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Pediatrics

Do young children consistently meet 24-h sleep and activity guidelines? A longitudinal analysis using actigraphy

International Journal of Obesity volume 43, pages 2555–2564 (2019)Cite this article

Subjects

Abstract

Background

Existing studies examining adherence to 24-h movement guidelines in young children are mostly cross sectional and have not assessed additional guidelines relating to activity intensity or regularity in sleep patterns. The aims of this study were to determine adherence to full sleep, activity, and sedentary behaviour guidelines from 1–5 years of age, whether adherence tracked over time, and how adherence was related to body composition cross sectionally and prospectively.

Subjects/methods

Data were obtained from 547 children who were participants in a randomised controlled trial. At 1, 2, and 5 years of age, children wore Actical accelerometers 24-h a day for 5–7 days, height and weight were measured, and parents completed questionnaires on screen time and restraint (1 and 2 years only). A dual-energy x-ray absorptiometry (DXA) scan measured body composition at 5 years of age.

Results

Although adherence to general sleep and activity guidelines was high, few children had regular sleep patterns. Adherence to all three guidelines ranged from 12.3 to 41.3% at the different ages, although these estimates decreased to 0.6–9.3% when activity intensity (60 min of energetic play) and sleep regularity (consistent sleep and wake times) were included. Children who met all three guidelines at a given age were more likely to meet all three guidelines at a subsequent age (odds ratio, 95% CI: 2.6, 1.04–6.4 at 1 year and 2.5, 1.1–5.9 at 2 years). However, adherence to meeting all three guidelines at earlier ages was not related to BMI z-score or body composition at age 5, either cross sectionally or prospectively.

Conclusions

Strategies to promote adherence to movement guidelines among young children are warranted, particularly to reduce screen time, and encouraging regular sleep patterns.

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References

  1. Tremblay MS, Chaput J-P, Adamo KB, Aubert S, Barnes JD, Choquette L, et al. Canadian 24-h movement guidelines for the early years (0–4 years): an integration of physical activity, sedentary behaviour, and sleep. BMC Public Health. 2017;17:874.

    Article  Google Scholar 

  2. Berglind D, Ljung R, Tynelius P, Brooke H. Cross‐sectional and prospective associations of meeting 24‐h movement guidelines with overweight and obesity in preschool children. Pediatr Obes. 2018;13:442–9.

    Article  CAS  Google Scholar 

  3. Chaput J-P, Colley RC, Aubert S, Carson V, Janssen I, Roberts KC, et al. Proportion of preschool-aged children meeting the Canadian 24-h movement guidelines and associations with adiposity: results from the Canadian Health Measures Survey. BMC Public Health. 2017;17:829.

    Article  Google Scholar 

  4. Cliff DP, McNeill J, Vella SA, Howard SJ, Santos R, Batterham M, et al. Adherence to 24-h movement guidelines for the early years and associations with social-cognitive development among australian preschool children. BMC Public Health. 2017;17:857.

    Article  Google Scholar 

  5. Okely AD, Ghersi D, Hesketh KD, Santos R, Loughran SP, Cliff DP, et al. A collaborative approach to adopting/adapting guidelines—the Australian 24-h movement guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep. BMC Public Health. 2017;17:869.

    Article  Google Scholar 

  6. Ministry of Health. Sit less, move more, sleep well: active play guidelines for under-fives. Wellington, New Zealand: Ministry of Health; 2017.

    Google Scholar 

  7. Kuzik N, Poitras VJ, Tremblay MS, Lee E-Y, Hunter S, Carson V. Systematic review of the relationships between combinations of movement behaviours and health indicators in the early years (0–4 years). BMC Public Health. 2017;17:849.

    Article  Google Scholar 

  8. Carson V, Chaput J-P, Janssen I, Tremblay MS. Health associations with meeting new 24-h movement guidelines for Canadian children and youth. Prev Med. 2017;95:7–13.

    Article  Google Scholar 

  9. Lee E-Y, Hesketh KD, Hunter S, Kuzik N, Rhodes RE, Rinaldi CM, et al. Meeting new Canadian 24-h movement guidelines for the early years and associations with adiposity among toddlers living in Edmonton, Canada. BMC Public Health. 2017;17:840.

  10. Santos R, Zhang Z, Pereira JR, Sousa-Sá E, Cliff DP, Okely AD. Compliance with the Australian 24-h movement guidelines for the early years: associations with weight status. BMC Public Health. 2017;17:867.

