Meeting 24-h movement behavior guidelines is associated with academic engagement, social-emotional functioning in obese/overweight youth

Background: The 24-h movement behavior (24-HMB) guidelines suggest that the integration of adequate sleep (SL), increased physical activity (PA), and limited screen time (ST) has general health benefits. However, associations of meeting integrated guidelines with academic engagement and social-emotional functioning among obese/overweight youth have yet to be fully examined. Thus, we aimed to investigate the associations between meeting 24-HMB guidelines and the above-presented outcome measures among this unique group. Methods: In this cross-sectional study, 2800 children and adolescents (youth aged 6-17 years old) that were retrieved from the National Survey of Children's Health (NSCH) were included for data analysis. Exposure of interests included adherence to 24-HMB guideline(s), while indicators of academic engagement and socialemotional functioning were operationalized. Furthermore, multiple logistic regression was conducted while adjusting for social-demographic variables including age, sex, ethnicity, household income, parental education level and mental health status. Results: The percentages of meeting 24-HMB guidelines varied greatly across different combinations: 1399 participants (49.96 %) met 1 of the 3 guidelines, 580 participants (20.91 %) met 2 guidelines, while only 91 participants (2.94 %) met all 3 guidelines. Meeting integrated guidelines was selectively associated with higher odds of indicators (showing interest/curiosity in learning, caring about school performance, and completing all required homework) of academic engagement. Additionally, Meeting SL + ST guideline (OR = 0.52, 95%CI: 0.29-0.93, p < 00.05) was associated with lower odds of serious difficulty in concentrating, remembering, and making decisions, while meeting ST + SL guideline (OR = 1.67, 95%CI: 1.03-2.69, p < 00.05) was more likely to be good at making and keeping friendships. Furthermore, meeting all 3 guidelines was associated with less argumentative behaviors (OR = 0.58, 95%CI: 0.33-0.99, p < 00.05) and a higher level of resilience (OR = 3.51, 95%CI: 1.88-6.54, p < 00.01), while meeting any two integrated guidelines was associated with a higher level of resilience (OR = 1.72, 95%CI: 1.09-2.71, p < 00.05). Conclusion: Findings have indicated the role of meeting 24-HMB guidelines, especially integrated guidelines in the healthy development of obese/overweight youth. Policymakers should implement a long-term plan for this unique group to engage in physical activity, achieve enough sleep, and limit screen time.