Probability of meeting the restrained sitting guideline in early childhood: an international cross-sectional study.
OBJECTIVES To estimate the proportion of children who meet the restrained sitting guidelines (i.e. <1 h in continuous restrained sedentary). The secondary aim was to determine which factors contribute to the probability a child will meet the restrained sitting guidelines. DESIGN Secondary data analysis of 32 countries participating in the SUNRISE International Study. METHODS Parent surveys were used to collect child demographic information and total restrained sitting. Physical activity was assessed with an accelerometer (ActiGraph wGT3X-BT). A generalized linear mixed model was used to determine the probability of a child meeting the restrained sitting guidelines based on sex, age, geographic region, time spent in a vehicle, and hours of total physical activity. Separate models were run by country income level. RESULTS Final analysis included 2647 children (4.3 ± 0.5 years, 50.6% girls, 49.0% rural). Overall, 81.9% of participants met the restrained sitting guidelines. Odds of meeting the guidelines were 35% lower for children in urban areas and 71% lower for spending 60 min or more in a vehicle. Every additional hour of physical activity increased the odds of meeting the guidelines by a factor of 1.25. These relationships differed when stratified by country income level. CONCLUSIONS While most children meet the guidelines, a focus on children living in urban areas, spending more time in vehicles, and those who engage in less physical activity is warranted.