    Article  Google Scholar 

  11. Acebo C, Sadeh A, Seifer R, Tzischinsky O, Wolfson AR, Hafer A, et al. Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures? Sleep. 1999;22:95–103.

    Article  CAS  Google Scholar 

  12. Cliff DP, Reilly JJ, Okely AD. Methodological considerations in using accelerometers to assess habitual physical activity in children aged 0–5 years. J Sci Med Sport. 2009;12:557–67.

    Article  Google Scholar 

  13. Reilly JJ, Penpraze V, Hislop J, Davies G, Grant S, Paton JY. Objective measurement of physical activity and sedentary behaviour: review with new data. Arch Dis Childhood. 2008;93:614–9.

    Article  CAS  Google Scholar 

  14. Moir C, Meredith-Jones K, Taylor BJ, Gray A, Heath A-L, Dale K, et al. Early intervention to encourage physical activity in infants and their families: an RCT. Med Sci Sports Exerc. 2016;48:2446–53.

    Article  Google Scholar 

  15. Taylor BJ, Gray AR, Galland BC, Heath A-LM, Lawrence J, Sayers RM, et al. Targeting Sleep, Food, and activity in infants for Obesity Prevention: an RCT. Pediatrics. 2017;139:e20162037.

    Article  Google Scholar 

  16. Taylor RW, Gray AR, Heath AM, Galland BC, Lawrence J, Sayers R, et al. Sleep, nutrition, and physical activity interventions to prevent obesity in infancy: follow-up of the Prevention of Overweight in Infancy (POI) randomized controlled trial at ages 3.5 and 5 y. Am J Clin Nutr. 2018;108:228–36.

    Article  Google Scholar 

  17. Taylor BJ, Heath A-L, Galland BC, Gray AR, Lawrence JA, Sayers RM, et al. Prevention of overweight in infancy (POI.nz) study: a randomised controlled trial of sleep, food and activity interventions for preventing overweight from birth. BMC Public Health. 2011;11:942.

    Article  Google Scholar 

  18. de Onis M, Onyango AW, Van den Broeck J, Chumlea CW, Martorell R. Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference. Food Nutr Bull. 2004;25:S27–36.

    Article  Google Scholar 

  19. World Health Organization. WHO child growth standards: length/height for age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age, methods and development. Oslo, Norway: World Health Organization; 2006.

  20. Hnatiuk J, Ridgers ND, Salmon J, Campbell K, McCallum Z, Hesketh K. Physical activity levels and patterns of 19-month-old children. Med Sci Sports Exerc. 2012;44:1715–20.

    Article  Google Scholar 

  21. Rich C, Geraci M, Griffiths L, Sera F, Dezateux C, Cortina-Borja M. Quality control methods in accelerometer data processing: defining minimum wear time. PLoS ONE. 2013;8:e67206.

    Article  CAS  Google Scholar 

  22. Galland BC, Meredith-Jones K, Gray A, Sayers R, Lawrence J, Taylor BJ, et al. Criteria for nap identification in infants and young children using 24-hour actigraphy and agreement with parental diary. Sleep Med. 2016;19:89–92.

    Article  Google Scholar 

  23. Meredith-Jones K, Williams SM, Galland BC, Kennedy G, Taylor RW. 24 h accelerometry: impact of sleep-screening methods on estimates of physical activity and sedentary time. J Sport Sci. 2016;34:679–85.

    Article  Google Scholar 

  24. Esliger DW, Copeland JL, Barnes JD, Tremblay MS. Standardizing and optimizing the use of accelerometer data for free-living physical activity monitoring. J Phys Activity Health. 2005;2:366–83.

    Article  Google Scholar 

  25. Adolph A, Puyau M, Vohra F, Nicklas T, Zakeri I, Butte NF. Validation of uniaxial and triaxial accelerometers for the assessment of physical activity in children. J Phys Act Health. 2012;9:944–53.

    Article  Google Scholar 

  26. Trost S, Fees B, Haar S, Murray A, Crowe L. Identification and validity of accelerometer cut-points for toddlers. In: International society of behavioral nutrition and physical activity (ISBNPA) 2010 Annual Conference. Minneapolis, USA: University of Minnesota School of Public Health 2010.

