Health associations with meeting new 24-hour movement guidelines for Canadian children and youth

The study objective was to examine whether meeting the new Canadian 24-hour movement guidelines was associated with health indicators in a representative sample of Canadian children and youth. Cross-sectional findings are based on 4157 (1239 fasting subsample) children and youth aged 6-17 years from cycles 1-3 of the Canadian Health Measures Survey (CHMS). Sleep and screen time were subjectively measured while moderateto vigorous-intensity physical activity (MVPA) was accelerometer-determined. Health indicators in the full sample (body mass index (BMI) z-scores, waist circumference, blood pressure, behavioral strengths and difficulties score (lower = better), and aerobic fitness) and fasting subsample (triglycerides, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, and insulin) were measured. Meeting the overall guidelines was defined as: 9-11 hour/night (5-13 years) or 8-10 hour/day (14-17 years) of sleep, <= 2 hour/day of screen time, and >= 60 minute/day of MVPA. Compared to meeting all three recommendations, meeting none, one, and two recommendations were associated with a higher BMI z-score, waist circumference, and behavioral strengths and difficulties score and lower aerobic fitness in a gradient pattern (P-trend < 0.05 Additionally, compared tomeeting all three recommendations, meeting none and one recommendation were associated with higher systolic blood pressure and insulin (P-trend < 0.05). Finally, compared to meeting all three recommendations, meeting no recommendations was associated with higher triglycerides and lower HDL-cholesterol (Ptrend b 0.05). Collectively, meeting more recommendations within the 24-hour movement guidelines was associated with better overall health. Since a small proportion (17%) of this representative sample was meeting the overall guidelines, efforts to promote adoption are needed.