Adherence to 24-Hour Movement Guidelines in Relation to the Risk of Overweight and Obesity Among Children and Adolescents

Siyi Huang; Yuhui Huang; Yuxuan Gu; Hui Chen; Rongxia Lv; Shiyi Wu; Peige Song; Dong Zhao; Liang Hu; Changzheng Yuan

doi:10.1016/j.jadohealth.2023.06.009

Adherence to 24-Hour Movement Guidelines in Relation to the Risk of Overweight and Obesity Among Children and Adolescents

J Adolesc Health. 2023 Nov;73(5):887-895. doi: 10.1016/j.jadohealth.2023.06.009. Epub 2023 Aug 11.

Authors

Siyi Huang¹, Yuhui Huang², Yuxuan Gu³, Hui Chen², Rongxia Lv², Shiyi Wu², Peige Song⁴, Dong Zhao⁵, Liang Hu⁶, Changzheng Yuan⁷

Affiliations

¹ School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Sports Science, College of Education, Zhejiang University, Hangzhou, Zhejiang, China.
² School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
³ Department of Social Security, Nanjing Normal University, Nanjing, Jiangsu, China.
⁴ School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
⁵ Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
⁶ Department of Sports Science, College of Education, Zhejiang University, Hangzhou, Zhejiang, China. Electronic address: lianghu@zju.edu.cn.
⁷ School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: chy478@zju.edu.cn.

PMID: 37565981
DOI: 10.1016/j.jadohealth.2023.06.009

Abstract

Purpose: Adherence to overall 24-hour Movement Guidelines (24HGs) has been associated with childhood obesity in cross-sectional studies. However, few longitudinal studies have examined such associations, especially in China. We aimed to explore prospective associations between adherence to recommendations of 24HGs and risks of developing overweight and obesity among children and adolescents.

Methods: We included participants (aged 6-17 years) without overweight and obesity at enrollment from the China Health and Nutrition Survey in 2004-2011 surveys and followed them till 2015. We assigned one point each to the adherence of guidelines for moderate-to-vigorous physical activity, recreational screen time and sleep, and summed them up to indicate the overall level of adherence to 24HGs (range: 0-3 points). The primary outcome was the first occurrence of overweight or obesity. Multivariable cox proportional hazard models were used to evaluate the corresponding associations.

Results: Among 1,382 participants (mean age: 10.3 ± 3.2 years; 48.4% girls), a total of 152 (11%) individuals were identified as incident overweight and obesity during an average of 4.7 years of follow-up. Compared with participants nonadherent to any of the guidelines, those adhering to one (hazard ratio [HR] = 0.38, 95% confidence interval [CI]: 0.21-0.71, p < .01), two (HR = 0.49, 95% CI: 0.28-0.88, p = .02), and three (HR = 0.40, 95% CI: 0.17-0.91, p = .03) recommendations had significantly lower risks of developing overweight and obesity.

Discussion: Children and adolescents who met any recommendations of 24HGs had significantly lower risks of developing subsequent overweight and obesity. Setting achievable goals such as adopting at least one recommendation could be considered in future public health recommendations to accelerate progress in childhood obesity prevention.

Keywords: 24-hour movement; Chinese school-aged children; Cohort study; Obesity and overweight.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Cross-Sectional Studies
Exercise
Female
Humans
Male
Overweight* / epidemiology
Pediatric Obesity* / epidemiology
Pediatric Obesity* / prevention & control
Sleep