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Int J Behav Nutr Phys Act. 2016 Nov 25;13(1):123.

Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study.

Author information

1
Department of Physical Activity and Sport Sciences, Psychology, Education and Sport Sciences, FPCEE Blanquerna, Universitat Ramon Llull, 34 Cister, 08022, Barcelona, Spain.
2
Nutrition Research Foundation, 242 Rocafort, 08029, Barcelona, Spain.
3
CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
4
Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
5
Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
6
Department of Food and Environmental Sciences, University of Helsinki, 00014, Helsinki, Finland.
7
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, PO Box 115, Newlands, Cape Town, South Africa.
8
Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, City East Campus, North Terrace, Adelaide, 5000, Australia.
9
CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal.
10
Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya.
11
School of Medicine Universidad de los Andes, Carrera 1ª N° 18A 12, Bogotá, Colombia.
12
Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
13
Department of Kinesiology, University of Massachusetts, 111 Totman, 30 Eastman Lane, Amherst, MA, 01002, USA.
14
Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. mtremblay@cheo.on.ca.

Abstract

BACKGROUND:

The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE).

METHODS:

Cross-sectional results were based on 6128 children aged 9-11 years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kg · m-2) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score > +2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations.

RESULTS:

The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR = 0.28, 95% CI 0.18-0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower.

CONCLUSIONS:

For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night's sleep in children.

TRIAL REGISTRATION:

The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).

KEYWORDS:

Children; Obesity; Physical activity; Prevalence; Recommendations; Screen time; Sleep

PMID:
27887654
PMCID:
PMC5123420
DOI:
10.1186/s12966-016-0449-8
[Indexed for MEDLINE]
Free PMC Article
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