline sleep in that range.

CONCLUSIONS

Children with a baseline sleep period time <8½ hours a night obtained the most sleep from earlier bedtimes maintained over a week, demonstrating experimentally the value of earlier bedtimes to improve sleep.

CLINICAL TRIALS REGISTRY

Australian New Zealand Clinical Trial Registry, ACTRN12618001671257, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true.

Meeting 24-h movement behavior guidelines is linked to academic engagement, psychological functioning, and cognitive difficulties in youth with internalizing problems

BACKGROUND

This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth.

METHODS

In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates.

RESULTS

The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05).

CONCLUSION

Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.

Sleep and dropout from upper secondary school: A register-linked study

OBJECTIVE

The present study investigates the association between sleep in late adolescence and completion of upper secondary school.

METHODS

The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked with official educational data in Norway (N = 8838).

RESULTS

High school dropout was more prevalent among adolescents who had insomnia (20.6%) compared to those without insomnia (14.3%; adjusted risk ratios = 1.50; 95% confidence intervals: [2.19-2.92]). There was also a higher rate of school dropout among those who had symptoms of delayed sleep-wake phase (21%) compared to those without delayed sleep-wake phase (14.3%); adjusted risk ratios = 1.43, 95% confidence intervals: (1.28-1.59). School noncompleters were also characterized by reporting 44 minutes shorter sleep duration, longer sleep onset latency, and wake after sleep onset (both approx. 15 minutes) compared to school completers.

CONCLUSION

The importance of sleep for high school dropout rates highlights the importance of including sleep as a risk indicator and a possible target for preventive interventions in late adolescence.

Strategies to Improve Physical Activity and Nutrition Behaviours in Children and Adolescents: A Review

Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of "best bets" to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a 'road map' to achieving prevention and improving the health of children and adolescents.

Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study

Objective

Electronic devices have become an indispensable part of our daily lives. The frequency and duration of device use in children and adolescents have increased drastically over the years and the study of its negative musculoskeletal, visual and psychosocial health impacts is necessary.

Materials and methods

This cross-sectional study aimed to evaluate the associations between electronic device use and the prevalence and severity of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life in children and adolescents studying at primary and secondary schools. Data were collected through confidential online and paper-and-pencil questionnaires. Primary 4-5 and Secondary 1-4 students were recruited from 3 schools in Hong Kong. Demographics, frequency and duration of electronic device use, frequencies of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life outcomes were measured.

Results

1,058 children and adolescents aged 9-17  years participated. Sixty-one percent and 78% of all students spent more than 2  h per day using electronic devices during school days and weekend/holidays, respectively. Extended electronic device use was associated with increased prevalence and severity of musculoskeletal symptoms (ρ's = 0.28-0.33, P's < 0.001), visual symptoms (ρ's = 0.33-0.35, P's < 0.001), and poorer device use-related psychosocial health (ρ's = 0.38-0.47, P's < 0.001). Secondary school students reported greater device use and severity of symptoms than primary school students.

Conclusion

Excessive electronic device use was associated with increased prevalence and severity of physical and psychosocial symptoms, and such use is more prevalent in adolescents when compared to the children. The findings have important health implications for children and adolescents, suggesting that early intervention is needed to reduce the risk of developing device use-related disorders.

Sedentary behaviour profiles and longitudinal associations with academic performance in youth: The UP&DOWN study

The current study evaluated longitudinal associations between profile transitions of context-specific sedentary behaviour (SB) and changes in academic performance (AP) among school-aged youth. Participants were 466 children and 717 adolescents (50.8% males) aged 8-18 years (children = 7.92 ± 0.41 years; adolescents = 11.85 ± 1.53 years). Non-school SBs and AP were evaluated at baseline and two years later. General linear mixed models were implemented, controlling for age, region, parental education, body mass index, and cardiorespiratory fitness. Cross-sectionally, participants with an Educative-profile (i.e., highest scores in doing homework with/without computer and reading for fun) had higher AP when compared to other profiles. Longitudinally, males who changed from a Screen- to an Educative-profile had higher AP than males who changed from an Educative- to a Social- or Screen-SB profile (p < 0.01). No significant differences were found in females. These findings show the importance of analysing SB patterns from a qualitative perspective (i.e., context-specific for boosting school children AP) and highlighting time spent in educative as the most positive for AP, as well the need to implement interventions to reduce time on screen and social behaviours, especially targeting males.

