Prevalence and correlates of compliance with 24-h movement guidelines among children from urban and rural Kenya-The Kenya-LINX project

Does active participation in organised physical activity contribute to children's achievement of the 24-hour movement guidelines? findings from the family physical activity, sedentary behaviour, and sleep (FAMIPASS) study

BACKGROUND

The development of child's lifestyle occurs within regular 24-hour movement patterns under the guidance of parents. Accelerometer-based monitoring allows for the capture of these 24-hour movement patterns of behaviour. Therefore, the aim of this study was to reveal whether active participation in organised physical activity (OPA) contributed to the achievement of the World Health Organization's (WHO) 24-hour movement behaviour guidelines (24-hMBGS) among 3-10-year-old children, considering the influence of parents' movement behaviour and families' material background.

METHODS

The 24-hour movement behaviour (24-hMB) of 348 child-parent pairs (with at least one parent) was continuously monitored for 7 days via ActiGraph accelerometers placed on the non-dominant wrist. Children's adherence to the WHO's 24-hMBGS was analysed using logistic regression analysis. The socioeconomic status (SES) of families was measured using the Family Affluence Scale. Body mass level was determined according to body mass index gender- and age-specific WHO reference data. Univariate analysis of variance/Pearson's chi-square test was used to test differences in sedentary behaviour duration/excess body weight between active participants and non-participants in OPA.

RESULTS

Active 3-10-year-old participants in OPA, compared to non-participants, were significantly more likely to meet at least two of the 24-hMBGS (77.7% vs. 66.4%, p = 0.008), had significantly shorter daily sedentary time (by 30 min per day, p = 0.001), and a significantly lower prevalence of excessive body weight (10.26% vs. 24.87% p < 0.001). Engaging in OPA significantly (p < 0.01) helped 3-10-year-old children achieve at least two of the 24-hMBGS, regardless of their gender, age, excess body weight, or family SES. In addition, a mother's non-excessive body weight and achievement of at least two of the WHO's 24-hMBGS significantly (p < 0.05) contributed to children attaining at least two of the WHO's 24-hMBGS.

CONCLUSIONS

Even in young children, active participation in OPA tend to contribute to a healthier lifestyle profile, characterised by shorter sedentary behaviour and lower excess body weight, with a significant influence from the mother's movement behaviour.

Differences Between Health- and Skill-Related Physical Fitness Profiles of Kenyan Children from Urban and Rural Areas: The Kenya-LINX Project

Physical fitness is a key indicator of children's health, yet amidst rising inactivity and obesity, data on Kenyan children are scarce. This study assessed health- and skill-related fitness differences between rural and urban Kenyan children while examining demographic influences. Cardiorespiratory fitness (CRF), BMI, strength, flexibility, speed, agility, and coordination were assessed in 1131 children aged 11.07 ± 0.9 years (52.7% girls) recruited using stratified cluster random sampling. Significant rural-urban disparities were observed. In urban areas, 16.6% were overweight and 2.8% obese, compared to 4% and 0.6% in rural areas (p < 0.001). Conversely, 44.5% of the rural cohort were underweight versus 13.7% urban cohort (p < 0.001). Multivariable regression revealed that rural children demonstrated superior CRF (β = -4.68 laps, p < 0.001) and lower back flexibility (β = -2.77 cm, p < 0.001), while urban children excelled in speed and coordination (β = 3.68 bounces, p < 0.001) and grip strength (β = 2.16 kg, p < 0.001). Boys outperformed girls in explosive leg power (β = -6.75 cm, p < 0.001) and CRF (β = -6.92 laps, p < 0.001). These findings highlight fitness inequities among Kenyan children, emphasising the need for equitable, targeted, and inclusive physical activity opportunities.

Exploring urban-rural differences in 24-h movement behaviours among tunisian preschoolers: Insights from the SUNRISE study

Little is known about differences in physical activity among children from urban and rural areas in low-to middle-income countries and some previous investigations revealed disparities in physical activity levels among children and adolescents residing in urban and rural environments. We aimed to: (i) assess the proportion of preschool-aged children (3.0-4.9 years) meeting the global movement guidelines, (ii) evaluate the feasibility of the methods for the SUNRISE study, (iii) examine gender- and urban-rural differences in health and behavior outcomes. Urban and rural location was based on national classifications. Physical activity (waist-worn ActiGraph); sleep duration, screen time and movement behaviors; Gross and fine motor skills (Lower body strength and mobility, Supine-Timed up and go [S-TUG], One-leg standing balance test, hand grip dynamometer, 9-hole peg-board test); and executive functions (visual-spatial working memory and inhibition) were assessed in 112 preschoolers (n ​= ​50 boys, 33 urban), (n ​= ​62 girls, 41 urban). The results showed that only 18% of children met all movement guidelines, with 53% and 41% meeting the recommendations for sedentary screen time and total physical activity, respectively. A large proportion of children (81%) met the recommended sleep duration of 10-13 ​hours (h) per day. There is a clear need to promote healthy movement behaviours among preschool-aged children through targeted interventions that address their unique challenges related to gender and urban/rural residence.

