Associations Between Meeting the 24-Hour Movement Guidelines and Cardiometabolic Risk in Young Children

in Pediatric Exercise Science
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  • 1 Hospital for Sick Children Research Institute
  • | 2 St. Michael’s Hospital
  • | 3 University of Toronto
  • | 4 CHEO Research Institute
  • | 5 McMaster University
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Introduction: The authors aimed to examine the association between meeting the integrative movement behavior guidelines (physical activity, screen viewing, and sleep) and cardiometabolic risk (CMR) factors in young children. Methods: In this cross-sectional study, physical activity, screen viewing, and sleep were assessed using parent-reported data. The 24-Hour Movement Guidelines for the Early Years (0–4 y) were defined as 180 minutes of physical activity/day (of which ≥60 min should be moderate-to-vigorous intensity), ≤1 hour of screen viewing/day, and 10 to 13 hours of sleep/night. Waist circumference, glucose, high-density lipoprotein cholesterol, triglycerides, and systolic blood pressure were measured in a clinical setting by trained staff. A total CMR score and individual CMR factors served as primary and secondary outcomes, respectively. Results: Of the 767 participants (3–4 y), 26.4% met none of the guideline’s recommendations, whereas 41.3%, 33.1%, and 10.6% of the sample met 1, 2, or all 3 recommendations, respectively. The number of recommendations met was not associated with the total CMR score or individual CMR factors (P > .05), with the exceptions of high-density lipoprotein (odds ratio = 1.61; 95% confidence interval, 1.11 to 2.33; P = .01). Conclusion: Meeting the 24-Hour Movement Guidelines in early childhood was not associated with overall CMR, but was associated with favorable cholesterol outcomes.

Vanderloo, Parkin, Borkhoff, and Birken are with the Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada. Maguire and Keown-Stoneman are with The Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada. Maguire, Parkin, and Borkhoff are also with the Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Maguire and Parkin are also with the Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Maguire is also with the Department of Pediatrics, St. Michael’s Hospital, Toronto, ON, Canada. Parkin and Borkhoff are also with the Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. Tremblay is with Healthy Active Living and Obesity Research, CHEO Research Institute, Ottawa, ON, Canada. Anderson is with the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. Keown-Stoneman and Birken are also with the Dalla Lana School of Public Health, Epidemiology, University of Toronto, Toronto, ON, Canada.

Vanderloo (lvande32@uwo.ca) is corresponding author.

Supplementary Materials

    • Supplementary Table S1 (PDF 812 KB)
  • 1.

    Albaum JM, Carsley S, Chen Y, et al. Persistent high non-high-density lipoprotein cholesterol in early childhood: a latent class growth model analysis. J Pediatr. 2017;191:1527. PubMed ID: 29173300 doi:10.1016/j.jpeds.2017.08.079

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Anderson LN, Lebovic G, Hamilton J, et al. Body mass index, waist circumference, and the clustering of cardiometabolic risk factors in early childhood. Paediatr Perinat Epidemiol. 2016;30(2):16070. PubMed ID: 26645704 doi:10.1111/ppe.12268

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Anderson LN, Maguire JL, Lebovic G, et al. Duration of fasting, serum lipids, and metabolic profile in early childhood. J Pediatr. 2017;180:4752.e1. PubMed ID: 27742126 doi:10.1016/j.jpeds.2016.09.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa heart study. N Engl J Med. 1998;338(23):16506. PubMed ID: 9614255 doi:10.1056/NEJM199806043382302

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Biddle SJH, Pearson N, Ross GM, Braithwaite R. Tracking of sedentary behaviours of young people: a systematic review. Prev Med (Baltim). 2010;51(5):34551. PubMed ID: 20682330 doi:10.1016/j.ypmed.2010.07.018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Brambilla P, Lissau I, Flodmark CE, et al. Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome. Int J Obes. 2007;31(4):591600. PubMed ID: 17384660 doi:10.1038/sj.ijo.0803581

