Department of Medicine, Dunedin, New Zealand.
Department of Women's and Children's Health, Dunedin, New Zealand.
Int J Obes (Lond). 2019 Dec;43(12):2555-2564. doi: 10.1038/s41366-019-0432-y. Epub 2019 Sep 2.
Existing studies examining adherence to 24-h movement guidelines in young children are mostly cross sectional and have not assessed additional guidelines relating to activity intensity or regularity in sleep patterns. The aims of this study were to determine adherence to full sleep, activity, and sedentary behaviour guidelines from 1-5 years of age, whether adherence tracked over time, and how adherence was related to body composition cross sectionally and prospectively.
SUBJECTS/METHODS: Data were obtained from 547 children who were participants in a randomised controlled trial. At 1, 2, and 5 years of age, children wore Actical accelerometers 24-h a day for 5-7 days, height and weight were measured, and parents completed questionnaires on screen time and restraint (1 and 2 years only). A dual-energy x-ray absorptiometry (DXA) scan measured body composition at 5 years of age.
Although adherence to general sleep and activity guidelines was high, few children had regular sleep patterns. Adherence to all three guidelines ranged from 12.3 to 41.3% at the different ages, although these estimates decreased to 0.6-9.3% when activity intensity (60 min of energetic play) and sleep regularity (consistent sleep and wake times) were included. Children who met all three guidelines at a given age were more likely to meet all three guidelines at a subsequent age (odds ratio, 95% CI: 2.6, 1.04-6.4 at 1 year and 2.5, 1.1-5.9 at 2 years). However, adherence to meeting all three guidelines at earlier ages was not related to BMI z-score or body composition at age 5, either cross sectionally or prospectively.
Strategies to promote adherence to movement guidelines among young children are warranted, particularly to reduce screen time, and encouraging regular sleep patterns.
现有的研究主要是横断面研究，检查了幼儿对 24 小时运动指南的遵守情况，而没有评估与活动强度或睡眠模式规律性相关的其他指南。本研究的目的是确定 1-5 岁儿童对完整睡眠、活动和久坐行为指南的遵守情况，以及随着时间的推移是否进行跟踪，以及如何与横断面和前瞻性的身体成分相关。
数据来自参加随机对照试验的 547 名儿童。在 1、2 和 5 岁时，儿童每天佩戴 Actical 加速度计 24 小时，持续 5-7 天，测量身高和体重，并由父母在 1 岁和 2 岁时仅填写屏幕时间和限制（约束）问卷。双能 X 射线吸收法（DXA）扫描在 5 岁时测量身体成分。
尽管普遍遵守睡眠和活动指南，但很少有儿童有规律的睡眠模式。在不同年龄时，对所有三项指南的遵守率在 12.3%至 41.3%之间，尽管当包括活动强度（60 分钟能量运动）和睡眠规律性（一致的睡眠和醒来时间）时，这些估计值下降至 0.6%至 9.3%。在给定年龄满足所有三项指南的儿童在后续年龄更有可能满足所有三项指南（优势比，95%CI：1 岁时 2.6，1.04-6.4；2 岁时 2.5，1.1-5.9）。然而，在较早年龄时满足所有三项指南的情况与 5 岁时 BMI z 分数或身体成分均无横断面或前瞻性关系。
需要制定促进幼儿遵守运动指南的策略，特别是要减少屏幕时间，并鼓励有规律的睡眠模式。