Attainment of World Health Organization physical activity recommendations by Ecuadorian children: Analysis of social and anthropometrics factors in two distinct populations

Daily adherence to WHO recommended physical activity guidelines has multiple health benefits in children and adolescents. Limited data from low and middle-income countries are available regarding adherence to WHO physical activity recommendations. This study aims to objectively measure physical activity intensities and explore associations with sociodemographic and anthropometric factors related to nonadherence to the WHO minimum physical activity recommendations. Two cross-sectional studies were conducted between 2014 and 2019 in two distinct populations of Ecuador in terms of poverty and residency (Cuenca: 66% live in urban areas, and 38.2% have unsatisfied basic needs; Quininde, 76.4% live in rural areas and 91% have unsatisfied basic needs). Waist-worn accelerometers were used to measure daily physical activity, standardized questionnaires were used to assess sociodemographic variables (age, sex, ethnicity, and socioeconomic status), and anthropometric (weight, height, waist circumference) measurements were taken. Multivariable regression was used to assess the relationship between sociodemographic and anthropometric factors with physical activity in each study population. The study involved 650 participants in Cuenca, with a mean age of 9.1 years (SD 2.9), and 985 children and adolescents in Quinindé, with a mean age of 8.3 years (SD 0.4). In both settings, boys were more likely than girls (Cuenca: adj. OR 3.09, 95% CI 2.17-4.39; Quinindé adj. OR 5.63, 95% CI 4.03-7.85) to achieve the WHO physical activity guidelines. More affluent participants were much less likely to meet this recommendation than their poorer counterparts in both settings. In Cuenca, a higher waist circumference was inversely associated with meeting WHO daily physical activity recommendation (adj. OR 0.96, 95% CI 0.94-0.98), whereas in Quinindé, adherence to WHO guidelines was more likely in non-Mestizo than Mestizo children (adj. OR 1.45, 95% CI 1.02-2.07). The findings suggest that anthropometric differences and sociodemographic disparities influence the attainment of WHO physical activity recommendations in Ecuadorian children.

Urban Versus Rural Differences in Meeting 24-h Movement Behaviour Guidelines Among 3-4-Year-Olds: An Analysis of SUNRISE Pilot Study Data From 10 Low- and Middle-Income Countries

BACKGROUND

Insufficient physical activity, excessive screen time and short sleep duration among young children are global public health concerns; however, data on prevalence of meeting World Health Organisation 24-h movement behaviour guidelines for 3-4-year-old children in low- and middle-income countries (LMICs) are limited, and it is unknown whether urbanisation is related to young children's movement behaviours. The present study examined differences in prevalence of meeting 24-h movement behaviour guidelines among 3-4-year-old children living in urban versus rural settings in LMICs.

METHODS

The SUNRISE Study recruited 429, 3-4-year-old child/parent dyads from 10 LMICs. Children wore activPAL accelerometers continuously for at least 48 h to assess their physical activity and sleep duration. Screen time and time spent restrained were assessed via parent questionnaire. Differences in prevalence of meeting guidelines between urban- and rural-dwelling children were examined using chi-square tests.

RESULTS

Physical activity guidelines were met by 17% of children (14% urban vs. 18% rural), sleep guidelines by 57% (61% urban vs. 54% rural), screen time guidelines by 50% (50% urban vs. 50% rural), restrained guidelines by 84% (81% urban vs. 86% rural) and all guidelines combined by 4% (4% urban vs.4% rural). We found no significant differences in meeting the guidelines between urban and rural areas.

CONCLUSIONS

Only a small proportion of children in both rural and urban settings met the WHO 24-h movement guidelines. Strategies to improve movement behaviours in LMICs should consider including both rural and urban settings.

Mapping the research using 24-h movement guidelines in children and adolescents: A bibliometric analysis

BACKGROUND

There are limited comprehensive bibliometric analyses that have examined research articles using the 24-h movement guidelines, which are necessary to evaluate the impact of the research field, map the scientific structure of the research landscape, and identify knowledge gaps.

OBJECTIVES

The aim of this study was to analyse the published research articles using the 24-h movement guidelines and assess their bibliometric characteristics.

METHODS

The search was conducted across all databases indexed in the Web of Science on March 6, 2024, and the bibliometric characteristics of studies published from 2016 onwards were analysed. Descriptive statistics and visualisations by the VOSviewer were used for the presentation of bibliometric characteristics.

