Body Mass Index, Physical Activity, Sedentary Behavior, Sleep, and Gross Motor Skill Proficiency in Preschool Children From a Low- to Middle-Income Urban Setting

Abstract

Background: Limited research reports on the relationship between body mass index (BMI) and physical activity (PA), sedentary behavior (SB), sleep, and gross motor skills (GMS) in low- and middle-income countries. The aim of this study was to (1) describe BMI, PA, SB, sleep duration, and GMS proficiency in South African preschool children and (2) identify relationships between variables. Methods: BMI, including z scores for height, weight, and BMI were determined. Seven-day PA, SB, and sleep were measured using accelerometry. GMS were assessed using the Test of Gross Motor Development (second edition). Associations were explored by comparing sleep, PA, SB, and GMS between BMI tertiles using the Kruskal–Wallis test. Results: Most (86%) children (n = 78, 50% boys) had a healthy BMI (15.7 [1.3] kg/m2). Children spent 560.5 (52.9) minutes per day in light- to vigorous-intensity PA and 90.9 (30.0) minutes per day in moderate- to vigorous-intensity PA; most (83%) met the current PA guideline. Nocturnal sleep duration was low (9.28 [0.80] h/d). Although daytime naps increased 24-hour sleep duration (10.17 [0.71] h/d), 38% were classified as short sleepers. Around half (54.9%) of participants complied with both PA and sleep guidelines. No associations between variables were found. Conclusion: Despite being lean, sufficiently active, and having adequate GMS, many children were short sleepers, highlighting a possible area for intervention.

Association between Compliance with the 24-Hour Movement Guidelines and Fundamental Movement Skills in Preschoolers: A Network Perspective

“…Although prior studies have examined the association between daily movement behavior and FMS in preschoolers [ 14 , 32 , 33 ], the current study offers unique insight into these relationships, considering the compliance with the 2-h movement behaviors, using network analysis.…”

The South African 24-Hour Movement Guidelines for Birth to 5 Years: An Integration of Physical Activity, Sitting Behavior, Screen Time, and Sleep

“…This study found that 54.9% of participants complied with available physical activity and sleep guidelines (from Canada and Australia), but found no associations found between sleep and adiposity variables. 17 One might speculate that this was due to the limited variation in adiposity measures in this group. In the study of preschool-aged children across settings, sleep was assessed using objective measures, and these findings were presented to the panel (paper in preparation).…”

“…Similar findings have been reported with preschool-aged children from another low-income, urban setting: 560.5±52.9min/day of total physical activity and 90.9±30.0min/day of MVPA (objectively measured), with 83% of children meeting current guidelines. 17 Using direct observation at preschools, low-income urban children spent 11% of their time in MVPA, which was more than the 8% observed in mid-/high-income children. 18 Various studies have looked at associations between physical activity and measures of adiposity, and gross motor skills.…”

“The thing is, kids don’t grow the same”: Parent perspectives on preschoolers’ weight and size in Soweto, South Africa

“…Obesity in early childhood is concerning because it is associated with health and psychosocial problems both in childhood and later in life, and it is likely to track into adolescence and adulthood [6][7][8][9][10][11]. Children living in urban low-income settings in South Africa have been identified as being particularly at risk when it comes to childhood obesity [12][13][14].…”