Impact of COVID-19 pandemic on 24-hour movement behaviors among preschoolers from Brazil
Healthy habits during early childhood are essential for a healthy adolescence and adulthood. Before the COVID-19 pandemic, the number of children who met the 24-h movement behavior (physical activity [PA], sedentary behavior, and sleep) guidelines was low worldwide. Despite a lack of evidence, the restriction measures imposed during the COVID-19 pandemic are claimed to have further reduced the number, especially among preschoolers. Thus, this study was designed to compare the time spent on movement behaviors before and during the COVID-19 pandemic in low-income preschoolers from the Northeast Region of Brazil. Forty mothers provided data on their preschoolers’ sleep, sedentary behavior, and outdoor and indoor PA. To compare indoor and outdoor PA, sleep duration, and sedentary time during the weekdays and weekends, before and during the pandemic, generalized estimation equations were used. During the weekdays, a significant increase in sleep duration (553.7 vs. 627.0; p < 0.01) and sedentary times (225.0 vs. 409.5; p < 0.01) were observed. Further, an increase in the sedentary time during the weekend (319.5 vs. 406.5; p < 0.01) and the total time between the pre-pandemic and pandemic periods (249.0 vs. 409.5; p < 0.01) was observed. Our findings also unveiled that preschoolers were seven times more likely to be active outdoors for an hour or more before than during the pandemic (OR = 6.55; 95% CI = 2.07 – 20.73). In summary, the pandemic has altered preschoolers’ routines, leading to changes in their health behaviors over time.
Aguilar-Farias, N., Toledo-Vargas, M., Miranda-Marquez, S., Cortinez-O’Ryan, A., Cristi-Montero, C., Rodriguez- Rodriguez, F., Del Pozo Cruz, B., et al. (2021). Sociodemographic predictors of changes in physical activity, screen time, and sleep among toddlers and preschoolers in Chile during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18(1):176. https://doi.org/10.3390/ijerph18010176
Alonso-Martínez, A.M., Ramírez-Vélez, R., García-Alonso, Y., Izquierdo, M., & García-Hermoso, A. (2021). Physical activity, sedentary behavior, sleep and self-regulation in Spanish preschoolers during the COVID-19 lockdown. International Journal of Environmental Research and Public Health, 18(2):693. https://doi.org/10.3390/ijerph18020693
An, R., Shen, J., Yang, Q., & Yang, Y. (2019). Impact of built environment on physical activity and obesity among children and adolescents in China: A narrative systematic review. Journal of Sport and Health Science, 8(2):153-169. https://doi.org/10.1016/j.jshs.2018.11.003
Bezerra, T.A., Clark, C.C.T., Souza Filho, A.N.D., Fortes, L.D.S., Mota, J.A.P.S., Duncan, M.J., et al. (2021). 24-hour movement behaviour and executive function in preschoolers: A compositional and isotemporal reallocation analysis. European Journal of Sport Science, 21(7):1064-1072. https://doi.org/10.1080/17461391.2020.1795274
Blair, P.S., Humphreys, J.S., Gringras, P., Taheri, S., Scott, N., Emond, A., et al. (2012). Childhood sleep duration and associated demographic characteristics in an English cohort. Sleep, 35(3):353-360. https://doi.org/10.5665/sleep.1694
Brazil, Ministry of Health. Panel of Coronavirus Disease 2019 (COVID-19) Cases in Brazil by the Ministry of Health. Available from: https://covid.saude.gov.br
Brazil, Ministry of Health. Vaccinometer COVID-19. Available from: https://infoms.saude.gov.br/extensions/seidigi_ demas_vacina_c19/seidigi_demas_vacina_c19.html [Last accessed on 2023 Jan 11].
Buck, C., Bolbos, A., & Schneider, S. (2019). Do poorer children have poorer playgrounds? A geographically weighted analysis of attractiveness, cleanliness, and safety of playgrounds in affluent and deprived urban neighborhoods. Journal of Physical Activity and Health, 16(6):397-405. https://doi.org/10.1123/jpah.2018-0177
Cliff, D.P., McNeill, J., Vella, S.A., Howard, S.J., Santos, R., Batterham, M., et al. (2017). Adherence to 24-hour movement guidelines for the early years and associations with social-cognitive development among Australian preschool children. BMC Public Health, 17(5):207-215. https://doi.org/10.1186/s12889-017-4858-7
Correia, L.C., Sette, C., Santos, M., Magliano, C.A., & Toscas, F.S. (2022). Brazil’s COVID-19 guidelines: Political hijack of public health. Lancet, 399(10331):1223. https://doi.org/10.1016/S0140-6736(22)00338-5
De Craemer, M., McGregor, D., Androutsos, O., Manios, Y., & Cardon, G. (2018). Compliance with 24-h movement behaviour guidelines among Belgian pre-school children: The ToyBox-study. International Journal of Environmental Research and Public Health, 15(10):2171. https://doi.org/10.3390/ijerph15102171
Fonseca, E.M.D., Nattrass, N., Lazaro, L.L.B., & Bastos, F.I. (2021). Political discourse, denialism and leadership failure in Brazil’s response to COVID-19. Global Public Health, 16(8-9):1251-1266. https://doi.org/10.1080/17441692.2021.1945123
