Associations Between 24‐h Movement Behaviours and Health in 3‐ and 4‐Year‐Old Children From a Low‐Income Country: The SUNRISE Ethiopia Study

Abstract

BACKGROUND: There is little evidence on the associations between 24-h movement behaviours and health in children from low-income countries. We examined the associations of physical activity, sedentary behaviour, screen time and sleep with adiposity, motor skills and executive functions among 3- and 4-year-old children in Ethiopia. METHODS: Cross-sectional study conducted in Adama city and Lume Woreda, Oromia region, Ethiopia. We recruited children from kindergartens and rural Kebeles or villages. Children's time spent in physical activity, sedentary behaviour and sleep were measured using hip worn ActiGraph accelerometers. Children's screen time was parent-reported. Linear mixed models tested associations of 24-h movement behaviours with adiposity (BMI z-score), motor skills (NIH Toolbox) and executive functions (Early Years Toolbox). All models accounted for child sex, age and dietary diversity as fixed effects and clustering of children within kindergarten/villages as a random effect. RESULTS: A total of 430 children participated (4.2 ± 0.6 years). Children who slept longer had lower adiposity (-0.12, 95% CI: -0.19, -0.06). Those who had higher levels of total physical activity (TPA) (0.06, 95% CI 0.01, 0.13) and moderate to vigorous-intensity physical activity (MVPA) (0.03, 95% CI 0.01, 0.06) had higher scores on handgrip strength. Children who spent more time in sedentary behaviour had lower handgrip strength (-0.08, 95% CI -0.16, -0.01). There were no significant associations with executive functions. CONCLUSIONS: Strategies to improve adiposity and motor skills should focus on promoting healthy levels of 24-h movement behaviours, especially adequate sleep and time spent in physical activity in Ethiopian children.