The Canadian 24-hour movement guidelines and self-rated physical and mental health among adolescents

The associations of physical activity and sedentary behavior with self-rated health in Chinese children and adolescents

OBJECTIVE

The study aimed to analyze the independent and joint associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) among Chinese children and adolescents.

METHODS

Cross-sectional data on moderate-to-vigorous physical activity (MVPA), school-based PA, extracurricular physical activity (EPA), screen time (ST), homework time, and SRH were assessed through a self-report questionnaire in the sample of 4227 Chinese children and adolescents aged 13.04 ± 2.62 years. Binary logistic regression was used to compare gender differences in PA, SB, and SRH among children and adolescents, and analyses were adjusted for age and ethnicity.

RESULTS

In independent associations, boys and girls engaging in ≥60 min/day of MVPA and >1 hour/day of EPA reported optimal SRH. Only boys who participated in >1 hour/day of school-based PA were significantly more likely to have optimal SRH (OR = 1.49, 95%CI = 1.19-1.86). Only girls who had ≤2 hours/day of ST were significantly associated with optimal SRH (weekdays: OR = 1.38, 95%CI = 1.10-1.74; weekends: OR = 1.40, 95%CI = 1.14-1.71; whole week: OR = 1.42, 95%CI = 1.16-1.73). In joint associations, regardless of SB recommendation, meeting PA recommendation was significantly associated with optimal SRH in both boys (meet PA and SB recommendations, OR = 1.61, 95%CI = 1.03-2.50; meet PA but not SB recommendations, OR = 2.40, 95%CI = 1.57-3.65) and girls (meet PA and SB recommendations, OR = 3.72, 95%CI = 2.08-6.65; meet PA but not SB recommendation, OR = 4.27, 95%CI = 2.09-8.75).

CONCLUSION

Increased PA and reduced SB were positively associated with optimal SRH in Chinese children and adolescents. Notably, lower ST positively influenced only girls' SRH. Meeting PA recommendation is more impactful than meeting SB recommendation for improving SRH in Chinese children and adolescents. Future studies could explore these associations using objective measures of PA and SB in China.

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.

Associations between joint lifestyle behaviors and depression among children and adolescents: A large cross-sectional study in China

BACKGROUND

Lifestyles in children and adolescents are associated with mental health, yet the combined effects of diet-related joint lifestyles on depression are unclear.

METHODS

A cross-sectional study was conducted in January 2020 in primary and secondary schools in Shanghai, China, with 6478 participants in the analysis. Lifestyle behaviors (physical activity, sleep duration, screen time, and diet quality) and depressive symptoms were measured using validated questionnaires. A series of multivariable logistic regressions were performed to examine the associations between lifestyle behaviors and their combinations and depression.

RESULTS

The prevalence of depressive symptoms 12.2 % (n = 788). Compared to those considered physically active, physically inactive individuals showed higher odds of depression (adjusted odds ratio [aOR] = 1.206). Similarly, insufficient sleep duration (aOR = 1.449), long screen time (aOR = 1.457) and poor diet quality (aOR = 1.892) were all associated with higher odds of depression. Compared to participants with behaviors meeting all guidelines, the odds of depression increased as the number of behaviors not meeting guidelines increased in a dose-response relationship, with an average increase in depression odds of 49 % on average for each additional unhealthy behavior. Moreover, different combinations of behaviors not meeting guidelines showed varied odds of depression.

CONCLUSIONS

Our research suggests that lifestyle behaviors not meeting guidelines in children and adolescents are associated with poorer mental health, and the risk varies with the number and specific combination of behaviors not meeting guidelines. Diet-related joint behaviors may be overlooked, and practical measures targeting joint lifestyles are needed to prevent and alleviate mental health problems among children and adolescents.

School-aged children's movement behaviours and subjective health complaints in Japan: a cross-sectional study during COVID-19 pandemic-related school closures and after school reopenings

BACKGROUND

Social restrictions associated with the COVID-19 pandemic have altered children's movement behaviours and impacted their mental health. However, the influence of social restrictions on subjective health complaints remains inadequately understood. This study compared adherence to 24-hour movement behaviour guidelines and the prevalence of subjective health complaints during school closure and one year after reopening. We also examined how combinations of adherence to movement behaviour recommendations relate to subjective health complaints.

