Relationship of 24-Hour Movement Behaviors with Weight Status and Body Composition in Chinese Primary School Children: A Cross-Sectional Study

Abstract

24 h movement behaviors, specifically physical activity (PA), sedentary behavior, and sleep, play a crucial role in the prevention and intervention of childhood obesity. This study aimed to examine the association of 24 h movement behaviors with weight status and body composition among Chinese primary school children. Using a random stratified sampling, 978 eligible participants (9.1 ± 1.4 years, 53.2% boys) were recruited from 1 May to 15 July 2021. Demographics included children’s age, gender, grade, parents’ education level, and household income. Movement behaviors were measured by validated self-reported scales. Weight status and body composition (percent of body fat, PBF; fat-free mass, FFM; skeletal muscle mass, SMM) were measured objectively. Results indicated that participants who were younger, boys, and at lower grade showed higher guidelines adherence. PA was inversely associated with PBF, while screen time (ST) was positively associated with overweight/obesity risk and FFM. Sleep showed no association with any health indicators. Meeting the behavioral guidelines was associated with better weight status and lower PBF, yet not with FFM and SMM. Interventions to improve the Children’s weight status and PBF should involve enhancing their overall movement behaviors and considering their demographic differences. More research on examining the association of movement guidelines adherence with body composition indicators is needed.

Are 24‐hour movement recommendations associated with obesity‐related indicators in the young population? A meta‐analysis

“…Regarding obesity‐related indicators, the most common obesity‐related indicators were zBMI [35, 37, 38, 40, 42, 44–47, 49, 55, 56], waist circumference [36, 38, 45, 48, 53, 54, 60], BMI [35, 36, 39, 41, 48, 53, 58], body fat by bioelectrical impedance analysis [57, 62] or dual‐energy x‐ray absorptiometry [38, 55], only obesity [48, 63], and overweight/obesity [35, 37, 41, 43, 46, 50–52, 56, 59, 61–63]. Regarding the measurement of the 24‐hour movement recommendations, physical activity was assessed by accelerometer‐based measures in 17 studies [35, 37, 38, 40, 41, 43, 45, 46, 49, 51–56, 58, 59] and self‐reported measures by young people and parents in 12 studies [36, 39, 42, 44, 47, 48, 50, 57, 60–63]. Screen time was self‐reported by young people in 14 studies [36, 38, 39, 44, 46–48, 50, 54, 56–58, 61, 62] and by parents in 15 studies [35, 37, 40–43, 45, 49, 51–53, 55, 59, 60, 63].…”

“…Regarding the measurement of the 24‐hour movement recommendations, physical activity was assessed by accelerometer‐based measures in 17 studies [35, 37, 38, 40, 41, 43, 45, 46, 49, 51–56, 58, 59] and self‐reported measures by young people and parents in 12 studies [36, 39, 42, 44, 47, 48, 50, 57, 60–63]. Screen time was self‐reported by young people in 14 studies [36, 38, 39, 44, 46–48, 50, 54, 56–58, 61, 62] and by parents in 15 studies [35, 37, 40–43, 45, 49, 51–53, 55, 59, 60, 63]. Sleep duration was determined by accelerometer‐based measures in 9 studies and self‐reported measures by young people and parents in 20 studies [35, 36, 40, 42–45, 47–53, 57, 59–63].…”

“…waist circumference [36,38,45,48,53,54,60], BMI [35,36,39,41,48,53,58], body fat by bioelectrical impedance analysis [57,62] or dual- [38,55], only obesity [48,63], and overweight/obesity [35, 37, 41, 43, 46, 50-52, 56, 59, 61-63]. Regarding the measurement of the 24-hour movement recommendations, physical activity was assessed by accelerometer-based measures in 17 studies [35, 37, 38, 40, 41, 43, 45, 46, 49, 51-56, 58, 59] and self-reported measures by young people and parents in 12 studies [36,39,42,44,47,48,50,57,[60][61][62][63].…”

A school-family blended multi-component physical activity program for Fundamental Motor Skills Promotion Program for Obese Children (FMSPPOC): protocol for a cluster randomized controlled trial

“…An average medium effect size (Cohen d = 0.54) of PA intervention on FMSs in obese children was proposed based on previous studies [ 32 ]. Considering the minimal class size is 30 and the prevalence rate of childhood obesity is approximately 20% [ 60 ], a cluster size of 6 (for each class) was selected in this study. Using an ICC of 0.01 [ 61 ], an alpha of 0.05, a statistic power of 80%, and an attrition rate of 15% [ 43 ], at least 84 participants in each condition (12 clusters per condition), for a total of 168 participants in 24 clusters will be required for this CRCT.…”

“…A Bio-Impedance Analysis (BIA) was conducted using Portable body composition analyzer (InBody230, Seoul, South Korea) and Lokin Body 120 software (DMS-BIA technology; InBody Co., Seoul, South Korea) to estimate body composition, including percent of body fat (PBF), fat mass (FM), fat-free mass (FFM, kg) and skeletal muscle mass (SMM, kg). The instrument was validated against dual-energy X-ray absorptiometry for school-age children with satisfactory results for estimating body fat [ 93 ] Additional information Demographics Children’s age, gender, grade (primaries 1–6), ethnicity (Han or others), parental educational level (below college; college or above) and yearly household income (low: RMB < 84,000; medium: RMB 84,000 – 132,000; high: RMB > 132,000) [ 60 ] will be reported by parents …”