Academic Pressure and 24-Hour Movement Behaviors among Bangladeshi Children and Adolescents: A Structural Equation Modeling Study

Background Academic pressure may shape children’s daily movement habits and sedentary lifestyle, possibly contributing to changes in body mass index (BMI). Limited empirical evidence is available on the relationships among educational commitment, 24-hour movement behaviors, and BMI in low- and middle-income settings such as Bangladesh. This study explored the associations among academic pressure, sleep duration, moderate-to-vigorous physical activity (MVPA), screen time, and BMI among Bangladeshi children and adolescents and aimed to estimate whether sleep duration, MVPA, and screen time reflected indirect pathways between academic pressure and BMI. Methods A cross-sectional study was conducted among 1144 children and adolescents aged 5–17 years. Academic pressure was assessed as a latent construct using three items. Structural equation modeling was performed to examine the associations between indicators while adjusting for age and sex. Log-transformed MVPA was used in the primary model, and a sensitivity analysis was also performed via raw MVPA to assess the influence of functional form. Results Academic pressure was negatively associated with MVPA (standardized β = −0.222, p < 0.001) and positively associated with screen time (β = 0.24, p < 0.001) but was not associated with sleep duration (β = −0.01, p = 0.707) or BMI (β = −0.03, p = 0.430). A longer sleep duration was associated with a lower BMI (β = −0.06, p = 0.032), whereas MVPA (β = −0.04, p = 0.141) and screen time (β = 0.03, p = 0.284) were not independently associated with BMI. None of the hypothesized indirect associations were statistically significant in the primary model. The total indirect association was also not significant (β = 0.018, p = 0.054). In the sensitivity analysis, the indirect association through MVPA became significant when raw MVPA was used (β = 0.015, p < 0.001), indicating the sensitivity of this pathway to the MVPA functional form. Conclusions Academic pressure, but not BMI, was associated with lower MVPA and greater screen time. A longer sleep duration was associated with a slightly lower BMI.