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. 2024 Aug 21;16(16):2788.
doi: 10.3390/nu16162788.

Isotemporal Substitution Effects of Daily Time Use on Cardiorespiratory Fitness of Children in the OptiChild Study: A Mediation Analysis with Diet Quality

Youxin Wang  1   2 , Pingping Zhang  3 , Mingyue Wang  2 , Qinghai Gong  4 , Canqing Yu  5   6 , Haijun Wang  2 , Antje Hebestreit  7 , Patrick W C Lau  8   9 , Hui Wang  2 , Li Li  1
Affiliations

Isotemporal Substitution Effects of Daily Time Use on Cardiorespiratory Fitness of Children in the OptiChild Study: A Mediation Analysis with Diet Quality

Youxin Wang et al. Nutrients. .

Abstract

(1) Background: Although daily time-use is associated with diet quality and cardiorespiratory fitness (CRF) in children, their interdependence remains unexplored. This study first examined the associations between reallocating daily movement time and diet quality and CRF, and second the mediating role of diet quality in the relationship between daily time-use and CRF. (2) Methods: This study included 1131 Chinese children (aged 8 to 10 years; median [interquartile range]: 8.5 [8.3, 8.8]) at baseline (September 2022) and 1268 children at the 9-month follow-up (June 2023) from the OptiChild study. Daily durations of moderate-to-vigorous physical activity (MVPA), sleep, and sedentary behavior (e.g., screen time) were self-reported or proxy-reported by parents. Diet quality was assessed via the Diet Quality Questionnaire (DQQ), which uses a 24 h dietary recall and is categorized according to the Global Dietary Recommendations (GDR) score and Food Group Diversity Score (FGDS). The CRF was measured using VO2max after the 20 m shuttle run test. Longitudinal associations between daily time-use, diet quality, and CRF were calculated using isotemporal substitution models. Mediation analyses were used to determine whether diet quality mediated the associations between daily time-use and CRF. (3) Results: Reallocation of 30 min from screen time to MVPA resulted in significant improvements in the GDR score (β baseline = 0.11, p = 0.024; β follow-up = 0.26, p < 0.001), FGDS (β baseline = 0.11, p = 0.006; β follow-up = 0.19, p < 0.001), and CRF (β baseline = 0.40, p < 0.001; β follow-up = 0.26, p = 0.001). Diet quality partially mediated the associations between MVPA, screen time, and CRF. Substituting 30 min of screen time for MVPA led to diet quality mediating a proportion of the association with CRF (GDR score: 11.4%, FGDS: 6.6%). (4) Conclusions: These findings underscore the importance of optimizing daily time-use of MVPA and screen time and improving diet quality to promote physical fitness in school-aged children.

Keywords: cardiorespiratory fitness; children; diet quality; physical activity; screen time.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart for the selection of the participants in current longitudinal study.
Figure 2
Figure 2
Mediation analysis: contribution of screen time and MVPA on CRF through GDR score and FGDS, adjusting for potential confounders (age, sex, BMI, mother’s education, schools and intervention groups). (A) mediation role of GDR score between MVPA and CRF; (B) mediation role of GDR score between screen time and CRF; (C) mediation role of FGDS between MVPA and CRF; (D) mediation role of FGDS between screen time and CRF.
Figure 3
Figure 3
Mediation analysis of GDR score and FGDS on the relationships between 30 min of daily screen time displacing MVPA time and CRF, adjusting for potential confounders (age, sex, BMI, mother’s education, schools and intervention groups). (A) mediation analysis of GDR score; (B) mediation analysis of FGDS.
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