Accelerometer-measured 24-hour movement behaviours over 7 days in Malaysian children and adolescents: A cross-sectional study

PLoS One. 2024 Feb 20;19(2):e0297102. doi: 10.1371/journal.pone.0297102. eCollection 2024.

Abstract

Background: Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-participant differences in movement behaviours by demographic characteristics and timing of data collection during Ramadan and COVID-19 restrictions.

Methods: Data came from the South-East Asia Community Observatory health surveillance cohort, 2021-2022. Children aged 7-18 years within selected households in Segamat, Malaysia wore an Axivity AX6 accelerometer on their wrist for 24 hours/day over 7 days, completed the PAQ-C questionnaire, and demographic information was obtained. Accelerometer data was processed using GGIR to determine time spent asleep, inactive, in light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Differences in accelerometer-measured PA by demographic characteristics (sex, age, ethnicity, socioeconomic group) were explored using univariate linear regression. Differences between data collected during vs outside Ramadan or during vs after COVID-19 restrictions, were investigated through univariate and multiple linear regressions, adjusted for age, sex and ethnicity.

Results: The 491 participants providing accelerometer data spent 8.2 (95% confidence interval (CI) = 7.9-8.4) hours/day asleep, 12.4 (95% CI = 12.2-12.7) hours/day inactive, 2.8 (95% CI = 2.7-2.9) hours/day in LPA, and 33.0 (95% CI = 31.0-35.1) minutes/day in MVPA. Greater PA and less time inactive were observed in boys vs girls, children vs adolescents, Indian and Chinese vs Malay children and higher income vs lower income households. Data collection during Ramadan or during COVID-19 restrictions were not associated with MVPA engagement after adjustment for demographic characteristics.

Conclusions: Demographic characteristics remained the strongest correlates of accelerometer-measured 24-hour movement behaviours in Malaysian children and adolescents. Future studies should seek to understand why predominantly girls, adolescents and children from Malay ethnicities have particularly low movement behaviours within Malaysia.

MeSH terms

  • Accelerometry
  • Adolescent
  • COVID-19* / epidemiology
  • Child
  • Cross-Sectional Studies
  • Exercise*
  • Female
  • Humans
  • Male
  • Surveys and Questionnaires

Grants and funding

This work was supported by the Medical Research Council, grant reference MR/T018984/1 and the Ministry of Higher Education/UK-MY Joint Partnership on Non-Communicable Diseases 2019/MR/T018984/1. Monash University funds the SEACO health and demographic surveillance system. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Co-authors of this study are also supported by the National Institute for Health and Care Research Bristol Biomedical Research Centre (MA). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.