RESULTS

120 studies using the 24-h movement guidelines in children and adolescents were included for analysis in this study. In general, number of the related publications using the 24-h movement guidelines increased from 2016 until now. 16 distinct clusters of author networking were displayed, of which the Canadian team was the strongest cluster with the highest research impacts. Of the included studies, cross-sectional studies accounted for the majority. North America and Europe were the leading two study locations across the included studies. Highly varied adherence rate to the 24-h movement guidelines across the included studies were observed. In terms of correlates and health outcomes of meeting the 24-h movement guidelines, separately, sociodemographic and health functioning characteristics were the most examined aspects.

CONCLUSIONS

This study provides a comprehensive scientific overview for research using the 24-h movement guidelines in children and adolescents, which may help guide potential research directions to improve the low compliance rates in this population.

Proportion, Correlates and the Associations of Meeting 24-h Movement Guidelines With Mental Well-Being and Psychological Distress: A Cross-Sectional Study of 10 589 Chinese Students

BACKGROUND

The increased trends in psychological distress and mental illness have been of great significance in public health concerns. The study aimed to investigate the proportion and correlates of meeting 24-h movement guidelines (including moderate to vigorous physical activity, screen time and sleep duration) and the associations between 24-h movement guidelines met and mental well-being and psychological distress in a large sample of Chinese students.

METHODS

All participants received a physical examination and filled out questionnaires in this study. Chi-square tests were used to analyse the proportion of reaching 24-h guidelines by gender and logistic regression was used to analyse correlates of meeting 24-h guidelines. Two binary logistic regression models were used to analyse the association between meeting 24-h guidelines and mental well-being and psychological distress. The back-propagation artificial neural network was used to describe the importance of the independent variables.

RESULTS

The findings revealed a generally low rate of meeting the 24-h movement guidelines, particularly concerning moderate to vigorous physical activity (16.5%). Meeting all three guidelines was related to better mental health in both boys and girls. Particularly, meeting screen time guideline and meeting sleep duration guideline appeared to be more important on mental outcomes, compared to meeting moderate to vigorous physical activity guideline. Compared with boys, girls were more susceptible to the influences of 24-h movement guidelines on mental health.

CONCLUSIONS

Meeting all three components of the 24-h movement guidelines was associated with the most favourable mental health outcomes for both boys and girls. Thus, maintaining a daily balance of sufficient physical activity, limited screen time, and adequate sleep is crucial for enhancing the mental health status of students.

Compliance with the 24-h movement behaviors guidelines among urban and rural Brazilian preschoolers

BACKGROUND

The importance of movement behaviors for health is well-known, although few studies have examined the compliance with movement guidelines in preschoolers from different living contexts. This study reported the compliance with the 24-h movement behaviors guidelines among low-income Brazilian preschoolers from rural and urban areas, according to age.

METHODS

A total of 453 preschoolers (n = 222 urban), aged between 3 and 5 years, provided physical activity (PA) data (Actigraph wGT3X). Sleep duration, and screen time were parent-reported. Preschoolers were classified as compliant/non- compliant with the 24-h movement guidelines, according to age. The association between prevalence of compliance with the recommendations and the children's living setting were estimated (SPSS; 27.0).

RESULTS

Preschoolers were active (mean = 299.19 ± 76.42; and 369.76 ± 95.56 min/day in urban and rural areas, respectively), though moderate-to-vigorous physical activity (MVPA) time was below the 60 daily minutes recommended in both urban and rural settings (mean = 38.39 ± 21.36; and 47.32 ± 24.28, respectively). None of the urban children complied with the three recommendations simultaneously, while in the rural area, only 2.6% were compliant. Single movement behaviors compliances in the urban setting were 6.8%, 28.8% and 5.4% for PA, sleep, and screen time, respectively; while for rural settings were 16.5%, 21.2%, and 7.4%. Living in the rural area was related to the compliance with PA recommendation for the 5-year-old preschoolers.

CONCLUSION

In both urban and rural Brazilian areas, very few preschoolers are compliant with the guidelines, and more than one third of the children do not comply with any of the recommendations. Strategies and programs to promote compliance with movement behaviors guidelines should consider children's living setting and their age groups.

Association between meeting 24-h movement guidelines and health in children and adolescents aged 5-17 years: a systematic review and meta-analysis

Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one's lifespan. Consistent with movement behaviors, several countries have formulated and published 24-h movement guidelines. This review summarized the studies related to 24-h movement guidelines among children and adolescents from six databases (MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, and SPORTDiscus). In a total of 61 studies that discussed compliance with 24-h movement guidelines, the overall adherence rate was very low (7.1%), with boys exceeding girls, children surpassing adolescents, and regional differences. A total of 39 studies examined the associations between 24-h movement guidelines and health indicators. Findings indicated that meeting all three guidelines was favorably associated with adiposity, cardiometabolic health, mental and social health, physical fitness, health-related quality of life, academic achievement, cognitive development, perceived health, dietary patterns, and myopia. Future research should utilize longitudinal and experimental designs to enhance our understanding of the associations between 24-h movement guidelines and health indicators, thereby aiding the formulation and refinement of such guidelines.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, CRD42023481230.