Related Experiment Video
Updated: Jun 7, 2025
Physical Activity Measurement in Children Accepting Table Tennis Training
Published on: July 27, 2022
Longitudinal changes in preschoolers' adiposity indicators according to compliance with 24-hour movement behavior
Marieke De Craemer1, Greet Cardon2, Marga Decraene3
1Ghent University, Department of Rehabilitation Sciences, Corneel Heymanslaan 10, Ghent, Belgium. Marieke.DeCraemer@UGent.be.
Insights
Adhering to 24-hour movement guidelines in preschoolers is linked to better Body Mass Index (BMI) z-score changes. Non-compliance showed a small increase in BMI z-scores, highlighting the importance of these guidelines for childhood adiposity.
Area of Science:
- Pediatric Health
- Public Health
- Child Development
Background:
- Limited research exists on longitudinal changes in childhood adiposity and adherence to 24-hour movement behavior guidelines.
- Preschoolers' adiposity indicators and their association with physical activity, screen time, and sleep require further investigation.
Purpose of the Study:
- To examine associations between changes in Body Mass Index (BMI) z-scores, waist circumference, and waist-to-height ratio.
- To investigate the relationship between these adiposity indicators and compliance with 24-hour movement behavior guidelines in preschoolers.
Main Methods:
- Longitudinal study of 719 European preschoolers (aged 3-6) over one year.
- Objective measurement of physical activity (pedometers); subjective measurement of screen time and sleep (parental questionnaire).
- Standardized measurements of height, weight, and waist circumference to calculate BMI z-scores and waist-to-height ratio; linear mixed-effects models used for analysis.
Main Results:
- A significant difference in BMI z-score changes was observed based on guideline compliance on weekdays (effect estimate = -0.15, p=0.001) and weekend days (effect estimate = -0.12, p=0.046).
- Preschoolers not adhering to guidelines showed a small, significant increase in BMI z-scores compared to those who complied.
- No significant differences in changes for waist circumference or waist-to-height ratio were found between compliant and non-compliant groups.
Conclusions:
- One-year changes in BMI z-scores were less optimal for preschoolers not complying with 24-hour movement behavior guidelines.
- While not clinically relevant, these findings suggest that adherence to integrated guidelines may positively influence BMI z-score trajectory in early childhood.
- Longer follow-up studies are recommended to fully understand the long-term impact of guideline compliance on adiposity indicators in preschoolers.
Background:
There is a lack of studies evaluating longitudinal changes in adiposity indicators and the association with 24-hour movement behavior guidelines in preschoolers. Therefore, this study aimed to investigate associations between changes in Body Mass Index (BMI) z-scores, waist circumference and waist-to-height ratio, and compliance with the 24-hour movement behavior guidelines in three- to six-year-old children from a European sample.
Methods:
In total, data from a European sample of 719 preschoolers (50.9% boys, 4.76 ± 0.45 years) were analyzed at baseline and one year later. Physical activity (steps/day) was objectively measured using Omron pedometers. Screen time and sleep duration were subjectively measured using a parental questionnaire. Height, weight and waist circumference were measured by well-trained researchers, using standardized procedures and equipment, and were used to calculate BMI z-score and waist-to-height ratio. Linear mixed-effects models were used to investigate associations between changes in adiposity indicators (BMI z-score, waist circumference and waist-to-height ratio) and compliance with 24-hour movement behavior guidelines.
Results:
BMI z-scores changed differently from baseline to follow-up according to compliance with the integrated guidelines, both for weekdays (effect estimate = -0.15, p = 0.001) and weekend days (effect estimate = -0.12, p = 0.046). Preschoolers who did not comply with the integrated guidelines showed a small, significant increase in BMI z-scores compared to compliers having no significant change in BMI z-score. No significant difference between both groups over time was found for waist circumference and waist-to-height ratio neither for weekdays nor weekend days.
Conclusions:
The change in BMI z-scores after one year is less optimal for preschoolers who do not comply with the 24-hour movement behavior guidelines compared to preschoolers who comply with the integrated guidelines, although not clinically relevant. Future studies should incorporate longer follow-up periods to observe the effects of compliance to the integrated guidelines on adiposity indicators in preschool children.