Development of a ParticipACTION App-Based Intervention for Improving Postsecondary Students' 24-Hour Movement Guideline Behaviors: Protocol for the Application of Intervention Mapping

BACKGROUND

The Canadian 24-Hour Movement Guidelines for adults provide specific recommendations for levels of physical activity, sedentary behavior, and sleep (ie, the movement behaviors) required for optimal health. Performance of the movement behaviors is associated with improved mental well-being. However, most postsecondary students do not meet the movement behavior recommendations within the Canadian 24-Hour Movement Guidelines and experience increased stress and declining well-being, suggesting the need for an intervention targeting students' movement behaviors.

OBJECTIVE

We aimed to develop and implement a theory-informed intervention intended to improve the movement behaviors and mental well-being of first-year postsecondary students.

METHODS

The Intervention Mapping protocol was applied in the development and implementation of the intervention. Intervention Mapping entailed performing a needs assessment, determining the intervention outcomes, selecting theory- and evidence-based change methods and applications, preparing and producing intervention plans and materials, developing the implementation plan, and finally developing an evaluation plan. The Theoretical Domains Framework and the Behavior Change Wheel were also used in conjunction with the Intervention Mapping protocol to ensure a solid theoretical basis for the intervention. This protocol led to the development and implementation of a 6-week, theory-informed ParticipACTION app-based intervention aimed at helping first-year postsecondary students improve their movement behaviors and mental well-being. The developed app content provided students with information on each of the movement behaviors and behavioral strategies (ie, goal setting, action planning, monitoring, and coping planning). The use of Intervention Mapping allowed for the continuous involvement of various multidisciplinary partners and end users, ensuring that the intervention design and implementation was appropriate for the target audience. The feasibility, acceptability, and potential impact of the intervention will be examined in a subsequent proof-of-concept study at 2 Canadian university campuses.

RESULTS

Participant recruitment occurred during September 2021, and the intervention was conducted from October to December 2021. The deadline for completion of the postintervention questionnaire by participants was mid-December 2021. The analysis of data examining the feasibility, acceptability, and potential impact of the intervention began in January 2022, with the publication of the proof-of-concept evaluation expected in 2023.

CONCLUSIONS

Intervention Mapping with the Theoretical Domains Framework and Behavior Change Wheel was a useful approach to combine evidence and theoretical concepts to guide the design and implementation of a ParticipACTION app-based intervention targeting postsecondary students' movement behaviors and mental well-being. This process may serve as an example for other researchers developing multiple behavior change app-based interventions. Should the forthcoming evaluation demonstrate the intervention's acceptability, feasibility, and potential impact, the intervention may provide a scalable method of improving postsecondary students' movement behaviors and mental well-being.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/39977.

Physical Activity, Screen Time, and Academic Burden: A Cross-Sectional Analysis of Health among Chinese Adolescents

This paper aims to analyze the effects of physical activity, screen time, and academic burden on adolescent health in China and compare their effects by using the nationally representative sample data from the CEPS (China Educational Panel Survey) cross-section data. This paper first uses regression analysis to examine the relationship between physical activity, screen time, academic burden and health among Chinese adolescents. Then, this paper uses the clustering analysis the influence of physical activity, screen time, and academic burden on the health of Chinese adolescents. The empirical results show that: (1) along with exercise, helping with the housework also has a clear health-promoting effect on adolescents; (2) the time spent surfing the Internet or playing video games, and heavy studying or homework off campus have a negative effect on adolescents' self-rated health and mental health; (3) physical activity has the greatest impact on self-rated health, while screen time has the greatest impact on mental health, and academic burden is not the most important factor affecting adolescent health in China.