METHODS

A repeated cross-sectional survey was conducted at two points. The first survey in May 2020 included 1535 (766 boys and 769 girls) participants during school closures, while the second survey from May to July 2021 involved 1125 (583 boys and 542 girls) participants one year after school reopening. The questionnaire covered socio-demographics, physical activity, screen time, sleep, and subjective health complaints. Differences between periods were analysed using chi-square tests. Logistic regression models assessed the association between adherence to guidelines and subjective health complaints.

RESULTS

During school closure, children were more likely to meet 'only sleep' recommendations and have irritability and lethargy symptoms. Irrespective of sex, those adhering to two or all three recommendations (excluding physical activity and screen time) had a lower risk of symptoms related to physical and mental pain, fatigue, irritability, and lethargy as compared to those who met none of the recommendations.

CONCLUSIONS

Children should meet at least one physical activity or screen time recommendation in addition to sleep recommendations for subjective health. Strategies considering the priority of each movement behaviour are crucial, even during abnormal situations, such as pandemic-related social restrictions. This study offers insightful findings concerning children's mental health issues during unprecedented and massive disasters or crises.

Meeting the Canadian 24-Hour Movement Guidelines and physical-mental comorbidity among Chinese children and adolescents: Prevalence, associations, and the population impacts

OBJECTIVES

To examine the association between meeting the Canadian 24-Hour Movement Guidelines and physical-mental comorbidity among children and adolescents in a cross-sectional study.

METHODS

A total of 21,061 students aged 11-17 years from Zhejiang Province, China was recruited in the study. We examined the coexistence of five specific physical illnesses - hypertension, high myopia, dental caries, scoliosis, and obesity - with mental illness, specifically depressive symptoms. Generalized linear mixed models were performed to assess the association between overall and specific combinations of movement guidelines and physical-mental comorbidity, presented by odds ratio (OR) and 95% confidence interval (CI). Population attributable fraction (PAF) was calculated to estimate the preventable proportion of comorbid cases via meeting all three movement recommendations.

RESULTS

Of the included participants, 19.3% had physical-mental comorbidity. There were 3.8% and 17.0% meeting all three and none of the recommendations, respectively. Meeting at least one recommendation, except for moderate-to-vigorous physical activity recommendation only, was associated with a lower risk of physical-mental comorbidity, with ORs (95% CIs) ranging from 0.72 (0.66-0.79) to 0.40 (0.31-0.51). Meeting more recommendations was associated with decreased comorbid risks, and the association was stronger in 4th-6th graders. The association between specific combinations of recommendations and comorbid risks showed differences by gender and grade. Of the comorbid cases, 42.1% were attributed to not adhering to all three recommendations, and the PAFs varied from 27.4% to 55.7% across different genders and grades.

CONCLUSION

Adherence to the 24-h movement guidelines was associated with lower risks of physical-mental comorbidity among children and adolescents.

A Canadian longitudinal study of the associations between weight control status and lifestyle behaviors during adolescence

This study aimed to estimate associations between weight control status (trying to lose, gain or maintain weight) and lifestyle behaviors (moderate-to-vigorous physical activity (MVPA), screen time, and the consumption of breakfast, fast food, fruits and vegetables, and sugar-sweetened beverages (SSB)) in adolescents. Data from 919 adolescents in the MATCH study, in New Brunswick, Canada, who self-reported their weight control status at least once within 24 data collection cycles over 8 years (from 2011 to 2019) and from 812 who provided data at least once over the 7 cycles on eating behaviors were used. Generalized estimating equations were used. At the first cycle, mean age was 11.3 (SD = 1.2) years old and 56% were girls. Trying to gain (β = 0.47, CI = [0.15, 0.79]) and maintain weight (β = 0.35, CI = [0.12, 0.57]) were positively associated with MVPA. Trying to lose weight was negatively associated with breakfast (IRR = 0.90, CI = [0.85, 0.94]) and positively associated with screen time (β = 0.62, CI = [0.15, 1.10]), fruit and vegetable (IRR = 1.12, CI = [1.01, 1.25]) and SSB (IRR = 1.42, CI = [1.10, 1.84]). Changes from one weight control status to trying to lose weight were associated with increases in fast food consumption (β = 0.49, CI = [0.15, 0.84]). Weight control status was associated with healthy and unhealthy behaviors in adolescents. Trying to gain or maintain weight was generally associated with more favorable health-related behaviors. Education on healthy weight management behaviors is needed to improve adolescents' health.

