Health associations with meeting new 24-hour movement guidelines for Canadian children and youth

Carson V, Chaput JP, Janssen I, Tremblay MS.

Prev Med. 2016 Dec 5;95:7-13. doi: 10.1016/j.ypmed.2016.12.005. [Epub ahead of print]

Abstract

The study objective was to examine whether meeting the new Canadian 24-hour movement guidelines was associated with health indicators in a representative sample of Canadian children and youth. Cross-sectional findings are based on 4157 (1239 fasting subsample) children and youth aged 6-17years from cycles 1-3 of the Canadian Health Measures Survey (CHMS). Sleep and screen time were subjectively measured while moderate- to vigorous-intensity physical activity (MVPA) was accelerometer-determined. Health indicators in the full sample (body mass index (BMI) z-scores, waist circumference, blood pressure, behavioral strengths and difficulties score (lower=better), and aerobic fitness) and fasting subsample (triglycerides, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, and insulin) were measured. Meeting the overall guidelines was defined as: 9-11 hour/night (5-13years) or 8-10 hour/day (14-17years) of sleep, ≤2 hour/day of screen time, and ≥60 minute/day of MVPA. Compared to meeting all three recommendations, meeting none, one, and two recommendations were associated with a higher BMI z-score, waist circumference, and behavioral strengths and difficulties score and lower aerobic fitness in a gradient pattern (Ptrend<0.05). Additionally, compared to meeting all three recommendations, meeting none and one recommendation were associated with higher systolic blood pressure and insulin (Ptrend<0.05). Finally, compared to meeting all three recommendations, meeting no recommendations was associated with higher triglycerides and lower HDL-cholesterol (Ptrend<0.05). Collectively, meeting more recommendations within the 24-hourmovement guidelines was associated with better overall health. Since a small proportion (17%) of this representative sample was meeting the overall guidelines, efforts to promote adoption are needed.

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

Roman-Viñas B, Chaput JP, Katzmarzyk PT, Fogelholm M, Lambert EV, Maher C, Maia J, Olds T, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, Tremblay MS; ISCOLE Research Group.

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

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) as registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).

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