The 24-hour movement guidelines and body composition among youth receiving special education services in the United States

Background: The purposes of this study were to examine the proportions of youth receiving special education services in the United States who individually and jointly met physical activity, screen time, and sleep duration guidelines, and to examine the impact of meeting none, one, two, and three of the guidelines on overweight and obesity. Methods: This cross-sectional analysis utilized data from the 2016 to 2017 National Survey for Children’s Health data set on 3582 youth aged 10–17 years who received special education services. The frequency of the participants’ compliance with the 24-hour movement guidelines and body weight status (based on the age- and sex-specific percentile cutoffs) were estimated. Meeting guidelines was defined as: 9–11 hours/night (5–13 y) or 8–10 hours/night (14–17 y) of sleep, ≤120 minutes per day of screen time, and ≥60 minutes per day of moderate to vigorous physical activity. A multinomial logistic regression analysis was conducted to estimate the impact of meeting none, one, two, or three guidelines on body weight status, adjusted for potential confounders. Results: Overall, 8.1% of youth met all three guidelines, 42.0% met two guidelines, 38.0% met one guideline, and 11.9% did not meet any guideline. Meeting all three guidelines was associated with an approximately 50% decreased likelihood of overweight than meeting no guideline, or sleep or screen time guidelines independently. Conclusions: This study extends the 24-hour movement framework to children receiving special education services and should prompt the continued study of its utility for understanding health disparities experienced by this population.