Adherence to 24-hour movement guidelines in children with mental,behavioral,and developmental disorders:Data from the 2016-2020 National Survey of Children's Health

Background:Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens.However,the lifestyles of children with mental,behavioral,and developmental disorders(MBDDs)remains under-described within the literature of public health field.This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.Methods:Data were from the 2016-2020 National Survey of Children’s Health—A national,population-based,cross-sectional study.We used the data of 119,406 children aged 6-17 years,which included 38,571 participants with at least 1 MBDD and 80,835 without.Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity,screen time,and sleep duration.Results:Among children with MBDDs,20.3%,37.0%,60.7%,and 77.3%met the physical activity,screen time,sleep,and at least 1 of the 24-hour movement guidelines.These rates were lower than those in children without MBDDs(22.8%,46.2%,66.7%,and 83.4%,respectively;all p<0.001).Children with MBDDs were less likely to meet these guidelines(odds ratio(OR)=1.21,95%confidence interval(95%CI):1.13-1.30;OR=1.37,95%CI:1.29-1.45;OR=1.29,95%CI:1.21-1.37;OR=1.45,95%CI:1.35-1.56)than children without MBDDs.Children with emotional disorders had the highest odds of not meeting these guidelines(OR=1.43,95%CI:1.29-1.57;OR=1.48,95%CI:1.37-1.60;OR=1.49,95%CI:1.39-1.61;OR=1.72,95%CI:1.57-1.88)in comparison to children with other MBDDs.Among children aged12-17 years,the difference in proportion of meeting physical activity and screen time guidelines for children with vs.children without MBDD was larger than that among children aged 6-11 years.Furthermore,the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.Conclusion:Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs.In educational and clinical settings,the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs;and specifically for white children who have MBDDs,increasing physical activity may help.

Pre-conceptional and prenatal exposure to secondhand smoke and autism spectrum disorder:a national multi-center study in China

Background Despite extensive research evaluating the association between prenatal exposure to secondhand smoke(SHS)and the development of autism spectrum disorders(ASD),no study has investigated the association by considering the pre-conceptional period.This study aimed to investigate the associations of pre-conceptional and prenatal SHS exposure and the development of ASD among toddlers.Methods In this cross-sectional study,parents of 6049 toddlers aged 16–30 months were recruited from 7 tertiary hospitals,21 communities,and 7 kindergartens located in seven cities in six provinces from five geographical regions of China.We analyzed the associations of SHS exposure and the odds of ASD among toddlers in different exposure windows(pre-conceptional and/or prenatal periods).Data were analyzed from November 2021 to January 2022.Results Among the 6049 toddlers included in the analysis[22.7(4.1)months;44.8%girls],71 were identified and diagnosed with ASD.Compared with the unexposed toddlers,toddlers with pre-conceptional SHS exposure had higher odds of ASD(OR 2.30,95%CI 1.36–3.84),while we observed a non-significantly positive association regarding prenatal SHS exposure.When considering both pre-conceptional and prenatal periods,toddlers who were continuously exposed to SHS during these two periods had higher odds than those without SHS exposure(OR 2.32,95%CI 1.24–4.14).Conclusion We reported positive SHS–ASD associations when exposed during the pre-conceptional period and continuously exposed during pre-conceptional and prenatal periods,emphasizing the critical window of pre-conception for targeted intervention on smoking.

Association between maternal gestational diabetes and allergic diseases in offspring:a birth cohort study

Background Previous studies have linked gestational diabetes(GDM)with allergies in offspring.However,the effect of specific glucose metabolism metrics was not well characterized,and the role of polyunsaturated fatty acids(PUFAs),a modifier of metabolism and the immune system,was understudied.We aimed to investigate the association between maternal GDM and allergic diseases in children and the interaction between glucose metabolism and PUFAs on allergic outcomes.Methods This prospective cohort study included 706 mother–child dyads from Guangzhou,China.Maternal GDM was diagnosed via a 75-g oral glucose tolerance test(OGTT),and dietary PUFAs were assessed using a validated food frequency questionnaire.Allergic disease diagnoses and the age of onset were obtained from medical records of children within three years old.Results Approximately 19.4%of women had GDM,and 51.3%of children had any allergic diseases.GDM was positively associated with any allergic diseases(hazard ratio[HR]1.40;95%confidence interval(CI)1.05–1.88)and eczema(HR 1.44;95%CI 1.02–1.97).A unit increase in OGTT after two hours(OGTT-2 h)glucose was associated with an 11%(95%CI 2%–21%)higher risk of any allergic diseases and a 17%(95%CI 1–36%)higher risk of food allergy.The positive associations between OGTT-2 h glucose and any allergic diseases were strengthened with decreased dietary a-linolenic acid(ALA)and increased n-6 PUFAs,linoleic acid(LA),LA/ALA ratio,and n-6/n-3 PUFA ratio.Conclusions Maternal GDM was adversely associated with early-life allergic diseases,especially eczema.We were the first to identify OGTT-2 h glucose to be more sensitive in inducing allergy risk and that dietary PUFAs might modify the associations.

Brain structure underlying the empathizing–systemizing difference in children with autism spectrum disorder

Background Behavioral research has shown that children with autism spectrum disorder(ASD)have a higher empathizing–systemizing difference(D score)than normal children.However,there is no research about the neuroanatomical mechanisms of the empathizing–systemizing difference in children with ASD.Methods Participants comprised 41 children with ASD and 39 typically developing(TD)children aged 6‒12 years.Empathizing–systemizing difference was estimated using the D score from the Chinese version of Children’s Empathy Quotient and Systemizing Quotient.We quantified brain morphometry,including global and regional brain volumes and surface-based cortical measures(cortical thickness,surface area,and gyrification)via structural magnetic resonance imaging.Results We found that the D score was significantly negatively associated with amygdala gray matter volume[β=−0.16;95%confidence interval(CI):−0.30,−0.02;P value=0.030]in children with ASD.There was a significantly negative association between D score and gyrification in the left lateral occipital cortex(LOC)in children with ASD(B=−0.10;SE=0.03;cluster-wise P value=0.006)and a significantly positive association between D score and gyrification in the right fusiform in TD children(B=0.10;SE=0.03;cluster-wise P value=0.022).Moderation analyses demonstrated significant interactions between D score and diagnosed group in amygdala gray matter volume(β=0.19;95%CI 0.04,0.35;P value=0.013)and left LOC gyrification(β=0.11;95%CI 0.05,0.17;P value=0.001)but not in right fusiform gyrification(β=0.08;95%CI−0.02,0.17;P value=0.105).Conclusions Neuroanatomical variation in amygdala volume and gyrification of LOC could be potential biomarkers for the empathizing–systemizing difference in children with ASD but not in TD children.Large-scale neuroimaging studies are necessary to test the replicability of our findings.