  27. Poitras VJ, Gray CE, Borghese MM, Carson V, Chaput J-P, Janssen I, 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:S197–239.

    Article  Google Scholar 

  28. Migueles JH, Cadenas-Sanchez C, Ekelund U, Nystrom CD, Mora-Gonzalez J, Lof M, et al. Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. Sports Med. 2017;47:1821–45.

    Article  Google Scholar 

  29. Chaput J-P, Gray CE, Poitras VJ, Carson V, Gruber R, Birken CS, 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. https://doi.org/10.1186/s12889-017-4850-2.

  30. Taylor RW, Williams SM, Farmer VL, Taylor BJ. The stability of sleep patterns in children 3–7 years of age. J Pediatr. 2015;166:697–702.

    Article  Google Scholar 

  31. Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev. 2011;16:213–22.

    Article  Google Scholar 

  32. Fatima Y, Doi SA, Manum AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16:137–49.

    Article  CAS  Google Scholar 

  33. Fatima Y, Doi SA, Mamum AA. Sleep quality and obesity in young subjects: a meta-analysis. Obes Rev. 2016;17:1154–66.

    Article  CAS  Google Scholar 

  34. Iwata S, Iwata O, Iemura A, Iwasaki M, Matsuishi T. Determinants of sleep patterns in healthy Japanese 5-year-old children. Int J Dev Neurosci. 2011;29:57–62.

    Article  Google Scholar 

  35. Fan HE, Bixler EO, Berg A, Kawasawa YI, Vgontzas AN, Fernandez-Mendoza J, et al. Habitual sleep variability, not sleep duration, is associated with caloric intake in adolescents. Sleep Med. 2015;16:856–61.

    Article  Google Scholar 

  36. Meredith-Jones K, Haszard J, Moir C, Heath A-L, Lawrence J, Galland B, et al. Physical activity and inactivity trajectories associated with body composition in pre-schoolers. Int J Obes. 2018.

  37. Touchette É, Petit D, Tremblay RE, Boivin M, Falissard B, Genolini C, et al. Associations between sleep duration patterns and overweight/obesity at age 6. Sleep. 2008;31:1507–14.

    Article  Google Scholar 

  38. Biddle SJ, Pearson N, Ross GM, Braithwaite R. Tracking of sedentary behaviours of young people: a systematic review. Prev Med. 2010;51:345–51.

    Article  Google Scholar 

  39. Jones RA, Hinkley T, Okely AD, Salmon J. Tracking physical activity and sedentary behavior in childhood: a systematic review. Am J Prev Med. 2013;44:651–8.

    Article  Google Scholar 

  40. Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput J-P, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab. 2016;41:S240–65.

    Article  Google Scholar 

  41. Chaput J-P, Gray CE, Poitras VJ, Carson V, Gruber R, Olds T, et al. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41:S266–82.

    Article  Google Scholar 

  42. Saunders TJ, Gray CE, Poitras VJ, Chaput J-P, Janssen I, Katzmarzyk PT, 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:S283–93.

    Article  Google Scholar 

  43. Williams HG, Pfeiffer KA, O’Neill JR, Dowda M, McIver KL, Brown WH, et al. Motor skill performance and physical activity in preschool children. Obesity. 2008;16:1421–6.

    Article  Google Scholar 

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Acknowledgements

We thank the POI research staff in the Departments of Women’s and Children’s Health, and Medicine at the University of Otago.

Funding

Funding

The POI Study was funded by the Health Research Council of New Zealand and the Southern District Health Board. RT is supported by a Fellowship from Karitane Products Society. The funding source had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Medicine, Dunedin, New Zealand

    Kim Meredith-Jones, Jillian Haszard & Rachael Taylor

  2. Department of Women’s and Children’s Health, Dunedin, New Zealand

    Barbara Galland, Rachel Sayers & Maha Hanna

  3. Centre for Biostatistics, Dunedin, New Zealand

    Andrew Gray

  4. Dunedin School of Medicine Dean’s Office, University of Otago, Dunedin, New Zealand

    Barry Taylor

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  1. Kim Meredith-Jones
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Correspondence to Kim Meredith-Jones.

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Meredith-Jones, K., Galland, B., Haszard, J. et al. Do young children consistently meet 24-h sleep and activity guidelines? A longitudinal analysis using actigraphy. Int J Obes 43, 2555–2564 (2019). https://doi.org/10.1038/s41366-019-0432-y

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