Sedentary behaviours and their relationship with academic performance in adolescents: A mediation analysis

The present research aims to examine the relationship between the four dimensions of sedentary behaviours and academic performance, as well as to test the association between sedentary behaviours and academic performance in boys and girls in a sample of Spanish adolescents. A total of 2,216 adolescents aged 11 to 16 years old, both males (13.30 ± 0.92) and females (13.06 ± 0.86), participated. Sleep duration, physical activity, and sedentary behaviours were measured through questionnaires. Academic performance was assessed with students´ marks. Potential confounders such as sex, age, socioeconomic status, and cardiorespiratory fitness were also measured. Descriptive analysis, correlation analysis, analysis of differences, and multiple mediation analysis were conducted. It was observed that girls spend more time on sedentary educational or social behaviours, while boys spend much more time on screen time. Sedentary behaviours such as educational time, screen time, and relaxing time were associated with academic performance. Specifically, educational time appears to be positively related to academic performance. Nevertheless, screen time and relaxing time were negatively associated with academic performance. The multiple mediation analysis revealed that screen time was the most negative behaviour on academic performance. The outcomes are discussed to improve knowledge about sedentary behaviours and academic performance.

Associations between 24-h Movement Behavior and Internet Addiction in Adolescents: A Cross-Sectional Study

OBJECTIVE

This study aimed to explore the relationship between 24-h activity behavior and Chinese adolescents' Internet addiction.

METHODS

A survey of 2045 adolescents (56.5% boys) was conducted, and adolescents' 24-h movement behavior and Internet addiction were measured via a questionnaire. Descriptive statistics were used to analyze the basic situation of the respondents; chi-square analysis was used to compare gender differences, and logistic regression was used to analyze the relationship between 24-h exercise guide entries and Internet addiction.

RESULTS

From the number of 24-h movement behavior guides, 25.3% of the children did not meet the recommended amount of any kind of activity behavior guide, while 50.4% and 21.7% of the children reached the recommended amount of one and two activity behavior guidelines, respectively; only 3.2% of the children met the recommended amount of all three activity behavior guidelines. Adolescents who did not meet the recommended 24-h activity behavior guidelines were more likely to have Internet addiction (OR = 8.46, 95 CI = 3.06-23.36), and were more likely to have one item (OR = 4.50, 95 CI = 1.64-12.39) or two items (OR = 3.12, 95 CI = 1.11-8.74).

CONCLUSIONS

Physical activity, static behavior, and sleep may all have a greater impact on adolescents' Internet addiction, among which physical activity has a greater impact on adolescents' Internet addiction. Different combinations of 24-h movement behavior have different effects on adolescents' Internet addiction.

Physical activity, sedentary behavior and educational outcomes in university students: A systematic review

ObjectiveTo systematically review available evidence focusing on the relationship between physical activity (PA), sedentary behavior (SB), and educational outcomes (EO), among university students. Method: Articles published in English and up to April 2019 were eligible to be included in the review if they examined associations between either PA or SB measures and EO in undergraduate university students. Results: Thirty-five articles met the eligibility criteria. The majority of papers used self-report measures of PA and SB and were rated as demonstrating poor quality (22/35). Evidence indicated no associations with EO for overall PA, MPA, VPA, and indeterminate associations for MVPA and leisure-based screen time. Conclusion: Mixed findings for PA, SB, and EO were found. Future studies should use more rigorous designs, including robust measures of relevant outcomes, to further our understanding of this area.

Effect of a 16-week multi-level classroom standing desk intervention on cognitive performance and academic achievement in adolescents

The replacement of traditional classroom desks for active-permissive desks has been tested to reduce sitting time during classes. However, their impact on other domains is still unclear. We aimed to verify the potential effects of a classroom standing desk intervention on cognitive function and academic achievement in 6th-grade students. This was a controlled trial conducted with two classes [intervention (n = 22) and control (n = 27)] from a public school in Lisbon, Portugal. The intervention was carried out for 16 weeks and consisted of multi-level actions (students, parents, and teachers) centered on the implementation of standing desks in the intervention classroom. The control group had traditional classes with no use of standing desks or any other interference/action from the research team. Pre- and post-assessments of executive functions (attention, inhibitory function, memory, and fluid intelligence) and academic achievement were obtained. No differences between groups were found at baseline. Both groups improved (time effect) academic achievement (p < 0.001), memory span (p < 0.001), and inhibitory function (p = 0.008). Group versus time interactions were observed regarding operational memory (intervention: + 18.0% and control: + 41.6%; p = 0.039) and non-verbal fluid intelligence (intervention: − 14.0% and control: + 3.9%; p = 0.017). We concluded that a 16-week classroom standing desk intervention did not improve cognitive performance or academic achievement more than the traditional sitting classes.

