Meeting 24-hour movement guidelines: Their relationships with overweight and obesity among Chinese children with autism spectrum disorder

Background: Canada's and Australia's 24-hour movement guidelines for children and youth provide daily recommendations for physical activity (PA), screen time (ST), and sleep for optimal health. Previous studies have examined the associations between meeting these 24-hour move-ment guidelines and overweight and obesity among children without disabilities. Less is known about potential associations between the 24-hour movement behaviors and the weight status of children with disabilities.Therefore, the purpose of this study was to examine whether meeting movement behavior rec-ommendations (i.e. >= 60 min of Moderate-to-vigorous activity [MVPA] per day, <= 2 h of rec-reational ST per day, and 9-11 h of sleep for those aged 5-13 years [or 8-10 h for children aged 14-17 years]), and combinations of these recommendations, are associated with overweight and obesity in Chinese children with ASD.Method: Participants were 99 children with autism spectrum disorder (ASD) 7-17 years old recruited from one Chinese special school. MVPA and nightly sleep duration were measured using 24-hour wrist-worn accelerometer. ST was reported by parents by using reliable and valid items derived from the Health Behavior in School-aged Children (Chinese version). A series of binary logical regression analyses were performed for analysis.Results: Only 16.2% met all the three movement behavior recommendations. The proportions of children with ASD who met the recommendation for PA, ST, and sleep were 32.3%, 52.5%, and 65.7%, respectively. The children with ASD who met the MVPA (OR = 0.37, 95% CI: 0.15-0.94), MVPA + Sleep (OR = 0.27, 95% CI: 0.09-0.81), and all three 24-hour movement guidelines (OR = 0.14, 95% CI: 0.03-0.77), had significantly lower odds ratios for overweight/obesity than those who did not meet the respective recommendations.Conclusions: Meeting the MVPA, MVPA + Sleep, and all three of the guidelines was associated with lower odds ratios for overweight and obesity in children with ASD, and MVPA was the single most important activity for weight control among this population. Therefore, meeting the 24-hour movement guidelines, especially the MVPA guideline should be considered an effective inter-vention and can inform the design of strategies and policies for the prevention of overweight and obesity in children with ASD.