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.

Associations between meeting 24-hour movement guidelines and myopia among school-aged children: A cross-sectional study

BACKGROUND

The Canadian 24-hour movement behavior (24-HMB) guidelines recommend an adequate level of physical activity (PA), a limited amount of screen time (ST), and a sufficient sleep duration (SLP) to promote the healthy development of children. Although the positive effects of adhering to the 24-HMB guidelines have been established for several health parameters, less is known about how adherence to the 24-HMB guidelines relates to the myopia risk (i.e., inability to see distant objects properly). Thus, this study investigated associations between meeting 24-HMB guidelines and myopia risk in school-aged children.

METHOD

Using a questionnaire survey, this cross-sectional study was conducted among parents of school-aged children (5-13 years) in China from 15th September to 15th October 2022, with a total of 1423 respondents with complete data for analysis. Parents reported their child's time spent in moderate-to-vigorous-intensity physical activity (MVPA), SLP, and ST. Multiple logistic regression analyses were performed to examine the associations between measures of PA, ST, and SLP alone and in combination, and the occurrence of myopia.

RESULTS

A relatively low percentage of the children being included in the current study (4.92%) met all 24-HMB guidelines, while 32.46% had myopia. Girls had a significantly higher risk of myopia compared to boys (OR = 1.3, 1.002 to 1.68, p = 0.049). Children of parents without myopia had a lower risk of myopia (OR = 0.45, 0.34-0.59, p < 0.001). Children who lived in urban areas (OR = 1.83, 95% CI 1.33 to 2.52, p < 0.001) or towns (OR = 1.60, 1.03 to 2.47, p = 0.04) had a significantly higher risk of myopia compared to those living in rural areas. Meeting SLP guidelines (OR = 0.50, 95% CI 0.31 to 0.82, p < 0.01), meeting ST + SLP guidelines (OR = 0.47, 95% CI 0.32-0.69, <0.001), and meeting all three guidelines were associated with significantly lower risk of myopia (OR = 0.40, 95% CI 0.20-0.82, p = 0.01). Meeting more 24-HMB guidelines was associated with a reduced risk of myopia.

CONCLUSIONS

Our data suggest that adhering to SLP, ST + SLP, and ST + SLP + PA guidelines is associated with the risk of myopia. Future research investigating dose-response associations, and potential mechanisms, is necessary to achieve a more nuanced understanding of the observed associations.

24-hour movement behaviours and self-rated health in Chinese adolescents: a questionnaire-based survey in Eastern China

Objective

Although much evidence has demonstrated the benefits of adhering to the 24-hour movement guidelines, little is known about their association with self-rated health in adolescents. The objective of this study was to explore the association between adherence to the 24-hour movement guidelines (i.e., physical activity, screen time, and sleep) and self-rated health among Chinese adolescents aged 10-17 ages.

Methods

A convenient sample of 12 schools and their students were recruited for this cross-sectional study. Physical activity and screen time were assessed using a questionnaire based on the Health Behaviour in School-aged Children questionnaire, while sleep duration was used measured using the Pittsburgh Sleep Scale. Ordinal logistic regression was performed to examine the association between adherence to the 24-hour movement guidelines and self-rated health.

Results

Adolescents who adhered to more guidelines contained in the 24-hour movement guidelines reported better self-rated health. A dose-response association was observed, with the odds ratio (OR) for adhering to all three = 11.26, 95% CI [4.82-26.35]; OR for meeting two = 1.62, 95% CI [1.25-2.12]; OR for meeting one = 1.16, 95% CI [0.98-1.38]) indicating a higher probability of better self-rated health with increasing adherence. Regarding adherence to specific combination of 24-hour movement guidelines, positive associations were found for adhering to all three recommendations (OR = 11.95, 95% CI [5.06-28.19]), only MVPA (OR = 4.96, 95% CI [2.82-8.72]), MVPA + screen time (OR = 5.50, 95% CI [3.02-9.99]), and MVPA + sleep (OR = 4.63, 95% CI [2.52-8.51]).

Conclusion

This study provides evidence supporting the association between adherence to the 24-hour movement guidelines and better self-rated health among Chinese adolescents. Sufficient physical activity may be particularly important for promoting self-rated health in this population.