Trial registration: ClinicalTrials.gov Identifier (NCT03137836) (date of first registration: 03/05/2017).

Associations of Passive and Mentally Active Screen Time With Perceived School Performance of 197,439 Adolescents Across 38 Countries

OBJECTIVE

To examine the associations of passive (ie, television) and active (ie, electronic games, computer use) screen time (ST) with perceived school performance of adolescents across gender.

METHODS

Data were from the 2014 Health Behaviour in School-aged Children survey conducted across 38 European countries and Canada. Perceived school performance was assessed using an item and dichotomized as high (good/very good) versus the remainder (average/below-average as reference). Participants reported hours per day of time spent watching television, playing electronic games, and using a computer in their free time. Multilevel logistic regression was used to estimate the associations.

RESULTS

A total of 197,439 adolescents (average age 13.6 [standard deviation 1.63] years; 51% girls) were analyzed. Multivariable modeling showed that engaging in >2 h/d of ST was progressively and adversely associated with high performance in both boys and girls. Adolescents reporting >4 h/d of television time (≤1 h/d as reference) had 32% lower odds in boys (odds ratio [OR] 0.68; 95% confidence interval [CI]: 0.65-0.71) and 39% lower odds in girls (OR 0.61; 95% CI, 0.58-0.65) of reporting high performance. Playing electronic games for >4 h/d was associated with high performance with odds being 38% lower in boys (OR 0.62; 95% CI, 0.59-0.66) and 45% lower in girls (OR 0.55; 95% CI, 0.52-0.57). Sex differences in the estimates were mixed.

CONCLUSIONS

High screen use, whether active or passive, was adversely associated with perceived high school performance, with association estimates being slightly stronger in girls than boys, and for mentally active than passive screen use. Discouraging high levels of screen use of any type could be beneficial to school performance.

Prevalence of meeting 24-Hour Movement Guidelines from pre-school to adolescence: A systematic review and meta-analysis including 387,437 participants and 23 countries

BACKGROUND

Meeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide.

METHODS

Four electronic databases (MEDLINE, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021. Studies that were conducted with apparently healthy participants and reported the overall (non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.

RESULTS

Sixty-three studies comprising 387,437 individuals (51% girls) aged 3-18 years from 23 countries were included. Overall, 7.12% (95% confidence interval (95%CI): 6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines, and 19.21% (95%CI: 16.73%-21.69%) met none of the 3 recommendations. Concerning sex, adherence to all recommendations was significantly lower in girls (3.75%, 95%CI: 3.23%-4.27%) than in boys (6.89%, 95%CI: 5.89%-7.89%) (p < 0.001). However, there were no sex differences regarding adherence to any of the 3 individual recommendations (girls, 15.66%, 95%CI: 8.40%-22.92%; boys, 12.95%, 95%CI: 6.57%-19.33%). In terms of age group, adherence to the 3 recommendations was 11.26% (95%CI: 8.68%-13.84%), 10.31% (95%CI: 7.49%-13.12%), and 2.68% (95%CI: 1.78%-3.58%) in preschoolers, children, and adolescents, respectively. Conversely, 8.81% (95%CI: 5.97%-11.64%) of preschoolers, 15.57% (95%CI: 11.60%-19.54%) of children, and 28.59% (95%CI: 22.42%-34.75%) of adolescents did not meet any of the recommendations. South America was the region with the lowest adherence (all: 2.93%; none: 31.72%). Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index (β = -0.37, 95%CI: -0.65 to -0.09; p = 0.010).

CONCLUSION

Most young people fail to meet the three 24-Hour Movement Guidelines, particularly adolescents, girls, and those who are from countries with a lower Human Development Index. Moreover, 1 in 5 young people did not meet any of these recommendations. Therefore, these results highlight the need to develop age- and sex-specific strategies to promote these movement behaviors from the early stages of life.

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.

