Associations Between Adherence to 24-hour Movement Guidelines and Academic Achievement in School-Aged Children

Purpose This study examined associations between adherence to the 24-hour movement guidelines (moderate-to-vigorous physical activity (MVPA), screen time, and sleep) and academic achievement in school-aged children. Design Cross-sectional study. Setting Elementary schools in Hangzhou, China. Sample Sample of 268 children aged 8-12 years (52% boys). Measures MVPA and sleep duration were measured using accelerometers, while screen time was self-reported. Academic achievement was assessed through grades in Chinese, Math, and English, standardized into Z-scores. Covariates included age, sex, school location, and body mass index z-score. Analysis Multiple linear regression was conducted to assess associations between combinations of adherence to the 24-hour movement guidelines and academic achievement. Results Meeting two or more recommendations was significantly associated with higher overall academic achievement compared to those meeting none ( P < 0.05). Specifically, adherence to the screen time guideline only (β = 0.39, 95% CI: 0.14, 0.64) and combined adherence to both screen time and sleep guidelines (β = 0.37, 95% CI: 0.04, 0.69) were positively associated with overall academic achievement. For subject-specific Z-scores, meeting at least two guidelines was linked to higher achievement in Chinese and Math ( P < 0.05). Conclusion Adherence to multiple 24-hour movement guidelines, particularly limiting recreational screen time, is associated with higher academic achievement in school-aged children. These findings highlight the potential value of integrated movement behavior strategies for educational outcomes and underscore the need for longitudinal research to clarify underlying mechanisms.