Follow-up analysis on the relationship between 24-hour movement behaviors and physical fitness in preschool children
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摘要:
目的 探讨学龄前儿童24 h活动行为和体质健康之间的横向和纵向联系，并采用等时替代分析法评估不同活动行为时间重新分配后对体质健康得分的影响，为促进学龄前儿童健康提供科学依据。 方法 2023年10—12月，采用分层整群随机抽样方法从上海市静安、宝山和嘉定3个区共抽取193名3~6岁儿童，使用加速度计监测其一周的活动行为，并通过《国民体质测定标准(2023年修订)》(幼儿部分)测试学龄前儿童的体质健康状况；2024年10—12月，使用相同测试方法追踪调查学龄前儿童体质健康状况。组间比较采用t检验，采用成分多元线性回归模型分析学龄前儿童24 h活动行为与体质健康的关系。 结果 基线阶段男童中高强度身体活动(MVPA)时间[(84.10±25.78)min/d]高于女童[(70.44±25.98)min/d]，男童体质健康综合得分(71.65±8.69)高于女童(68.84±9.89)，差异均有统计学意义(t值分别为3.65，2.10，P值均 < 0.01)。在调整性别、年龄、体质量指数后，成分多元线性回归分析结果显示，学龄前儿童MVPA时间占比与基线的体质健康综合得分呈正相关(β=6.61)、与1年后的双脚连续跳时间呈负相关(β=-1.12)，低强度身体活动(LPA)时间占比与1年后的走平衡木时间呈负相关(β=-4.44)，久坐行为(SB)时间占比与基线的体质健康综合得分呈负相关(β=-6.55)(P值均 < 0.05)。等时替代分析显示，以10 min MVPA替代睡眠(SP)、SB和LPA，基线体质健康综合得分分别提高0.750，0.689和0.575个单位，1年后分别提高1.440，1.419和1.430个单位；以10 min SP、SB和LPA替代MVPA，基线体质健康综合得分分别降低0.836，0.777和0.669个单位，1年后分别降低1.613，1.592和1.598个单位(P值均 < 0.05)。 结论 学龄前儿童的24 h活动行为，尤其是MVPA与体质健康密切相关。适当采取措施增加学龄前儿童身体活动时间、减少久坐时间，可以改善学龄前儿童的体质健康。 Abstract:Objective To explore the cross-sectional and longitudinal associations between 24-hour movement behaviors and physical fitness in preschool children, and to adopt the method of equal time substitution analysis to evaluate the impact of time redistribution of different activity behaviors on physical fitness scores, so as to provide a scientific basis for promoting the health of preschool children. Methods A total of 193 preschool children aged 3-6 years were selected from three Shanghai districts (Jing'an, Baoshan, Jiading) from October to December 2023 by the stratified cluster random sampling method. The 24-hour movement behaviors were monitored via 7-day accelerometry, and physical fitness was measured according to the National Physical Fitness Measurement Standards (Revised 2023, preschool section). From October to December 2024, the follow-up of physical fitness among preschool children used the same testing method. The comparison between groups was conducted by t-test. Compositional regression analyses evaluated the relationship of 24-hour movement behaviors and physical fitness among preschool children. Results At baseline, moderate-to-vigorous physical activity (MVPA) time was significantly higher in boys [(84.10±25.78)min/d] than in girls [(70.44±25.98)min/d]; the composite physical fitness score was significantly higher in boys (71.65±8.69) than in girls (68.84±9.89), and the differences were statistically significant (t=3.65, 2.10, both P < 0.01). After adjusting for gender, age and body mass index, the results of component multiple linear regression analysis showed that MVPA time proportion was positively correlated with the composite physical fitness score at