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Buuren SV, Groothuis-Oudshoorn K. MICE: multivariate imputation by chained equations in R. J Stat Softw. 2011;45(3):167. doi:10.18637/jss.v045.i03

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Cardiometabolic Risk Working Group: Executive Committee, Leiter LA, Fitchett DH, et al. Cardiometabolic risk in Canada: a detailed analysis and position paper by the cardiometabolic risk working group. Can J Cardiol. 2011;27(2):e1e33. PubMed ID: 21459257 doi:10.1016/j.cjca.2010.12.054

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Carsley S, Borkhoff CM, Maguire JL, et al. Cohort profile: the applied research group for kids (TARGet Kids!). Int J Epidemiol. 2015;44(3):77688. PubMed ID: 24982016 doi:10.1093/ije/dyu123

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Carson V, Chaput J-P, Janssen I, Tremblay MS. Health associations with meeting new 24-hour movement guidelines for Canadian children and youth. Prev Med. 2017;95:713. PubMed ID: 27923668 doi:10.1016/j.ypmed.2016.12.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Carson V, Hunter S, Kuzik N, et al. Systematic review of physical activity and cognitive development in early childhood. J Sci Med Sport. 2016;19(7):5738. PubMed ID: 26197943 doi:10.1016/j.jsams.2015.07.011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Carson V, Hunter S, Kuzik N, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab. 2016;41(6):S24065. PubMed ID: 27306432 doi:10.1139/apnm-2015-0630

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Carson V, Lee E-Y, Hewitt L, et al. Systematic review of the relationships between physical activity and health indicators in the early years (0–4 years). BMC Public Health. 2017;17 Suppl 5:854. PubMed ID: 29219090 doi:10.1186/s12889-017-4860-0

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Carson V, Tremblay MS, Chaput JP, Chastin SF. Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses. Appl Physiol Nutr Metab. 2016;41(6):S294S302. PubMed ID: 27306435 doi:10.1139/apnm-2016-0026

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Cespedes EM, Rifas-Shiman SL, Redline S, Gillman MW, Peña MM, Taveras EM. Longitudinal associations of sleep curtailment with metabolic risk in mid-childhood. Obesity. 2014;22(12):258692. PubMed ID: 25234485 doi:10.1002/oby.20894

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Chaput JP, Colley RC, Aubert S, et al. Proportion of preschool-aged children meeting the Canadian 24-hour movement guidelines and associations with adiposity: results from the Canadian health measures survey. BMC Public Health. 2017;17 Suppl 5:14754. PubMed ID: 29219075 doi:10.1186/s12889-017-4854-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Chaput J-P, Gray CE, Poitras VJ, Carson V, Gruber R, Olds T. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6):S26682. PubMed ID: 27306433 doi:10.1139/apnm-2015-0627

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Chaput J-P, Gray CE, Poitras VJ, et al. Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years). BMC Public Health. 2017;17 Suppl 5:855. PubMed ID: 29219078 doi:10.1186/s12889-017-4850-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Roman-Vinas B, Chaput JP, Katzmarzyk PT, et al. Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study. Int J Behav Nutr Phys Act. 2016;13:123.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Eisenmann JC. On the use of a continuous metabolic syndrome score in pediatric research. Cardiovasc Diabetol. 2008;7(1):17. PubMed ID: 18534019 doi:10.1186/1475-2840-7-17

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Eisenmann JC, Laurson KR, DuBose KD, Smith BK, Donnelly JE. Construct validity of a continuous metabolic syndrome score in children. Diabetol Metab Syndr. 2010;2(1):8. PubMed ID: 20181030 doi:10.1186/1758-5996-2-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Eisenmann JC, Wickel EE, Welk GJ, Blair SN. Relationship between adolescent fitness and fatness and cardiovascular disease risk factors in adulthood: the aerobics center longitudinal study (ACLS). Am Heart J. 2005;149(1):4653. PubMed ID: 15660033 doi:10.1016/j.ahj.2004.07.016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A. Association of moderate to vigorous physical activity and sedentary time with cardiometabolic risk factors in children and adolescents. JAMA. 2012;307(7):70412. PubMed ID: 22337681 doi:10.1001/jama.2012.156

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Enders CK. Using the expectation maximization algorithm to estimate coefficient alpha for scales with item-level missing data. Psychol Methods. 2003;8(3):32237. PubMed ID: 14596494 doi:10.1037/1082-989X.8.3.322

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128 Suppl 5:S21356. PubMed ID: 22084329 doi:10.1542/peds.2009-2107c

    • Search Google Scholar
    • Export Citation
  • 26.