What does it mean to use the mean? The impact of different data handling strategies on the proportion of children classified as meeting 24-hr movement guidelines and associations with overweight and obesity

Background

Despite the widespread endorsement of 24-hour movement guidelines (physical activity, sleep, screentime) for youth, no standardized processes for categorizing guideline achievement exists. The purpose of this study was to illustrate the impact of different data handling strategies on the proportion of children meeting 24-hour movement guidelines (24hrG) and associations with overweight and obesity.

Methods

A subset of 524 children (ages 5-12yrs) with complete 24-hour behavior measures on at least 10 days was used to compare the impact of data handling strategies on estimates of meeting 24hrG. Physical activity and sleep were measured via accelerometry. Screentime was measured via parent self-report. Comparison of meeting 24hrG were made using 1) average of behaviors across all days (AVG-24hr), 2) classifying each day and evaluating the percentage meeting 24hrG from 10-100% of their measured days (DAYS-24hr), and 3) the average of a random sample of 4 days across 10 iterations (RAND-24hr). A second subset of children (N=475) with height and weight data was used to explore the influence of each data handling strategy on children meeting guidelines and the odds of overweight/obesity via logistic regression.

Results

Classification for AVG-24hr resulted in 14.7% of participants meeting 24hrG. Classification for DAYS-24hr resulted in 63.5% meeting 24hrG on 10% of measured days with <1% meeting 24hrG on 100% of days. Classification for RAND-24hr resulted in 15.9% of participants meeting 24hrG. Across 10 iterations, 63.6% of participants never met 24hrG regardless of the days sampled, 3.4% always met 24hrG, with the remaining 33.0% classified as meeting 24hrG for at least one of the 10 random iterations of days. Using AVG-24hr as a strategy, meeting all three guidelines associated with lower odds of having overweight obesity (OR=0.38, p<0.05). The RAND-24hr strategy produced a range of odds from 0.27 to 0.56. Using the criteria of needing to meet 24hrG on 100% of days, meeting all three guidelines associated with the lowest odds of having overweight and obesity as well (OR=0.04, p<0.05).

Conclusions

Varying estimates of meeting the 24hrG and the odds of overweight and obesity results from different data handling strategies and days sampled.

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.

Regional Socioeconomic Deprivation in Germany and Adherence to the 24-h Movement Guidelines among Children and Adolescents

To examine the relationship between regional socioeconomic deprivation and adherence to the 24-h movement guidelines among children and adolescents, a cross-sectional study was conducted. A total of 17,433 students aged 9-17 participated in a survey in winter 2021/2022. Daily screen time (ST), moderate-to-vigorous physical activity (MVPA), and sleep behavior were outcome variables. The German Index of Socioeconomic Deprivation (GISD), a regional socioeconomic objective measure, was the exposure variable. Associations between GISD and health behaviors were examined using regression models. Models were adjusted for age, gender, school type, and individual self-reported socioeconomic status (SES). The proportions of meeting the MVPA, ST, and sleep duration guidelines were 14%, 22%, and 34%, respectively. A total of 2.3% met all guidelines. Students from the most deprived communities were half as likely to meet all three guidelines compared to students from the most affluent regions (OR = 0.49 [0.28; -0.03], p = 0.010). There was a consistent relationship between GISD and lower levels of adherence to screen time guidelines (most deprived compared to most affluent: OR = 0.49 [0.38; 0.64], p < 0.001). There was no association between GISD and adherence to sleep time guidelines. We found mixed results for the association between GISD and MVPA. Regional SES appears to be an important factor associated with screen time. Screen time should be limited through intervention programs, especially in disadvantaged areas. Parents should be made aware of their children's increased media consumption. Recommendations for screen time should be clearly communicated, as should the health disadvantages of increased media consumption in childhood and adolescence.

Isolated and combined association of excessive screen time and physical inactivity with negative self-rated health in adolescents

OBJECTIVE

The aim of this study was to analyze isolated and combined associations of physical inactivity excessive screen time with negative self-rated health, according to sex, among school adolescents.

METHODS

In this cross-sectional study conducted with 2,517 adolescents in Amazonas State, participants were asked about their self-rated health with the following question: How do you rate your health? Responses were dichotomized into positive (excellent and good) and negative (regular, bad, and terrible). Information on sex, age group, family income, physical activity, and screen time (watching TV, using a computer, or playing video games) was collected through a self-administered questionnaire. Adolescents simultaneously classified as physically inactive (<60 min/day) and having excessive screen time (>2 h/day) were considered to have two risk factors. Data was analyzed using binary logistic regression.