Fitness, Fatness, and Academic Attainment in Male Schoolchildren from a Soccer Academy

This investigation explored the association between anthropometric measures, fitness, and academic attainment (mathematics and science grade point average [GPA]) in male schoolchildren from a soccer academy. Thirty-one males (age: 10.3 ± 1.19 years; body mass: 41.7 ± 6.5 kg; height: 1.43 ± 0.07 m; body mass index (BMI): 20.2 ± 2.8 kg/m2) participated. Body mass, body fat percentage (%BF), and BMI were used as measures of anthropometry. The Yo-Yo Intermittent Recovery Test (level 1), squat and counter-movement jumps (SJ and CMJ), static balance, 10 and 15 m sprint, and a T-half test for change-of-direction (CoD) performance were used to measure fitness parameters. The GPA of mathematics and science determined academic attainment. All physical performance tests showed excellent relative reliability. ICC was between 0.87 (10 m sprint) and 1.00 (15 m sprint, CMJ). Regarding correlations between fatness and academic attainment, we found three correlations of practical value (r > 0.5), but only for mathematics (BMI: r = 0.540, subscapular skinfold: r = 0.589, body fat: r = 0.560). Mathematics was relevantly correlated with 15 m sprint (r = 0.574) and Yo-Yo IR1 test (r = 0.770). Only static balance (r = 0.428) did not reach the relevance criteria (r > 0.5). Science only showed large correlations with static balance (r = 0.620) and Yo-Yo IR1 test (r = 0.730). In conclusion, fatness and fitness are related to academic attainment in schoolchildren. In addition, except for static balance, all physical performance parameters were relevantly (r > 0.5) correlated with mathematics.

Prevalence of electronic device use before bed among Australian children and adolescents: a cross-sectional population level study

OBJECTIVE

To understand the prevalence of children and adolescents' electronic device use (EDU) in the hour before bed and identify sociodemographic groups that are at increased risk of problematic use.

METHOD

A contemporary population wide sample of South Australian school students aged 8-18 years (n = 70,936) was utilised to present descriptive statistics of EDU before bed across sociodemographic groups. Data was collected from the 2019 Wellbeing and Engagement Collection, an annual self-report census of students' health, wellbeing and school engagement.

RESULTS

90% of children used an electronic device in the hour before bed at least one night a week, with 51% using a device every night. Older adolescent females in grades 10-12 were most frequent users and children from the most socioeconomically disadvantaged communities were also more likely to use electronic devices in the hour before bed.

CONCLUSION

EDU before bed is highly prevalent among Australian children and adolescents and given the negative health and educational impacts, it requires immediate and widespread action from policy makers to ensure the health of Australia's next generation. Implications for public health: The scale of the problem has now been identified; next steps rely on a public health approach to address this issue. This might include awareness raising campaigns and targeted interventions towards at-risk groups.

Physical Activity, Sedentary Behavior, and Educational Outcomes Among Australian University Students: Cross-Sectional and Longitudinal Associations

BACKGROUND

This study aimed to examine cross-sectional and longitudinal associations between physical activity (PA), sedentary behavior (SB), and educational outcomes (EO) in first-year university students in Australia.

METHOD

Participants (N = 80) engaged in 3 data collection points (semesters 1, 2, and 3) that included self-reported and device-based PA and SB, and objective EO measures. Cross-sectional associations were examined using linear and binary logistic regressions, and longitudinal associations were examined using generalized estimating equations.

RESULT

Overall, results indicated some positive but weak cross-sectional associations between some device-based and self-reported measures of PA and EO outcomes when controlling for confounders. Self-reported SB was negatively associated with semester GPA at time point 3 after adjusting for confounders (β = -0.224; 95% confidence interval, -0.446 to -0.001; P < .05). No other significant cross-sectional or longitudinal associations were identified.

CONCLUSION

Our findings suggest that SB may be a more important target healthy behavior than PA when aiming to influence EO, and that related interventions may be more appropriate in second rather than first-year university students. Further research is needed to better understand this relationship that uses larger sample sizes, follows students beyond first year, and includes measures that distinguish between leisure and educational screen time.

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.

Is adherence to 24-Hour Movement Guidelines associated with a higher academic achievement among adolescent males and females?

OBJECTIVES

This study aims to examine the independent and combined associations of 24-Hour Movement Guidelines for physical activity, screen time, and sleep duration with academic achievement in adolescent males and females.

DESIGN

Cross-sectional study.

