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Adherence to Screen Time and Physical Activity Guidelines is Associated with Executive Function in US Toddlers
Arden L McMath1, Samantha Iwinski2, Sa Shen3
1Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Champaign, IL.
Insights
Adhering to American Academy of Pediatrics (AAP) guidelines for physical activity and limiting screen time in toddlers is linked to better executive function (EF). Healthy weight status did not impact EF in this study.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Public Health
Background:
- Executive function (EF) is crucial for cognitive and behavioral development in toddlers.
- The American Academy of Pediatrics (AAP) provides guidelines for diet, physical activity, and screen time to promote healthy child development.
- Understanding the relationship between adherence to AAP guidelines and EF is important for early childhood interventions.
Purpose of the Study:
- To investigate if healthy weight status and adherence to AAP guidelines for diet and physical activity are associated with greater executive function (EF) at 24 months of age.
- To examine the specific impact of meeting AAP guidelines for diet, physical activity, and screen time on various aspects of EF.
Main Methods:
- The study analyzed data from 352 toddlers in the STRONG Kids 2 cohort at 24 months of age.
- Parent-reported data on diet, physical activity, and screen time were collected, alongside the Behavioral Rating Inventory of Executive Function for Preschoolers (BRIEF-P) to assess EF.
- Statistical analyses examined the relationship between meeting AAP guidelines (including fruit/vegetable intake, physical activity, sugar-sweetened beverage avoidance, and screen time limits) and EF, controlling for demographic and pre-pregnancy factors.
Main Results:
- No significant effect of weight-for-length z-score on EF was found.
- Toddlers meeting AAP screen time guidelines (<60 minutes/day) demonstrated greater EF, including inhibitory self-control and emergent metacognition.
- Increased screen time was associated with poorer overall EF, inhibitory self-control, cognitive flexibility, and emergent metacognition.
- Daily physical activity was linked to enhanced emergent metacognition.
Conclusions:
- Adherence to AAP guidelines for physical activity and screen time is associated with improved executive function in toddlers.
- These findings suggest that promoting physical activity and limiting screen time may support cognitive development in early childhood.
- Further research with randomized controlled trials and diverse populations is recommended to confirm these associations.
Objective:
To test the hypothesis that healthy weight status and adherence to American Academy of Pediatrics (AAP) guidelines for diet and physical activity would extend to greater executive function (EF) at age 24 months.
Study Design:
Parents of 24-month-old children from the STRONG Kids 2 cohort study (n = 352) completed the Behavioral Rating Inventory of Executive Function for Preschoolers (BRIEF-P) and reported physical activities, diet, and screen time. Toddlers met AAP guidelines if they consumed at least 5 servings of fruits and vegetables, were physically active, refrained from sugar-sweetened beverages, and limited daily screen time to <60 minutes. Relationships between EF, 24-month weight status, and meeting AAP guidelines were tested independent of child sex, ethnicity, socioeconomic status, weight status at birth, and maternal pregnancy weight status.
Results:
Weight-for-length z-score had no effect on EF. Toddlers meeting the screen time guideline had greater EF (β, -0.125; 95% CI, 0.234 to -0.008), inhibitory self-control (β, -0.142; 95% CI, -0.248 to -0.029), and emergent metacognition (β, -0.111; 95% CI, -0.221 to 0.002), indicated by lower BRIEF-P scores. Those with more minutes of screen time had poorer overall EF (β, 0.257; 95% CI, 0.118-0.384), inhibitory self-control (β, 0.231; 95% CI, 0.099-0.354), cognitive flexibility (β, 0.217; 95% CI, 0.082-0.342), and emergent metacognition (β, 0.257; 95% CI, 0.120-0.381). Daily physical activity was associated with greater emergent metacognition (β, -0.116; 95% CI, -0.225 to -0.005).
Conclusions:
Meeting AAP guidelines for physical activity and screen time was related to greater EF in a demographically homogenous sample of toddlers. Future randomized control trials and more diverse samples are needed to confirm the directionality of this relationship.
Clinical Trial Registration:
ClinicalTrials.gov, NCT03341858.
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