Pooled Analysis of Physical Activity, Sedentary Behavior, and Sleep Among Children From 33 Countries.

IF 24.7 1区 医学 Q1 PEDIATRICS JAMA Pediatrics Pub Date : 2024-11-01 DOI:10.1001/jamapediatrics.2024.3330
Kar Hau Chong, Thomas Suesse, Penny L Cross, Sarah T Ryan, Eivind Aadland, Oluwayomi Aoko, Ankhmaa Byambaa, Valerie Carson, Jean-Philippe Chaput, Hayley Christian, Dylan P Cliff, Marieke De Craemer, Clarice Maria de Lucena Martins, Christine Delisle Nyström, Catherine E Draper, Asmaa El Hamdouchi, Alex Antonio Florindo, Hongyan Guan, Amy S Ha, Najmeh Hamzavi Zarghani, Kylie D Hesketh, Mohammad Sorowar Hossain, Jajat Jajat, Thanh Kim, Denise Koh, Anna V Kontsevaya, Nicholas Kuzik, Marja H Leppänen, Marie Löf, Himangi Lubree, Kim Meredith-Jones, Tawonga W Mwase-Vuma, Johan Y Y Ng, Rachel Novotny, Jackline Jema Nusurupia, Bang N Pham, Bee Koon Poh, John J Reilly, Amanda E Staiano, Kuston Sultoni, Chiaki Tanaka, Hong K Tang, Rachael W Taylor, Simone A Tomaz, Mark S Tremblay, Stewart G Trost, Ali Turab, Susana Vale, V Pujitha Wickramasinghe, Anthony D Okely
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Abstract

Importance: The prevalence estimates of physical activity, sedentary behavior, and sleep (collectively known as movement behaviors) in 3- and 4-year-old children worldwide remains uncertain.

Objective: To report the proportion of 3- and 4-year-old children who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep across 33 countries.

Design, setting, and participants: Pooled analysis of data from 14 cross-sectional studies (July 2008 to September 2022) identified through systematic reviews and personal networks. Thirty-three countries of varying income levels across 6 geographical regions. Each study site needed to have at least 40 children aged 3.0 to 4.9 years with valid accelerometry and parent-/caregiver-reported screen time and sleep duration data. Data were analyzed from October 2022 to February 2023.

Exposures: Time spent in physical activity was assessed by reanalyzing accelerometry data using a harmonized data-processing protocol. Screen time and sleep duration were proxy reported by parents or caregivers.

Main outcomes and measures: The proportion of children who met the World Health Organization guidelines for physical activity (≥180 min/d of total physical activity and ≥60 min/d of moderate- to vigorous-intensity physical activity), screen time (≤1 h/d), and sleep duration (10-13 h/d) was estimated across countries and by World Bank income group and geographical region using meta-analysis.

Results: Of the 7017 children (mean [SD] age, 4.1 [0.5] years; 3585 [51.1%] boys and 3432 [48.9%] girls) in this pooled analysis, 14.3% (95% CI, 9.7-20.7) met the overall guidelines for physical activity, screen time, and sleep duration. There was no clear pattern according to income group: the proportion meeting the guidelines was 16.6% (95% CI, 10.4-25.3) in low- and lower-middle-income countries, 11.9% (95% CI, 5.9-22.5) in upper-middle-income countries, and 14.4% (95% CI, 9.6-21.1) in high-income countries. The region with the highest proportion meeting the guidelines was Africa (23.9%; 95% CI, 11.6-43.0), while the lowest proportion was in North and South America (7.7%; 95% CI, 3.6-15.8).

Conclusions and relevance: Most 3- and 4-year-old children in this pooled analysis did not meet the current World Health Organization guidelines for physical activity, sedentary behavior, and sleep. Priority must be given to understanding factors that influence these behaviors in this age group and to implementing contextually appropriate programs and policies proven to be effective in promoting healthy levels of movement behaviors.

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对 33 个国家儿童的体育活动、久坐行为和睡眠情况进行汇总分析。
重要性:全球 3-4 岁儿童的体力活动、久坐行为和睡眠(统称为运动行为)的流行率估计值仍不确定:目的:报告 33 个国家中符合世界卫生组织体育锻炼、久坐不动和睡眠指导原则的 3-4 岁儿童的比例:对通过系统回顾和个人网络确定的 14 项横断面研究(2008 年 7 月至 2022 年 9 月)的数据进行汇总分析。横跨 6 个地理区域的 33 个不同收入水平的国家。每个研究地点至少需要有 40 名年龄在 3.0 至 4.9 岁之间的儿童,并提供有效的加速度测量和家长/护理人员报告的屏幕时间和睡眠时间数据。数据分析时间为 2022 年 10 月至 2023 年 2 月:暴露:通过使用统一的数据处理协议重新分析加速度计数据来评估体育活动时间。屏幕时间和睡眠时间由父母或看护人代理报告:主要结果和测量方法:采用荟萃分析法,按世界银行收入组别和地理区域估算了不同国家符合世界卫生组织体力活动指南(总体力活动时间≥180 分钟/天,中高强度体力活动时间≥60 分钟/天)、屏幕时间(≤1 小时/天)和睡眠时间(10-13 小时/天)的儿童比例:在本次汇总分析的 7017 名儿童(平均 [SD] 年龄为 4.1 [0.5]岁;3585 [51.1%] 名男孩和 3432 [48.9%] 名女孩)中,14.3%(95% CI,9.7-20.7)的儿童符合体育活动、屏幕时间和睡眠时间的总体指导方针。收入组别没有明显的模式:低收入和中低收入国家中符合指导方针的比例为 16.6%(95% CI,10.4-25.3),中上收入国家为 11.9%(95% CI,5.9-22.5),高收入国家为 14.4%(95% CI,9.6-21.1)。符合指南要求比例最高的地区是非洲(23.9%;95% CI,11.6-43.0),而比例最低的地区是北美和南美(7.7%;95% CI,3.6-15.8):在这项汇总分析中,大多数 3-4 岁儿童的体力活动、久坐行为和睡眠都不符合世界卫生组织的现行指导方针。我们必须优先了解影响该年龄组儿童这些行为的因素,并根据具体情况实施经证实能有效促进健康运动行为的计划和政策。
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来源期刊
JAMA Pediatrics
JAMA Pediatrics PEDIATRICS-
CiteScore
31.60
自引率
1.90%
发文量
357
期刊介绍: JAMA Pediatrics, the oldest continuously published pediatric journal in the US since 1911, is an international peer-reviewed publication and a part of the JAMA Network. Published weekly online and in 12 issues annually, it garners over 8.4 million article views and downloads yearly. All research articles become freely accessible online after 12 months without any author fees, and through the WHO's HINARI program, the online version is accessible to institutions in developing countries. With a focus on advancing the health of infants, children, and adolescents, JAMA Pediatrics serves as a platform for discussing crucial issues and policies in child and adolescent health care. Leveraging the latest technology, it ensures timely access to information for its readers worldwide.
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