Meeting the 24-h movement guidelines and health-related outcomes among youth with autism spectrum disorder: a seven-country observational study

Background: Meeting daily guidelines for physical activity, screen time, and sleep duration is associated with a host of health indicators for youth. In this cross-sectional observational study, we investigated the associations between adherence to the movement guidelines and health-related outcomes among youth with autism spectrum disorder (ASD).

Methods: Parents of youth with ASD (10–17 years) from seven countries and regions were invited to provide online proxy-reports for child’s movement behaviors (i.e., physical activity, sleep and screen time), and health-related outcomes (i.e., body mass index [BMI], general health, and quality of life). A series of multiple linear regression analyses were used to examine the associations between meeting movement guidelines and health-related outcomes, adjusted for covariates.

Results: The fnal sample consisted of 1165 youth with ASD. Compared with youth meeting all three guidelines, a higher BMI z-score was observed in those who met no guidelines (B=0.62, P=0.04), “sedentary time only” (B=0.60, P=0.047), and “physical activity plus sleep only” (B=0.85, P=0.04). Compared with meeting all three guidelines, meeting no guidelines was associated with poorer general health (B=−0.46, P=0.02). Further, compared with youth meeting all three guidelines, a lower quality of life score was observed in those who met no guidelines (B=−0.47, P=0.02) and “physical activity only” (B=−0.62, P=0.03). Lastly, there were dose–response associations between the number of guidelines met and all three health-related outcomes (all Ptrend<0.05). 

Conclusions: In conclusion, meeting more 24-h movement guidelines was generally associated with more favorable health-related outcomes in youth with ASD. The low level of adherence to all three guidelines (2.0%) suggests the urgent need to promote the adoption of all the guidelines in this group.