Gabel, L., Macdonald, H.M., Nettlefold, L., & McKay, H.A. (2017). Physical activity, sedentary time, and bone strength from childhood to early adulthood: A mixed longitudinal HR‐pQCT study. Journal of Bone and Mineral Research, 32(7):1525-1536. https://doi.org/10.1002/jbmr.3115
Guan, H., Okely, A.D., Aguilar-Farias, N., Del Pozo Cruz, B., Draper, C.E., El Hamdouchi, A., et al. (2020). Promoting healthy movement behaviours among children during the COVID-19 pandemic. The Lancet Child and Adolescent Health, 4(6):416-418. https://doi.org/10.1016/S2352-4642(20)30131-0
Guerrero, M.D., Barnes, J.D., Walsh, J.J., Chaput, J.P., Tremblay, M.S., & Goldfield, G.S. (2019). 24-hour movement behaviors and impulsivity. Pediatrics, 144(3):e20190187. https://doi.org/10.1542/peds.2019-0187
Hall, G., Laddu, D.R., Phillips, S.A., Lavie, C.J., & Arena, R. (2021). A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Progress in Cardiovascular Diseases, 64:108-110. https://doi.org/10.1016/j.pcad.2020.04.005
Larouche, R., Eryuzlu, S., Livock, H., Leduc, G., Faulkner, G., Trudeau, F., et al. (2017). Test-retest reliability and convergent validity of measures of children’s travel behaviours and independent mobility. Journal of Transport and Health, 6:105-118. https://doi.org/10.3389/fspor.2022.761723
Lindsay, A.C., Greaney, M.L., Wallington, S.F., Sands, F.D., Wright, J.A., & Salkeld, J. (2017). Latino parents’ perceptions of the eating and physical activity experiences of their pre-school children at home and at family child-care homes: A qualitative study. Public Health Nutrition, 20(2):346-356. https://doi.org/10.1017/S136898001600207X
Liu, Z., Tang, H., Jin, Q., Wang, G., Yang, Z., Chen, H., et al. (2021). Sleep of preschoolers during the coronavirus disease 2019 (COVID‐19) outbreak. Journal of Sleep Research, 30(1):e13142. https://doi.org/10.1111/jsr.13142
Martins, C.M.L., Lemos, L.F.G.B.P., De Souza Filho, A.N., Bezerra, T.A., Soares, I.A.A., Mota, J.G., et al. (2021). Adherence to 24‐hour movement guidelines in low‐income Brazilian preschoolers and associations with demographic correlates. American Journal of Human Biology, 33(4):e23519. https://doi.org/10.1002/ajhb.23519
Martins-Filho, P.R., Quintans-Júnior, L.J., De Souza Araújo, A.A., Sposato, K.B., Tavares, C.S., Gurgel, R.Q., et al. (2021). Socio-economic inequalities and COVID-19 incidence and mortality in Brazilian children: A nationwide register-based study. Public Health, 190:4-6. https://doi.org/10.1016/j.puhe.2020.11.005
May, E.M., Azar, S.T., & Matthews, S.A. (2018). How does the neighborhood “come through the door?” Concentrated disadvantage, residential instability, and the home environment for preschoolers. Am J Community Psychol, 61(1-2):218-228. https://doi.org/10.1002/ajcp.12223
Mota, J.G., Clark, C.C.T., Bezerra, T.A., Lemos, L., Reuter, C.P., Mota, J.A.P.S., et al. (2020). Twenty-four-hour movement behaviours and fundamental movement skills in preschool children: A compositional and isotemporal substitution analysis. Journal of Sports Sciences, 38(18):2071-2079. https://doi.org/10.1080/02640414.2020.1770415
Pan, W. (2001). Akaike’s information criterion in generalized estimating equations. Biometrics, 57(1):120-125. https://doi.org/10.1111/j.0006-341x.2001.00120.x
Souza, J.L. (2008). DHI. Development Challenges Journal, 5(39). Available: https://www.ipea.gov.br/desafios/index. php?id=2144:catid=28&option=com_content
Tandon, P.S., Zhou, C., Sallis, J.F., Cain, K.L., Frank, L.D., & Saelens, B.E. (2012). Home environment relationships with children’s physical activity, sedentary time, and screen time by socioeconomic status. International Journal of Behavioral Nutrition and Physical Activity, 9(1):1-9. https://doi.org10.1186/1479-5868-9-88
Telama, R. (2009), Tracking of physical activity from childhood to adulthood: A review. Obesity Facts, 2(3):187-195. https://doi.org/10.1159/000222244
Tremblay, M.S., Chaput, J.P., Adamo, K.B., Aubert, S., Barnes, J.D., Choquette, L., et al. (2017). Canadian 24-hour movement guidelines for the early years (0-4 years): An integration of physical activity, sedentary behaviour, and sleep. BMC Public Health, 17(5):1-32. https://doi.org/10.1186/s12889-017-4859-6
Van de Straat, V., Cheval, B., Schmidt, R.E., Sieber, S., Courvoisier, D., Kliegel, M., et al. (2020). Early predictors of impaired sleep: A study on life course socioeconomic conditions and sleeping problems in older adults. Aging and Mental Health, 24(2):322-332. https://doi.org/10.1080/13607863.2018.1534078
Walsh, J.J., Barnes, J.D., Cameron, J.D., Goldfield, G.S., Chaput, J.P., Gunnell, K.E., et al. (2018). Associations between 24 hour movement behaviours and global cognition in US children: A cross-sectional observational study. The Lancet Child and Adolescent Health, 2(11):783-791. https://doi.org/10.1016/S2352-4642(18)30278-5
WHO. (2020a). Coronavirus Disease (COVID-19) Pandemic. Switzerland: World Health Organization.
WHO. (2020b). Coronavirus disease (COVID-19) pandemic. In: GUIDELINES on Physical Activity, Sedentary Behavior and Sleep for Children Under 5 Years of Age: Web Annex: Evidence Profiles. Geneva: World Health Organization.