PURPOSE Integrated 24-Hour Movement Guidelines provide specific recommendations on screen viewing (SV), moderate-to-vigorous physical activity (MVPA) and sleep to improve health of children and youth. However, few studies have examined whether these guidelines are met in young children, particularly in Asia. We evaluated adherence to integrated and individual guidelines and its predictors in 5.5-year-old Singaporean children. METHODS Growing Up in Singapore towards Healthy Outcomes (GUSTO) is a mother-offspring birth cohort study. At age 5.5 years, child SV was reported by parents. Movement behaviours (MBs) were measured continuously using wrist-worn accelerometers over 7 consecutive days and nights. For accelerometer data including ≥3 days with ≥16 h/day we estimated mean (±SD) daily MVPA, SV and nighttime sleep duration across the week. Adherence to integrated (Canadian/Australian) guidelines was defined as meeting all individual guidelines: ≥60 min of MVPA/day, ≤2 h of screen time/day, and 9-11 h of sleep/night. Socio-demographic and maternal predictors collected at pregnancy enrolment and at 26-28 weeks' gestation were examined by multivariable logistic regression. RESULTS Of 864 children followed up age 5.5 years, 547 (63.3%) had both valid ActiGraph and questionnaire data (51.7% boys and 58.3% Chinese ethnicity). Children averaged 101.9 (± 88.7) min/day SV, 67.3 (± 23.7) min/day MVPA and 480.6 (± 57.2) min/night sleep. Few children met integrated guidelines. Specifically, the proportions of children who met none, SV, MVPA, sleep and integrated guidelines were 11.2, 70.2, 59.6, 13.7 and 5.5%, respectively. Multivariable analysis showed that maternal activity and television (TV) viewing were associated with meeting integrated guidelines (insufficiently vs. highly active (OR [95% CI]): 0.11 [0.01, 0.95]; 2-3 vs. ≥ 3 h TV: 3.52 [1.02, 12.22]). Examining higher adherence to individual guidelines, Chinese ethnicity, younger maternal age and lower maternal TV and sleep time were associated with greater SV; male sex, Malay ethnicity, higher birth order and higher maternal activity level were associated with greater MVPA; and older maternal age was associated with adherence to sleep guideline. CONCLUSIONS Beyond individual behaviours, consideration of the full spectrum of MBs may be important to improve children's health. However, few Singaporean children adhere to integrated 24-h movement guidelines. Maternal behaviours as early as during pregnancy could be important targets for future interventions aiming to promote these MBs in children.

中文翻译：

---

新加坡儿童遵守 24 小时运动指南的社会人口和母亲预测因素。

目的综合 24 小时运动指南提供有关屏幕观看 (SV)、中度至剧烈体力活动 (MVPA) 和睡眠的具体建议，以改善儿童和青少年的健康。然而，很少有研究检验幼儿是否符合这些准则，特别是在亚洲。我们评估了 5.5 岁新加坡儿童对综合和个人指南的遵守情况及其预测因素。方法“在新加坡成长走向健康”（GUSTO）是一项母子出生队列研究。5.5岁时，父母报告了儿童SV。使用腕戴式加速度计连续 7 个昼夜连续测量运动行为 (MB)。对于包括 ≥3 天、≥16 小时/天的加速度计数据，我们估计了一周内的平均 (±SD) 每日 MVPA、SV 和夜间睡眠持续时间。遵守综合（加拿大/澳大利亚）指南的定义是满足所有个人指南：每天 ≥60 分钟的 MVPA、每天 ≤ 2 小时的屏幕时间以及每晚 9-11 小时的睡眠。通过多变量逻辑回归分析在怀孕登记和妊娠 26-28 周时收集的社会人口统计学和母亲预测因素。结果 864 名 5.5 岁儿童中，547 名（63.3%）拥有有效的 ActiGraph 和问卷数据（51.7% 为男孩，58.3% 为华裔）。儿童平均 SV 为 101.9 (± 88.7) 分钟/天，MVPA 为 67.3 (± 23.7) 分钟/天，夜间睡眠时间为 480.6 (± 57.2) 分钟/天。很少有孩子符合综合指导方针。具体来说，不满足SV、MVPA、睡眠和综合指南的儿童比例分别为11.2%、70.2%、59.6%、13.7%和5.5%。多变量分析显示，母亲活动和看电视 (TV) 与满足综合指南相关（活动不足与高度活动 (OR [95% CI])：0.11 [0.01, 0.95]；2-3 与 ≥ 3 小时看电视： 3.52 [1.02，12.22]）。检查对个人指南的较高依从性、华裔、较年轻的产妇年龄以及较低的产妇电视和睡眠时间与较大的 SV 相关；男性、马来族、较高的出生顺序和较高的产妇活动水平与较高的 MVPA 相关；产妇年龄较大与遵守睡眠指南有关。结论 除了个人行为之外，考虑所有MBs对于改善儿童健康可能也很重要。然而，很少有新加坡儿童遵守 24 小时综合运动准则。早在怀孕期间的母亲行为可能是未来旨在促进儿童中这些MB的干预措施的重要目标。