Compliance with the 24-Hour Movement Behavior Guidelines and Associations with Adiposity in European Preschoolers: Results from the ToyBox-Study

Marga Decraene, Vera Verbestel, Greet Cardon, Violeta Iotova, Berthold Koletzko, Luis A. Moreno, María L. Miguel-Berges, Beata Gurzkowska, Odysseas Androutsos, Yannis Manios and Marieke De Craemer
Additional contact information
Marga Decraene: Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
Vera Verbestel: Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
Greet Cardon: Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
Violeta Iotova: Department of Pediatrics, Medical University of Varna, UMHAT ‘St. Marina’, 9002 Varna, Bulgaria
Berthold Koletzko: Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, 80337 München, Germany
Luis A. Moreno: GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza: Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), 500001 Zaragoza, Spain
María L. Miguel-Berges: GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza: Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), 500001 Zaragoza, Spain
Beata Gurzkowska: Public Health Division, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
Odysseas Androutsos: Department of Nutrition and Dietetics, University of Thessaly, 421 00 Trikala, Greece
Yannis Manios: Department of Nutrition and Dietetics, Harokopio University, 177 78 Athens, Greece
Marieke De Craemer: Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium

IJERPH, 2021, vol. 18, issue 14, 1-24

Abstract: In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays and weekend days), and the associations with adiposity. This cross-sectional study included 2468 preschoolers (mean age: 4.75 years; 41.9% boys) from six European countries. The associations were investigated in the total sample and in girls and boys separately. PA was objectively assessed by step counts/day. Parent-reported questionnaires provided ST and sleep duration data. Generalized estimating equations were used to analyze the association between guideline compliance and adiposity indicators, i.e., body mass index (BMI) z-score and waist to height ratio (WHR). Only 10.1% of the preschoolers complied with the 24 h movement behavior guidelines, 69.2% with the sleep duration guideline, 39.8% with the ST guideline and 32.7% with the PA guideline. No association was found between guideline compliance with all three movement behaviors and adiposity. However, associations were found for isolated weekday screen time (BMI z-scores and WHR: p = 0.04) and weekend day sleep duration (BMI z-scores and WHR: p = 0.03) guideline compliance with both lower adiposity indicators. The latter association for sleep duration was also found in girls separately (BMI z-scores: p = 0.02; WHR: p = 0.03), but not in boys. Longitudinal studies, including intervention studies, are needed to increase preschoolers’ guideline compliance and to gain more insight into the manifestation of adiposity in children and its association with 24 h movement behaviors from a young age onwards.

Keywords: 24 h guidelines; movement behavior; physical activity; sedentary behavior; screen time; sleep; compliance; adiposity; preschooler (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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