美国 STRONG Kids 2 出生队列研究中的幼儿坚持遵循屏幕时间和身体活动指南与执行功能相关。
Adherence to Screen Time and Physical Activity Guidelines is Associated with Executive Function in US Toddlers Participating in the STRONG Kids 2 Birth Cohort Study.
机构信息
Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Champaign, IL.
Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Champaign, IL.
出版信息
J Pediatr. 2023 Jan;252:22-30.e6. doi: 10.1016/j.jpeds.2022.08.026. Epub 2022 Aug 24.
OBJECTIVE
To test the hypothesis that healthy weight status and adherence to American Academy of Pediatrics (AAP) guidelines for diet and physical activity would extend to greater executive function (EF) at age 24 months.
STUDY DESIGN
Parents of 24-month-old children from the STRONG Kids 2 cohort study (n = 352) completed the Behavioral Rating Inventory of Executive Function for Preschoolers (BRIEF-P) and reported physical activities, diet, and screen time. Toddlers met AAP guidelines if they consumed at least 5 servings of fruits and vegetables, were physically active, refrained from sugar-sweetened beverages, and limited daily screen time to <60 minutes. Relationships between EF, 24-month weight status, and meeting AAP guidelines were tested independent of child sex, ethnicity, socioeconomic status, weight status at birth, and maternal pregnancy weight status.
RESULTS
Weight-for-length z-score had no effect on EF. Toddlers meeting the screen time guideline had greater EF (β, -0.125; 95% CI, 0.234 to -0.008), inhibitory self-control (β, -0.142; 95% CI, -0.248 to -0.029), and emergent metacognition (β, -0.111; 95% CI, -0.221 to 0.002), indicated by lower BRIEF-P scores. Those with more minutes of screen time had poorer overall EF (β, 0.257; 95% CI, 0.118-0.384), inhibitory self-control (β, 0.231; 95% CI, 0.099-0.354), cognitive flexibility (β, 0.217; 95% CI, 0.082-0.342), and emergent metacognition (β, 0.257; 95% CI, 0.120-0.381). Daily physical activity was associated with greater emergent metacognition (β, -0.116; 95% CI, -0.225 to -0.005).
CONCLUSIONS
Meeting AAP guidelines for physical activity and screen time was related to greater EF in a demographically homogenous sample of toddlers. Future randomized control trials and more diverse samples are needed to confirm the directionality of this relationship.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, NCT03341858.
目的
验证以下假设，即健康体重状况和遵循美国儿科学会（AAP）关于饮食和身体活动的指南，会延伸到 24 个月大的儿童更大的执行功能（EF）。
研究设计
来自 STRONG Kids 2 队列研究的 24 个月大儿童的父母（n=352）完成了学龄前行为评定量表的执行功能（BRIEF-P），并报告了身体活动、饮食和屏幕时间。如果儿童摄入至少 5 份水果和蔬菜、积极运动、避免含糖饮料、并将每日屏幕时间限制在<60 分钟，则认为他们符合 AAP 指南。EF、24 个月体重状况和符合 AAP 指南之间的关系是在不考虑儿童性别、种族、社会经济地位、出生时体重状况和母亲妊娠体重状况的情况下进行测试的。
结果
体重长度 z 评分对 EF 没有影响。符合屏幕时间指南的幼儿具有更好的 EF（β，-0.125；95%CI，0.234 至-0.008）、抑制自我控制（β，-0.142；95%CI，-0.248 至-0.029）和新兴元认知（β，-0.111；95%CI，-0.221 至 0.002），这表明 BRIEF-P 得分较低。屏幕时间分钟数较多的儿童整体 EF（β，0.257；95%CI，0.118-0.384）、抑制自我控制（β，0.231；95%CI，0.099-0.354）、认知灵活性（β，0.217；95%CI，0.082-0.342）和新兴元认知（β，0.257；95%CI，0.120-0.381）均较差。每日身体活动与新兴元认知的增加有关（β，-0.116；95%CI，-0.225 至-0.005）。
结论
在人口统计学同质的幼儿样本中，符合 AAP 关于身体活动和屏幕时间的指南与更大的 EF 相关。需要进行随机对照试验和更多样化的样本研究来证实这种关系的方向性。
临床试验注册
ClinicalTrials.gov，NCT03341858。
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