Wang Tian, Wang Junyu, Lu Xuelin, Chen Xuhui, Chen Lanzhi, Liang Yixin, Yang DongQing, Shi Yanmei, Li Rui, Yang Yong, Luo Beibei, Zhuang Jie
School of Exercise and Health, Shanghai University of Sport, 399 Changhai Rd, Yangpu District, Shanghai, 200438, China.
Officers College of PAP, Chengdu, China.
Child Adolesc Psychiatry Ment Health. 2025 May 9;19(1):52. doi: 10.1186/s13034-025-00911-7.
Mental health issues in preschool children are a significant public health concern with long-term developmental implications. Understanding how reallocations of time among different 24-hour movement behaviors-moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SED), and sleep (SLP)-affect various dimensions of mental health is essential for designing effective interventions.
In this cross-sectional study, 828 Chinese preschool children aged 3 to 6 years were assessed. Physical activity and sleep were objectively measured using accelerometers to capture MVPA, LPA, SED, and SLP. Mental health was evaluated using the Strengths and Difficulties Questionnaire (SDQ), assessing Total Difficulties, Internalizing Problems, Externalizing Problems, and Prosocial Behavior. Compositional data analysis was conducted using isometric log-ratio (ilr) transformation, followed by multivariate linear regression to assess associations. Additionally, isotemporal substitution modeling and dose-response analysis were applied to examine the effects of reallocating time between behaviors on mental health outcomes, adjusting for age, gender, BMI, parental education, and parental attitudes toward physical activity.
Increased MVPA was significantly associated with lower Total Difficulties (ß= - 1.587; P < 0.001) and Internalizing Problems (ß= - 0.663; P = 0.017). Increased SED was associated with higher Total Difficulties (ß= 1.512; P < 0.05), while increased SLP was linked to improved Externalizing Problems (ß= - 1.792; P = 0.008). Reallocating as little as 1 min from LPA or SED to MVPA or SLP significantly reduced Total Difficulties and Internalizing Problems (P < 0.05). Conversely, replacing SED or SLP with LPA increased Externalizing Problems, particularly Conduct Problems and Hyperactivity/Inattention (P < 0.05). A critical threshold at 30 min was identified, beyond which the effects on mental health outcomes became more pronounced.
Reallocating time from LPA or SED to MVPA or SLP significantly improves Total Difficulties and Internalizing Problems in preschool children, even with brief substitutions. However, increasing LPA at the expense of SED or SLP exacerbates Externalizing Problems, especially Conduct Problems and Hyperactivity/Inattention. Interventions should promote MVPA and adequate sleep while considering the critical 30-minute threshold where effects become more pronounced to enhance emotional and behavioral well-being.
学龄前儿童的心理健康问题是一个重大的公共卫生问题，具有长期的发育影响。了解24小时内不同运动行为（中度至剧烈身体活动（MVPA）、轻度身体活动（LPA）、久坐行为（SED）和睡眠（SLP））之间的时间重新分配如何影响心理健康的各个维度，对于设计有效的干预措施至关重要。
在这项横断面研究中，对828名3至6岁的中国学龄前儿童进行了评估。使用加速度计客观测量身体活动和睡眠，以获取MVPA、LPA、SED和SLP。使用优势与困难问卷（SDQ）评估心理健康，评估总困难、内化问题、外化问题和亲社会行为。使用等距对数比（ilr）变换进行成分数据分析，然后进行多元线性回归以评估关联。此外，应用等时替代模型和剂量反应分析来检验行为之间时间重新分配对心理健康结果的影响，并对年龄、性别、BMI、父母教育程度和父母对身体活动的态度进行了调整。
MVPA增加与总困难降低（β=-1.587；P<0.001）和内化问题降低（β=-0.663；P=0.017）显著相关。SED增加与总困难增加相关（β=1.512；P<0.05），而SLP增加与外化问题改善相关（β=-1.792；P=0.008）。将仅1分钟的时间从LPA或SED重新分配到MVPA或SLP可显著降低总困难和内化问题（P<0.05）。相反，用LPA替代SED或SLP会增加外化问题，特别是品行问题和多动/注意力不集中（P<0.05）。确定了30分钟的临界阈值，超过该阈值对心理健康结果的影响会更加明显。
即使是短暂的替代，将时间从LPA或SED重新分配到MVPA或SLP也能显著改善学龄前儿童的总困难和内化问题。然而，以SED或SLP为代价增加LPA会加剧外化问题，尤其是品行问题和多动/注意力不集中。干预措施应促进MVPA和充足睡眠，同时考虑到影响变得更加明显的关键30分钟阈值，以提高情绪和行为幸福感。