baseline among preschool children (β=6.61), but was negatively correlated with two-legged continuous hopping time at 1 year (β=-1.12) (both P < 0.05). Light physical activity (LPA) time proportion was negatively correlated with walking on the balance beam time at 1 year (β=-4.44), and sedentary behavior (SB) time proportion was negatively correlated with the composite score of physical fitness at baseline (β=-6.55) (both P < 0.05). Isotemporal substitution analysis revealed that replacing 10 minutes of sleep (SP), SB, and LPA with MVPA increased the baseline physical fitness composite score by 0.750, 0.689 and 0.575 units, respectively; at 1-year follow-up, the composite score increased by 1.440, 1.419 and 1.430 units, respectively (all P < 0.05). Conversely, replacing MVPA with 10 minutes of SP, SB, and LPA, resulted in decreases in baseline physical fitness composite scores of 0.836, 0.777 and 0.669 units, and reductions of 1.613, 1.592 and 1.598 units at 1-year follow-up (all P < 0.05). Conclusions Preschool children's 24-hour movement behaviors, especially MVPA, are closely related to physical health. Implementing appropriate strategies to increase physical activity and reduce sedentary time may improve the physical fitness of preschoolers. -
Key words:
- Motor activity /
- Behavior /
- Body constitution /
- Regression analysis /
- Child, preschool
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表 1 不同性别学龄前儿童基线身体形态、24 h活动行为时间及体质健康测试指标比较(x±s)
Table 1. Comparison of body morphology, 24-hour activity behavior time and physical fitness test indexes among different genders of preschool children at baseline(x±s)
性别 人数 身体形态指标 24 h活动行为时间/min 身高/cm 体重/kg BMI/(kg·m-2) SB LPA* MVPA SP 男 106 110.08±6.21 19.51±3.65 15.99±1.75 546.04±152.62 91.02(79.00, 107.70) 84.10±25.78 587.40±61.59 女 87 107.05±5.77 17.78±2.46 15.47±1.23 538.02±166.63 85.21(75.00, 93.11) 70.44±25.98 597.76±68.81 t/Z值 3.48 3.91 2.44 0.35 -0.88 3.65 -1.10 P值 < 0.01 < 0.01 0.02 0.73 0.38 < 0.01 0.27 性别 人数 体质健康测试指标 握力/kg 坐位体前屈/cm* 立定跳远/cm 双脚连续跳/s 15 m绕障碍跑/s 走平衡木/s* 体质健康综合得分 男 106 9.09±2.54 8.05(4.00, 12.40) 83.06±20.24 7.66±3.04 8.97±2.13 6.20(4.30, 11.28) 71.65±8.69 女 87 7.38±2.14 11.00(6.90, 14.20) 74.92±18.67 8.05±2.62 9.34±2.00 6.30(4.30, 11.20) 68.84±9.89 t/Z值 5.02 -2.82 2.88 -0.95 -1.23 -1.09 2.10 P值 < 0.01 < 0.01 < 0.01 0.34 0.22 0.27 0.04 注：双脚连续跳、15m绕障碍跑和走平衡木数据越小表示成绩越优异；*不符合正态分布，用M(P25, P75)表示。 
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表 2 学龄前儿童24 h活动行为时间占比与基线及1年后体质健康的成分线性回归分析(n=193)
Table 2. Component linear regression of 24-hour active behavior time percentage and physical fitness at baseline and one year later in preschool children(n=193)
