Compliance With 24-Hour Movement Guidelines in Hong Kong Adolescents: Associations With Weight Status

Abstract

Background: This study examined the compliance with the 24-Hour Movement Guidelines among Hong Kong adolescents and its associations with body mass index (BMI). Methods: A total of 1039 adolescents (11–18 y) wore the activPAL™ for 24 hours for 7 consecutive days to assess physical activity (PA) and sleep duration. Screen time was measured using the Children’s Leisure Activities Study Survey (Chinese version). Linear mixed models were performed for analysis. Results: The analytic sample consisted of 692 adolescents (53% girls). Only 1.0% of the adolescents met all of the recommendations. The proportions of adolescents who met the recommendation for PA, screen time, and sleep were 9.1%, 31.2%, and 38.6%, respectively. Adolescent boys who did not meet the PA recommendation (β = 3.36; 95% CI, 1.04 to 5.68; P = .001) and those who did not meet the combination of PA and sleep recommendations (β = 2.10, 95% CI, 0.64 to 3.56; P = .01) had a higher body mass index than those who met the respective recommendations. Conclusions: Compliance with the 24-Hour Movement Guidelines was alarmingly low among Hong Kong adolescents. Meeting the PA recommendation or the combination of PA and sleep recommendations was associated with a healthier body weight in boys.

The associations between meeting 24‐hour movement guidelines and adiposity in Asian Adolescents: The Asia‐Fit Study

“…We found that around half of the Asian adolescents did not meet any of the three guidelines, and less than 1% of the adolescents met all the three guidelines with an exception of those from Shanghai (3%). Similar results have been revealed in adolescents from other countries and subnational regions such as Canada (10), Hong Kong (11) and Korea (12).…”

“…From such a movement continuum perspective, children and adolescents aged 5 to 17 years are recommended to engage in at least 60 minutes of moderate-to-vigorous PA (MVPA), spend no more than 2 hours in recreational screen-time, and sleep 9-11 hours for those aged 5-13 years and 8-10 hours for those aged 14-17 years in daily life (9). Still, data on the movement behaviours are common for preschool-and school-aged children (Carson, Tremblay, & Chastin, 2017;Chaput et al, 2017;Walsh et al, 2018), and only few research has shown this knowledge in adolescents (10)(11)(12). A recent study found that 17.1% Canadian adolescents aged 12-17 years did not meet any of the PA, recreational screen-time, sleep duration guidelines and only 5.5% of those met all the three guidelines (10).…”

“…Few studies have examined the associations of adiposity indicators with number of the guidelines being met and combinations of the guidelines being met, still, the available evidence lacks for consistency (17,18). Some studies found that children and adolescents meeting all the three guidelines had lower odds ratios for BMI compared with those meeting none of the guidelines (11,19,20), while others have found that combinations of the guideline met did not associate with BMI (17,21). Further research is warranted to enrich the knowledge on how combinations of the 24-hour movement guidelines being met affect overweight and obesity in adolescents.…”

“…Multi-country data on compliance with the 24-hour movement behaviours are rare in current evidence, with an exception of one study in which older children's movement behaviours were investigated in 12 countries with a wide range of economic and demographic characteristics (19). In Asia, adolescents' 24-hour movement behaviours have been investigated in Korea and Hong Kong (11,12). Despite both of the two studies used nationally representative samples, a wide variety of sampling strategies and a lack of standardized and validated measurements make it difficult to evaluate inter-country differences in compliance with the 24-hour movement behaviours in Asian adolescents.…”

Movement in High School: Proportion of Chinese Adolescents Meeting 24-Hour Movement Guidelines

“…Given issues concerning pediatric obesity in China [6,7], research examining adherence to the 24-h movement guidelines may be timely. However, few studies have examined adherence to 24-h movement guidelines in China [7,13,20]. For example, Guan and colleagues [7] examined the proportion of children (aged 4.1 to 6.3 years) from three kindergartens in Beijing meeting movement guidelines suggested by the World Health Organization, and reported that just 15.0% met all three guidelines, and 2.7% did not meet any guidelines.…”