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.
School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
J Adolesc Health. 2023 Nov;73(5):887-895. doi: 10.1016/j.jadohealth.2023.06.009. Epub 2023 Aug 11.
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.
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.
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.
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.
在横断面研究中，遵守整体 24 小时运动指南（24HGs）与儿童肥胖有关。然而，很少有纵向研究探讨这种关联，特别是在中国。我们旨在探索儿童和青少年遵守 24HGs 建议与超重和肥胖风险之间的前瞻性关联。
我们纳入了 2004-2011 年中国健康与营养调查中没有超重和肥胖的参与者（年龄 6-17 岁），并对他们进行了随访，直到 2015 年。我们为中等至剧烈体力活动、娱乐屏幕时间和睡眠的指南遵守情况各分配 1 分，并将它们相加以表示对 24HGs 的总体遵守程度（范围：0-3 分）。主要结局是超重或肥胖的首次发生。多变量 Cox 比例风险模型用于评估相应的关联。
在 1382 名参与者中（平均年龄：10.3 ± 3.2 岁；48.4%为女孩），在平均 4.7 年的随访中，共有 152 名（11%）参与者被确定为新发超重和肥胖。与不遵守任何指南的参与者相比，遵守一项（风险比 [HR] = 0.38，95%置信区间 [CI]：0.21-0.71，p <.01）、两项（HR = 0.49，95% CI：0.28-0.88，p =.02）和三项（HR = 0.40，95% CI：0.17-0.91，p =.03）建议的参与者超重和肥胖的风险显著降低。
遵守 24HGs 任何建议的儿童和青少年发生后续超重和肥胖的风险显著降低。在未来的儿童肥胖预防公共卫生建议中，可以考虑设定可实现的目标，例如采用至少一项建议。