    Flynn JT, Kaelber DC, Baker-Smith CM, et al. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2017;140(3):e20171904. PubMed ID: 28827377 doi:10.1542/peds.2017-1904

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Friedman LA, Morrison JA, Daniels SR, McCarthy WF, Sprecher DL. Sensitivity and specificity of pediatric lipid determinations for adult lipid status: findings from the princeton lipid research clinics prevalence program follow-up study. Pediatrics. 2006;118(1):16572. PubMed ID: 16818562 doi:10.1542/peds.2005-2968

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Goldfield GS, Harvey A, Grattan K, Adamo KB. Physical activity promotion in the preschool years: a critical period to intervene. Int J Environ Res Public Health. 2012;9(4):132642. PubMed ID: 22690196 doi:10.3390/ijerph9041326

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Hayes G, Dowd KP, MacDonncha C, Donnelly AE. Tracking of physical activity and sedentary behavior from adolescence to young adulthood: a systematic literature review. J Adolesc Heal. 2019;65(4):44654. PubMed ID: 31248803 doi:10.1016/j.jadohealth.2019.03.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Hjorth MF, Chaput JP, Damsgaard CT, et al. Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: a longitudinal study in 8–11 year old Danish children. PLoS One. 2014;9(8):e104677. PubMed ID: 25102157 doi:10.1371/journal.pone.0104677

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Juonala M, Viikari JSA, Raitakari OT. Main findings from the prospective cardiovascular risk in young Finns study. Curr Opin Lipidol. 2013;24(1):5764. PubMed ID: 23069987 doi:10.1097/MOL.0b013e32835a7ed4

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Katzmarzyk P, Staino A. Relationship between meeting 24-hour movement guidelines and cardiometabolic risk factors in children. J Phys Act Health. 2017;14(10):77984. PubMed ID: 28556685 doi:10.1123/jpah.2017-0090

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Kelly AS, Steinberger J, Jacobs DR, Hong C-P, Moran A, Sinaiko AR. Predicting cardiovascular risk in young adulthood from the metabolic syndrome, its component risk factors, and a cluster score in childhood. Int J Pediatr Obes. 2011;6(2):e2839. PubMed ID: 21070100 doi:10.3109/17477166.2010.528765

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Kuzik N, Poitras VJ, Tremblay MS, Lee E-Y, Hunter S, Carson V. Systematic review of the relationships between combinations of movement behaviors and health indicators in the early years (0 to 4 years). BMC Public Health. 2017;17 Suppl 5:849. PubMed ID: 29219071 doi:10.1186/s12889-017-4851-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Malina RM. Physical activity and fitness: pathways from childhood to adulthood. Am J Hum Biol. 2001;13(2):16272. PubMed ID: 11460860 doi:10.1002/1520-6300(200102/03)13:2<162::AID-AJHB1025>3.0.CO;2-T

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Morrison KM, Anand SS, Yusuf S, et al. Maternal and pregnancy related predictors of cardiometabolic traits in newborns. PLoS One. 2013;8(2):e55815. PubMed ID: 23418462 doi:10.1371/journal.pone.0055815

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    National Heart, Lung and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. Pediatrics. 2011;128(Suppl 5):S213S256.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Okosun IS, Boltri JM, Lyn R, Davis-Smith M. Continuous metabolic syndrome risk score, body mass index percentile, and leisure time physical activity in American children. J Clin Hyoertens. 2010;12(8):63644. PubMed ID: 20695944 doi:10.1111/j.1751-7176.2010.00338.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Pietrobelli A, Malavolti M, Battistini NC, Fuiano N. Metabolic syndrome: a child is not a small adult. Int J Pediatr Obes. 2008;3 Suppl 1:6771. PubMed ID: 18278635 doi:10.1080/17477160801897133

