Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.

大学生24 h活动行为和心肺适能关系的成分数据分析

目的:运用成分数据分析探究大学生24 h活动行为与心肺适能(cardiorespiratory fitness,CRF)的关系,以及各活动行为间等时替代后CRF的预测变化。方法:数据来源于“上海体育大学校友健康队列研究”。共纳入1039名大学生[男生517人,女生522人,平均年龄(21.46±0.9)岁]作为研究对象。使用ActiGraph GT3X+三轴加速度计测量久坐行为(sedentary behavior,SB)、轻体力活动(light physical activity,LPA)和中高强度体力活动(moderate-to-vigorous physical activity,MVPA)及自主报告的方式采集睡眠数据。通过功率自行车进行有氧代谢测试以评估CRF,利用双能X射线吸收仪评估受试者的身体成分。采用成分数据分析探究24 h活动行为与CRF的关系,并以成分等时替代模型探究各项活动行为时间相互替代后,CRF的预测变化情况。结果:1)调整混杂因素后,结果表明24 h活动行为与CRF有显著关联。相对其他活动行为,MVPA和CRF成正相关,SB与CRF成负相关,未发现睡眠和LPA与CRF的关联。2)亚组分析显示调整混杂因素后发现,高体脂率组和非体育生组与上述结果一致;低体脂率组和体育生组未发现各分量与CRF相关。3)在等时替代结果中,MVPA等时替代其他活动行为,CRF增加的幅度要远小于其他活动行为等时替代MVPA时CRF下降时的幅度。结论:MVPA和SB行为是影响大学生CRF的主要因素,相对于简单地控制SB行为,更应鼓励将更多SB行为转成MVPA行为,尤其是高体脂率的学生。

Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

基于成分数据分析的青少年24 h活动行为与体质关联的研究

目的:基于成分数据分析方法,解决24 h活动行为“定和限制”所带来的共线性问题,探究青少年不同强度身体活动、静坐行为与睡眠对体质指标的综合影响。方法:以241名初中生为研究对象,采用ActiGraph GT3X+加速度计测量日常活动行为,并进行体质测试。通过成分数据分析方法,综合分析24 h活动行为与体质的关联,并采用成分等时替代模型,进行行为之间的10 min等时替代分析,以将不同行为对体质的影响效应定量化。结果:中高强度身体活动(moderate-to-vigorous physical activity,MVPA)与体质总分、50 m跑表现、长跑表现和跳远成绩呈正相关;低强度身体活动(light physical activity,LPA)则与这些指标呈负相关,但其与肺活量呈正相关。静坐行为(sedentary behaviour,SB)与多数体质指标呈负相关,睡眠时间与体质总分、坐位体前屈、跳远、仰卧起坐和长跑表现呈正相关。成分等时替代分析显示:10 min SB或LPA替代同等时间的MVPA产生的不利效应均远大于10 min MVPA替代相应行为所产生的有益效应(体质总分:SB,-0.92分vs 0.73分;LPA,-1.1分vs 0.91分)。结论:MVPA是学生群体体质发展的主要影响成分,而睡眠可能是体质健康干预的另一重要方向。相比单纯性地减少SB时间,保持MVPA水平更具意义。