Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross-sectional study

Objective: This study describes the distributions of body mass index (BMI) and movement behaviors among schoolchildren from 13 countries across a continuum of human development. Methods: Data were from a cross-sectional study of 9-11-year-old children (n = 8055) recruited from 269 urban schools in 13 countries, and an additional 7 rural schools in one of these countries (Mozambique). BMI was derived from objectively measured heights and weights. Moderate- to vigorous-intensity physical activity (MVPA), sedentary time (SED), and sleep duration were assessed by waist-worn Actigraph GT3X+ accelerometers. Linear models were used to describe the distributions of BMI z-scores, MVPA, SED, and sleep among sites across varying Human Development Indices (HDIs). Results: Mean MVPA, SED, and sleep duration were 63.1 ± 27.3 minutes/day, 508.7 ± 72.4 minutes/day, and 8.8 ± 0.9 hours/night, respectively. Overall, 2.1% of the sample were thin, 19.5% overweight, and 11.7% were obese. Density curves (BMI z-scores and SED) for urban children in Mozambique showed significantly higher mean values compared with rural children. Boys had significantly higher mean MVPA compared with girls. Mean BMI z-scores were positively associated (? =.02; P =.004) with HDI, mean daily MVPA minutes were negatively associated (? = ?.38; P =.025) with HDI, and mean SED time was positively associated with HDI (? = 1.18; P =.049). No significant association (? =.01; P =.29) was observed between sleep duration and HDI. Conclusion: Our findings show distinct differences in BMI and movement behavior profiles between urban and rural children in Mozambique. Mean BMI z-scores, MVPA, and SED differed by country HDI. These findings support the need to include both rural and urban participants in study samples. © 2019 Wiley Periodicals, Inc.