Longitudinal relationship between adherence to 24-h Movement Guidelines and adiposity among children.

This study aims to examine the prospective associations between adherence to 24-h Movement Guidelines (sleep duration, screen time [ST], and moderate to vigorous physical activity [MVPA]) and adiposity for children. A total of 202 children aged 8 to 12 years (boys, 51.0%) were enrolled from schools in Hangzhou, Zhejiang, China. The 24-h Movement Guidelines (sleep, ST, and MVPA) at baseline were assessed by accelerometer (MVPA) and questionnaires (sleep and ST). Changes (Δ) in adiposity (body mass index z-scores [ΔBMIz], percent body fat [ΔBF%], and waist-to-height ratio [ΔWHtR]) between baseline and 1-year follow-up were assessed by a standard procedure. General linear model or multi-level model was performed to examine the associations between 24-h Movement Guidelines with changes (Δ) in adiposity. Only 6.9% of children adhered to all three guidelines. As for WHtR, adherence to all three guidelines, ST & Sleep was prospective associated with a lower ΔWHtR of - 0.025 (95%CI =  - 0.049 to - 0.002, P < 0.05) and - 0.017 (95%CI =  - 0.033 to - 0.001, P < 0.05), respectively. As for BMIz, adherence to sleep guideline was prospective associated with a lower ΔBMIz (β =  - 0.18, 95%CI =  - 0.35 to - 0.003, P < 0.05); however, adherence to MVPA guideline was prospective associated with a higher ΔBMIz (β = 0.24, 95%CI 0.07-0.40, P < 0.001). As for BF%, no significant prospective associations were observed between adherence to 24-h Movement Guidelines and ΔBF%.

conclusionAdherence to 24-h Movement Guidelines is prospectively associated with a lower change in waist-to-height ratio. Interventions are needed to increase adherence to these guidelines for children. WHAT IS KNOWN: • The prevalence of obesity among children and adolescents has increased over recent decades. Greater adherence to 24-hour movement guidelines is positively associated with favorable adiposity-related outcomes in this population. However, many previous studies have been limited by cross-sectional designs, and there is still a lack of longitudinal prospective studies. WHAT IS NEW: • This study analyzed multiple adiposity indicators (BMI z-scores, body fat percentage, and waist-to-height ratio) and adherence to 24-hour movement guidelines in a longitudinal design, tracking school-aged children from baseline to one-year follow-up. Our findings provide new insights into the prospective association between adherence to all three 24-hour movement guidelines and a smaller increase in waist-to-height ratio. These results emphasize the importance of considering the composition of movement behaviors within a 24-hour period for promoting children's health.