RESULTS

Out of every 10 adolescents, 2 had a negative self-rated health. After adjusting for age and family income, there were no isolated or combined associations between physical inactivity or excessive screen time and negative self-rated health in girls. In boys, negative self-rated health was associated with insufficient levels of physical activity (odds ratio [OR]: 2.39; 95% confidence interval [CI]: 1.03-5.59) and with the accumulation of two risk factors (OR: 1.61; 95%CI 1.10-2.34).

CONCLUSIONS

Being insufficiently active and the combination of physical inactivity and excessive screen time become exposure factors to the negative self-rated health of adolescent boys.

Associations between 24-h movement behaviors and self-rated health: a representative sample of school-aged children and adolescents in Okinawa, Japan

OBJECTIVES

This study aimed to determine the associations between adherence to 24-h movement behavior guidelines and self-rated health (SRH) among Japanese adolescents according to their age group.

STUDY DESIGN

This was a cross-sectional study.

METHODS

Probability proportional sampling data, which were collected from six regions of Okinawa Prefecture, Japan, considering the number of schools, included 2408 fifth-grade students (aged 10-11 years) in 31 elementary schools and 4360 eighth-grade students (aged 13-14 years) in 30 junior high schools. SRH, moderate-to-vigorous physical activity (MVPA), screen time (ST), sleep duration, and confounding factors (sex, weight status, family affluence, parental support, school satisfaction, and school demands) were self-reported.

RESULTS

The logistic regression models showed that adherence to ST and sleep recommendations in elementary school students was associated with a high prevalence of good health only, whereas adherence to only MVPA, only sleep, ST and sleep, MVPA and sleep, and all three recommendations were associated with a high prevalence of good health among junior high school students. All combinations that included achievement of the recommended sleep duration were associated with SRH.

CONCLUSIONS

Achieving 24-h movement behavior guidelines, particularly sleep recommendations, is associated with better perceived health in school-aged children, especially in adolescents.

Vigorous physical activity and self-rated health during adolescence: A cross-sectional survey

Background

Despite the positive relationship between self-rated health and general physical activity, very little research has touched upon the relationship between self-rated health and vigorous physical activity. Such research will help to promote self-rated health among adolescents by addressing the close relationship between self-rated health and the components of physical activity.

Purpose

In this study, the relationship between self-rated health and vigorous physical activity among Chinese adolescents were analyzed.

Methods

The current study was based on a collaborative survey conducted by the WHO in several nations, and the data generated by Health Behavior in School-aged Children every 4 years on health behavior were adopted. The school class was taken as a basic unit for sampling. Cluster sampling was performed systematically, and the possibility was proportional to the population. The sampling was conducted to collect typical cases. The class teachers were informed of the sampling activities, and they were to collect data on the students by distributing the questionnaires.

Results

The research included 116,828 respondents from 36 countries. Among them, 51.82% were girls and 48.18% were boys. A total of 98.54% of the respondents considered their health status as fair or above when completing the questionnaire, while 1.46% believed that their health status was poor. Moreover, more than 86% of the respondents participated in vigorous exercise more than weekly, and better self-health ratings were found among respondents who exercised more than weekly (once a week: OR = 1.95, CI: 1.86-2.04; two or three times a week: OR = 1.69, CIL: 1.63-1.76; four or six times a week: OR = 1.30, CI: 1.25-1.35). Certain respondents reported better results for self-rated health (4-6 h every week: OR = 1.36, CI: 1.30-1.43; 2 or 3 h every week: OR = 1.48, CI: 1.42-1.55; 1 h every week: OR = 1.64, CI: 1.57-1.72).

Conclusion

In this study, empirical evidence is provided for the relationship between self-rated health and vigorous physical activity among adolescents. From the results, it can be observed that there is a positive relationship between self-rated health and vigorous physical activity among adolescents.