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Plumptre L, Anderson LN, Chen Y, et al. Longitudinal analysis of sleep duration and cardiometabolic risk in young children. Child Obes. 2017;13(4):2919. PubMed ID: 30433827 doi:10.1089/chi.2016.0279

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Poitras VJ, Gray CE, Borghese MM, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6) Suppl 3:S197239. PubMed ID: 27306431 doi:10.1139/apnm-2015-0663

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Poitras VJ, Gray CE, Janssen X, et al. Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0–4 years). BMC Public Health. 2017;17 Suppl 5:868. PubMed ID: 29219092 doi:10.1186/s12889-017-4849-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Retnakaran R, Zinman B, Connelly PW, Harris SB, Hanley A. Nontraditional cardiovascular risk factors in pediatric metabolic syndrome. J Pediatr. 2006;148(2):17682. PubMed ID: 16492425 doi:10.1016/j.jpeds.2005.08.025

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Rhodes RE, Janssen I, Bredin SSD, Warburton DER, Bauman A. Physical activity: health impact, prevalence, correlates and interventions. Psychol Heal. 2017;32(8):94275. PubMed ID: 28554222 doi:10.1080/08870446.2017.1325486

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Rollo S, Antsygina O, Tremblay M. The whole day matters: understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan. J Sport Heal Sci. 2020;9(6):493510. PubMed ID: 32711156 doi:10.1016/j.jshs.2020.07.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46.

    Saunders TJ, Gray CE, Poitras VJ, et al. Combinations of physical activity, sedentary behaviour and sleep: relationships with health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6):S28393. PubMed ID: 27306434 doi:10.1139/apnm-2015-0626

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Sovio U, Skow A, Falconer C, Park MH, Viner RM, Kinra S. Improving prediction algorithms for cardiometabolic risk in children and adolescents. J Obes. 2013;2013:684782. PubMed ID: 23862055 doi:10.1155/2013/684782

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Steiner MJ, Skinner AC, Perrin EM. Fasting might not be necessary before lipid screening: a nationally representative cross-sectional study. Pediatrics. 2011;128:46370. PubMed ID: 21807697 doi:10.1542/peds.2011-0844

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Timmons BW, LeBlanc AG, Carson V, Connor GS, Dillman C, Janssen I. Systematic review of physical activity and health in the early years (aged 0–4 years). Appl Physiol Nutr Metab. 2012;37(4):77392. PubMed ID: 22765840 doi:10.1139/h2012-070

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Tolfrey K, Jones AM, Campbell IG. The effect of aerobic exercise training on the lipid-lipoprotein profile of children and adolescents. Sport Med. 2000;29(2):99112. PubMed ID: 10701713 doi:10.2165/00007256-200029020-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51.

    Tremblay M, Wolfson M, Gorber SC. Canadian health measures survey: rationale, background and overview. Health Rep. 2007;18 Suppl:720. PubMed ID: 18210866

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Tremblay MS, Carson V, Chaput J-P, et al. Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2016;41(6) Suppl 3:S31127. PubMed ID: 27306437 doi:10.1139/apnm-2016-0151

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Tremblay MS, Chaput J-P, Adamo KB, et al. Canadian 24-hour movement guidelines for the early years (0–4 years): an integration of physical activity, sedentary behaviour, and sleep. BMC Public Health. 2017;17(S5):874. PubMed ID: 29219102 doi:10.1186/s12889-017-4859-6

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Williamson AA, Mindell JA, Hiscock H, Quach J. Sleep problem trajectories and cumulative socio-ecological risks: birth to school-age. J Pediatr. 2019;215:22937.e4. PubMed ID: 31564429 doi:10.1016/j.jpeds.2019.07.055

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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