METHODS

1290 Spanish adolescents (565 females), aged 11 to 16 years (13.06 ± 0.84), participated in this study. Self-reported physical activity, screen time, and sleep duration questionnaires were assessed. Academic achievement was calculated as an average score of the adolescents'' grades in first language (Spanish), first foreign language (English), and mathematics subjects. A multiple linear regression model was used to examine the association between meeting 24-Hour Movement Guidelines and academic achievement. Covariates included age, sex, socioeconomic status, body mass index, and cardiorespiratory fitness.

RESULTS

Not meeting any of the three 24-Hour Movement Guidelines was associated with lower academic achievement in the whole sample (p < 0.001). Meeting physical activity and sleep duration guidelines, both independently and together, was associated with higher academic achievement in the whole sample (p < 0.001). Meeting at least two recommendations was associated with higher academic achievement in males (p < 0.01). However, trend analysis revealed that participants who met two or three recommendations had higher academic achievement compared to those who met one or none of these recommendations (p < 0.05). All these results were similar for males and females.

CONCLUSIONS

Our findings suggest the importance of promoting more than one 24-Hour Movement Guidelines, mainly physical activity and sleep duration, which seems to contribute positively to increased academic performance in adolescents.

Parental Self-Efficacy-A Predictor of Children's Health Behaviors? Its Impact on Children's Physical Activity and Screen Media Use and Potential Interaction Effect Within a Health Promotion Program

Insufficient physical activity (PA) and increased screen media use (SMU) can have detrimental effects on children's health. Parental self-efficacy (PSE) can act as an important predictor for a healthy upbringing. The aim of this study was to investigate the influence of PSE on children's PA and SMU. Additionally, a moderating effect of PSE on the intervention effect of the health promotion program “Join the Healthy Boat” was examined. Using a prospective randomized controlled trial, 558 kindergarten children (3.6 years [SD = 0.6]) were examined. Data was collected using parental self-report. A significant influence of PSE on children's PA (B = 0.33, p = 0.025) and children's SMU (B = 0.42, p = 0.006) was found. The moderating effect of PSE on the intervention effect was neither significantly related to children's PA (p = 0.360) nor to children's SMU (p = 0.531). This confirms the importance of PSE on children's health development. Despite the lack of a moderating effect, interventions should also promote healthy activity behaviors and self-efficacy for parents in order to engage children in a healthy lifestyle.

Backyard benefits? A cross-sectional study of yard size and greenness and children's physical activity and outdoor play

BACKGROUND

The home environment is the most important location in young children's lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play.

METHODS

Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013-2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child's sex, mother's age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity.

RESULTS

Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: - 6.2, 11.0), light physical activity (β: 1.4, 95% CI: - 5.7, 8.5) or MVPA (β: -2.4, 95% CI: - 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play.

CONCLUSION

In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children's physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning.

Adherence to 24-Hour Movement Guidelines among Spanish Adolescents: Differences between Boys and Girls

Background: The 24-Hour Movement Guidelines for adolescents recommend ≥60 min/day of moderate-to-vigorous physical activity (PA), ≤ 2 h/day of screen time, and 8–10 h/day of sleep. Since little information is available on the 24-Hour Movement Guidelines in Spanish adolescents, this study aims to estimate the proportion of Spanish adolescents meeting individual and combinations of these 24-Hour Movement Guidelines. Moreover, another aim of this study is to examine gender differences in compliance with 24-Hour Movement Guidelines. Methods: A final sample of 1465 Spanish adolescents (44.50% girls; 13.08 ± 0.86) participated in this cross-sectional study. The 24-Hour Movement Guidelines were measured during weekdays and the weekend days by self-reported questionnaires. Results: Although most adolescents met sleep duration guidelines (81.3%), only 38% and 15.8% met physical activity and screen time guidelines, respectively. Only 5.4% of these adolescents met all three 24-Hour Movement Guidelines, whereas 10.2% of this sample did not meet any of these guidelines. Although boys reported greater compliance with physical activity recommendations and girls with screen time recommendations, no significant gender differences were found in the compliance of all three 24-Hour Movement Guidelines. Conclusion: Given that 94.4% of Spanish adolescents did not meet 24-Hour Movement Guidelines, promoting all these three movement behaviours in both boys and girls is an urgent public health priority.

Intervention Effects of the Health Promotion Programme "Join the Healthy Boat" on Objectively Assessed Sedentary Time in Primary School Children in Germany

Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme "Join the Healthy Boat" promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children's SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children's SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children's SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children's SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.