因变量 自变量 基线 1年后 基线与1年后的差异 β值 P值 β值 P值 β值 P值 握力 MVPA 0.98 0.08 1.08 0.38 0.09 0.12 LPA -0.47 0.10 0.10 0.89 0.57 < 0.01 SB -0.65 0.35 -1.61 0.34 -0.97 < 0.01 SP -0.31 0.80 -2.52 0.44 -2.21 < 0.01 坐位体前屈 MVPA 1.22 0.26 0.23 0.84 -0.99 < 0.01 LPA -0.95 0.09 -1.32 0.05 -0.37 0.06 SB -0.79 0.55 1.33 0.41 2.11 < 0.01 SP 0.99 0.67 1.72 0.58 0.73 0.08 立定跳远 MVPA 10.98 0.04 6.87 0.10 -4.11 < 0.01 LPA -0.92 0.67 -0.91 0.71 0.02 0.86 SB -11.67 0.04 -8.40 0.15 -3.27 < 0.01 SP -29.42 < 0.01 -20.27 0.07 -9.15 < 0.01 双脚连续跳 MVPA -2.36 < 0.01 -1.12 0.04 -1.25 < 0.01 LPA 1.00 < 0.01 0.10 0.77 0.91 < 0.01 SB 1.68 0.06 1.35 0.09 0.33 0.18 SP 3.60 0.03 2.96 0.05 0.64 < 0.01 15 m绕障碍跑 MVPA -0.23 0.62 -0.13 0.61 -0.10 0.34 LPA -0.12 0.62 -0.04 0.76 -0.07 0.19 SB 0.25 0.67 0.20 0.57 0.05 0.40 SP 0.62 0.54 0.16 0.81 2.34 < 0.01 走平衡木 MVPA -8.07 < 0.01 -0.24 0.93 -7.83 < 0.01 LPA -0.35 0.81 -4.44 < 0.01 -4.09 < 0.01 SB 9.88 < 0.01 4.99 0.18 4.89 < 0.01 SP 19.13 < 0.01 5.97 0.40 13.17 < 0.01 体质健康综合得分 MVPA 6.61 < 0.01 1.36 0.52 5.25 < 0.01 LPA -0.34 0.77 -0.78 0.53 -0.44 < 0.01 SB -6.55 0.04 -0.34 0.91 -6.21 < 0.01 SP -15.45 < 0.01 -6.34 0.26 -9.11 < 0.01 注：双脚连续跳、15m绕障碍跑和走平衡木数据越小表示成绩越优异。
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表 3 学龄前儿童24 h活动行为10 min重新分配与基线体质健康测试指标预测值变化(n=193)
Table 3. Change in predicted value of 10 min redistribution of 24-hour active behavior and baseline physical fitness test index(n=193)
体质健康测试指标 SP↑ SB↑ SB↓ LPA↓ MVPA↓ SP↓ LPA↓ MVPA↓ 握力 0.027(-0.014~0.068) 0.046(-0.018~0.110) -0.087(-0.218~0.043) -0.027(-0.068~0.014) 0.019(-0.016~0.054) -0.114(-0.242~0.014) 坐位体前屈 0.042(-0.037~0.120) 0.092(-0.031~0.215) -0.097(-0.347~0.154) -0.042(-0.120~0.037) 0.050(-0.017~0.118) -0.138(-0.384~0.108) 立定跳远 -0.270(-0.582~0.042) -0.481(-0.969~0.008) -1.543(-2.538~-0.547)** 0.273(-0.039~0.586) -0.211(-0.478~0.057) -1.273(-2.249~-0.297)* 双脚连续跳 0.017(-0.034~0.069) 0.001(-0.080~0.082) 0.286(0.121~0.451)** -0.018(-0.070~0.034) -0.016(-0.061~0.028) 0.268(0.106~0.430)** 15 m绕障碍跑 -0.004(-0.038~0.030) 0.007(-0.046~0.060) 0.026(-0.083~0.134) 0.004(-0.030~0.038) 0.011(-0.018~0.040) 0.030(-0.077~0.136) 走平衡木 0.073(-0.138~0.284) 0.260(-0.071~0.590) 1.029(0.355~1.703)** -0.075(-0.287~0.136) 0.186(0.005~0.367)* 0.956(0.295~1.616)** 体质健康综合得分 -0.059(-0.228~0.110) -0.173(-0.438~0.092) -0.836(-1.376~-0.297)** 0.061(-0.108~0.230) -0.113(-0.258~0.032) -0.777(-1.305~-0.248)** 体质健康测试指标 LPA↑ MVPA↑ SP↓ SB↓ MVPA↓ SP↓ SB↓ LPA↓ 握力 -0.044(-0.105~0.018) -0.017(-0.049~0.016) -0.131(-0.260~-0.003)* 0.076(-0.041~0.193) 0.103(-0.011~0.217) 0.122(0.006~0.239)* 坐位体前屈 -0.087(-0.206~0.031) -0.045(-0.108~0.017) -0.184(-0.431~0.064) 0.083(-0.142~0.307) 0.125(-0.095~0.344) 0.175(-0.049~0.399) 立定跳远 0.468(-0.002~0.938) 0.194(-0.054~0.441) -1.079(-2.060~-0.097)* 1.393(0.502~2.285)** 1.119(0.248~1.990)* 0.909(0.020~1.798)* 双脚连续跳 -0.003(-0.081~0.075) 0.015(-0.026~0.056) 