Relationship Between 24-hour Movement And Obesity Progression Among Pupils In Shanghai

Objective:With the development of social economy,the change of diet structure and lifestyle,the obesity of children and adolescents has become a global public health problem that needs to be solved urgently.Effective prevention and control of obesity in children and adolescents has become a top priority.Existing studies have shown that insufficient physical activity(PA),excessive screen time(ST)and insufficient sleep duration(SLP)are associated with obesity in children.In 2016,Canada released24-hourmovement guidelines for children and youth,which provides clear recommendations on PA,ST and SLP for school-age children.There were many cross-sectional studies at home and abroad to explore the influence of the satisfaction of 24-hour movement guidelines on childhood obesity,but the results of cross-sectional studies can only show the correlation between 24-hour activity and the degree of childhood obesity at a certain time point,and the vertical relationship with the progress of obesity is still unclear.Therefore,the objectives of this study were:to understand the basic situation of 24-hour activity and obesity among 3rd grade elementary school students in Shanghai;to analyze the longitudinal relationship between children’s 24-hour movement guidelines satisfaction and obesity progression in two consecutive years,with a view to providing new ideas for long-term promotion of obesity interventions for school-aged children in China from the perspective of24-hour activity.Methods:In this study,the testing and investigation work was carried out from March to June,2019.Four districts of Shanghai(Yangpu District,Huangpu District,Hongkou District and Songjiang District)were selected by stratified cluster random sampling.One primary school was randomly selected in each district,and four classes of Grade 3 were randomly selected in each primary school.A total of 430 students participated in this study.Student height,weight,and waist circumference were measured during the two-year follow-up period,which ended in June 2021.The PA of students was measured by accelerometer,height and weight were measured by height and weight meter,waist circumference was measured by soft ruler,and basic demographic information and screen time were obtained by questionnaire.Finally,the data were statistically analyzed by SPSS26.0 software:descriptive analysis was used to investigate the basic situation of the research object;chi-square test was used to analyze the difference of demographic variables to 24-hour movement behavior and obesity;paired sample t-test was used to compare the progress of obesity for two consecutive years;hierarchical linear regression model was used to test the relationship between 24-hour activity and the progression of obesity in primary school students.Results:The data of 318 students are valid,age distribution from 8 to 11 years.(1)In the basic 24-hour activity behavior,the average daily moderate-to-vigorous physical activity(MVPA)time of the study subjects at baseline was 39.92±22.46 minutes,the average daily ST was 76.43±96.56 minutes,and the daily SLP was 8.84±1.28 hours.The highest rate of ST compliance was 79.9%and the lowest rate of MVPA compliance was 42.5%,with 22.6%of all three guidelines being met.MVPA compliance has significant differences in family economic level.The lower the family economic level,the higher the MVPA compliance rate(P<0.05).There are significant differences in gender between ST and"ST+SLP"combination,and the success rate of girls is higher than that of boys(P<0.05).(2)Obesity of subjects showed that the average BMI of subjects was 17.88±3.39 kg/m~2and the average WHt R was 0.45±0.05 at baseline.There are 95 students with general obesity,of which the number of male students is significantly higher than that of female students(X~2=19.38,P<0.001).There are 85 people with central obesity,the gender difference is not statistically significant(P>0.05).The 2-year follow-up data showed that the rate of systemic and central obesity of third-grade students increased with age,and the rate of systemic obesity was significantly higher than that of central obesity(t=18.943,P<0.05).(3)Regression analysis showed that independent attainment of MVPA was effective in controlling the progression of systemic(B=-1.926,P=0.001)and central obesity(B=-0.014,P=0.043)in children,while ST and SLP attainment were not significantly associated with obesity(P>0.05).The combination of"MVPA+ST"attainment(B=-2.582,P=0.000)and"ST+SLP"attainment(B=-2.310,P=0.011)were negatively associated with the progression of generalized obesity,while The combination of"MVPA+SLP"(B=-0.016,P=0.032)was negatively associated with the progression of central obesity.Conclusion:The main results are as follows:(1)The 24-hour movement guidelines for third-grade students in Shanghai reached the highest ST standard rate,and the MVPA standard rate was the lowest.The lower the family economic level,the higher the MVPA compliance rate;the success rate of girls is higher ST than that of boys.(2)the obesity situation of third-grade students in Shanghai is more serious,and the obesity rate of boys is significantly higher than that of girls.The obesity rate has increased for two consecutive years,and the growth rate of systemic obesity is significantly higher than that of central obesity.(3)MVPA was an independent factor in the progression of obesity in pupils in Shanghai,and achieving different behavioral combinations of 24h activity slowed the progression of obesity in children.In the future,the epidemic of overweight obesity should be prevented and controlled through a combination of interventions that increase the amount of time children spend physically active and the corresponding behavioral mix.