Impact of Virtual vs. In-Person School on Children Meeting the 24-h Movement Guidelines during the COVID-19 Pandemic

The pandemic mitigation strategy of closing schools, while necessary, may have unintentionally impacted children's moderate-to-vigorous physical activity (MVPA), sleep, and time spent watching screens. In some locations, schools used hybrid attendance models, with some days during the week requiring in-person and others virtual attendance. This scenario offers an opportunity to evaluate the impact of attending in-person school on meeting the 24-h movement guidelines. Children (N = 690, 50% girls, K-5th) wore wrist-placed accelerometers for 14 days during October/November 2020. Parents completed daily reports on child time spent on screens and time spent on screens for school. The schools' schedule was learning for 2 days/week in-person and 3 days/week virtually. Using only weekdays (M-F), the 24-h movement behaviors were classified, and the probability of meeting all three was compared between in-person vs. virtual learning and across grades. Data for 4956 weekdays (avg. 7 d/child) were collected. In-person school was associated with a greater proportion (OR = 1.70, 95% CI: 1.33-2.18) of days that children were meeting the 24-h movement guidelines compared to virtual school across all grades. Students were more likely to meet the screen time (OR = 9.14, 95% CI: 7.05-11.83) and MVPA (OR = 1.50, 95% CI: 1.25-1.80) guidelines and less likely to meet the sleep (OR = 0.73, 95% CI: 0.62-0.86) guidelines on the in-person compared to the virtual school days. Structured environments, such as school, have a protective effect on children's movement behaviors, especially physical activity and screen time.

Prevalence and correlates of meeting physical activity, screen time and sleep duration guidelines among Brazilian adolescents: findings from ERICA

The prevalence of meeting movement guidelines is low in developed countries; however there is a lack of data among medium-income countries, including Brazil. We evaluated the prevalence and correlates of meeting physical activity, screen time, and sleep guidelines in Brazilian adolescents. Employing a cross-sectional design, Brazilian adolescents (aged 12-17) were surveyed about their physical activity levels, sleep, and screen time. The data was collected at schools through a self-administered questionnaire using a Personal Digital Assistant for entering the data. Poisson regression models were used to examine the associations between correlates (sex, age, socioeconomic status, region, skin colour and shift of school) and meeting movement guidelines. A total of 58,535 adolescents were included. Although only 8.7% of adolescents met all three movement guidelines, the prevalence of those who met physical activity, screen time and sleep duration guidelines was 46.4%, 42.5% and 40%, respectively. Moreover, male sex, age 14-15 years old, non-white skin colour, afternoon shift of school and living in the Northern and Northeastern regions were associated with a higher prevalence of meeting all movement guidelines. The prevalence of adolescents who met all three movement guidelines was low among Brazilian adolescents. Adolescents living in less developed regions show greater adherence to movement guidelines, suggesting a possible impact of the urbanization process on these behaviours. Novelty bullets: - The prevalence of Brazilian adolescents whom met all three movement behaviours guidelines was around 9%. - Among all adolescents, 40% met only one movement guideline.

Meeting 24-h movement guidelines: prevalence, correlates and associations with socioemotional behavior in Spanish minors

The aims of this study were to determine for the first time the prevalence of a national sample of Spanish minors meeting the 24‐h movement guidelines; to determine their correlates; and to examine their associations with socioemotional behavioral problems. Cross‐sectional data from the Spanish National Health Survey (2017) were analyzed for this study. A total of 3772 Spanish minors were included. Physical activity was parent‐reported by a modified short version of the International Physical Activity Questionnaire, which included a single question related to the participation in physical activity in free time. Recreational screen time was parent‐reported by asking respondents for weekdays and weekends independently: “How much time does your child typically spend in front of a screen, including a computer, tablet, television, video, video game, or cell phone screen?”. Sleep duration was parent‐reported by the following question: “Can you tell me approximately how many hours your child usually sleeps daily?”. The Strengths and Difficulties Questionnaire was applied for the evaluation of socioemotional behavioral problems. The prevalence of meeting of all the three guidelines was 13.5%. Compared to meeting all guidelines, higher odds of socioemotional behavioral problems were found in participants meeting two guidelines (OR = 1.42; CI95%, 1.10–1.83), one guideline (OR = 1.50; 95%CI,1.14–1.96), or none of the guidelines (OR = 1.92; 95%CI,1.30–2.83). Our study demonstrated that the proportion of Spanish minors who meet with all the 24‐h movement guidelines is low. Furthermore, it could be relevant to the promotion of the 24‐h movement guidelines to prevent the risk of socioemotional behavioral problems.