0.283(0.120~0.446)** -0.255(-0.403~-0.107)** -0.237(-0.382~-0.093)** -0.254(-0.401~-0.106)** 15 m绕障碍跑 -0.007(-0.058~0.045) -0.011(-0.038~0.016) 0.019(-0.088~0.126) -0.023(-0.120~0.074) -0.027(-0.122~0.068) -0.016(-0.113~0.081) 走平衡木 -0.251(-0.569~0.067) -0.177(-0.344~-0.009)* 0.779(0.115~1.444)* -0.923(-1.527~-0.320)** -0.849(-1.438~-0.259)** -0.662(-1.264~-0.060)* 体质健康综合得分 0.168(-0.086~0.423) 0.108(-0.026~0.242) -0.669(-1.201~-0.137)* 0.750(0.267~1.233)** 0.689(0.217~1.161)** 0.575(0.094~1.057)* 注：()内数字为指标预测值变化的95%CI；*P < 0.05；**P < 0.01。
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表 4 学龄前儿童24 h活动行为10 min替代与1年后体质健康预测值变化情况(n=193)
Table 4. Change in 10-minute substitution of 24-hour active behavior and predictive values of physical fitness at one year later in preschool children(n=193)
体质健康测试指标 SP↑ SB↑ SB↓ LPA↓ MVPA↓ SP↓ LPA↓ MVPA↓ 握力 -0.002(-0.124~0.120) -0.027(-0.177~0.123) -0.126(-0.440~0.188) 0.002(-0.012~0.125) -0.025(-0.104~0.054) -0.124(-0.399~0.152) 坐位体前屈 0.001(-0.015~0.118) 0.082(-0.061~0.225) -0.004(-0.304~0.295) -0.002(-0.118~0.115) 0.080(0.005~0.156)* -0.006(-0.268~0.257) 立定跳远 -0.223(-0.646~0.199) -0.339(-0.857~0.179) -0.147(-2.132~0.038) 0.225(-0.198~0.648) -0.116(-0.389~0.156) -0.825(-1.776~0.127) 双脚连续跳 0.021(-0.035~0.078) 0.039(-0.030~0.108) 0.153(0.008~0.298)* -0.022(-0.078~0.035) 0.018(-0.019~0.054) 0.132(0.004~0.259)* 15 m绕障碍跑 -0.006(-0.032~0.019) -0.004(-0.035~0.027) 0.008(-0.057~0.072) 0.006(-0.019~0.032) 0.002(-0.014~0.018) 0.014(-0.043~0.071) 走平衡木 -0.082(-0.348~0.183) 0.165(-0.161~0.490) -0.026(-0.708~0.656) 0.082(-0.184~0.347) 0.246(0.075~0.418)** 0.055(-0.543~0.653) 体质健康综合得分 -0.019(-0.239~0.200) -0.008(-0.277~0.260) -1.613(-2.175~-1.050)** 0.022(-0.197~0.241) 0.012(-0.129~0.154) -1.592(-2.085~-1.099)** 体质健康测试指标 LPA↑ MVPA↑ SP↓ SB↓ MVPA↓ SP↓ SB↓ LPA↓ 握力 0.026(-0.119~0.171) 0.024(-0.051~0.098) -0.100(-0.370~0.170) 0.113(-0.171~0.397) 0.111(-0.134~0.356) 0.086(-0.156~0.328) 坐位体前屈 -0.077(-0.216~0.061) -0.076(-0.147~-0.005)* -0.081(-0.339~0.176) 0.003(-0.268~0.274) 0.004(-0.230~0.238) 0.085(-0.146~0.315) 立定跳远 0.331(-0.171~0.832) 0.105(-0.152~0.362) -0.719(-1.652~0.214) 0.950(-0.032~1.932) 0.724(-0.123~1.571) 0.608(-0.227~1.444) 双脚连续跳 -0.038(-0.105~0.029) -0.017(-0.051~0.018) 0.115(-0.010~0.240) -0.138(-0.269~-0.007)* -0.116(-0.230~-0.003)* -0.099(-0.210~0.013) 15 m绕障碍跑 0.004(-0.026~0.034) -0.002(-0.018~0.013) 0.012(-0.044~0.067) -0.006(-0.065~0.052) -0.013(-0.063~0.038) -0.011(-0.061~0.039) 走平衡木 -0.153(-0.468~0.163) -0.235(-0.397~-0.074)** -0.179(-0.765~0.407) 0.025(-0.592~0.642) -0.058(-0.590~0.475) 0.190(-0.335~0.715) 体质健康综合得分 0.016(-0.244~0.276) -0.005(-0.139~0.128) -1.598(-2.082~-1.115)** 1.440(0.931~1.949)** 1.419(0.980~1.858)** 1.430(0.997~1.863)** 注：()内数字为指标预测值变化的95%CI；*P < 0.05，** P < 0.01。
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