Global analysis of meeting physical activity, sedentary behaviour and sleep recommendations in preschool-aged children

Abstract Overview

Background: In 2019, World Health Organization (WHO) released the first global guidelines on physical activity, sedentary behaviour and sleep (collectively known as movement behaviours) for children under five years of age. It is important to determine the global proportion of children meeting the guidelines to inform efforts to promote healthy movement behaviours in early childhood.

Purpose: This study presents a pooled analysis on the proportion of 3- and 4-year-old children meeting WHO guidelines across the globe using a harmonised data processing protocol.

Methods: Data were sourced from 14 cross-sectional studies conducted between 2008 and 2022. Physical activity was assessed using accelerometers and processed with a harmonised approach, while sedentary behaviour (operationalised as screen time) and sleep duration were proxy-reported by parents or caregivers. The proportion of children meeting WHO guidelines was estimated at a global level and by World Bank income group and WHO region using a meta-analysis approach.

Results: Our pooled analyses involving 7,017 children (51.1% boys) from 33 countries and territories revealed that only 14.3% (95% confidence interval 9.7,20.7) met the overall WHO guidelines for physical activity, screen time and sleep duration. The lowest proportion of meeting guidelines was observed in upper-middle-income countries (11.9% [5.9,22.5]) and the Americas (7.7% [3.6,15.8]), while the highest proportion was in low- and lower-middle-income countries (16.6% [10.4,25.3]) and Africa (23.9% [11.6,43.0]).

Conclusions: Less than one in six preschool children worldwide met the WHO guidelines for physical activity, sedentary behaviour and sleep. While differences were noted among regions and income groups, the proportion meeting guidelines was low for all.

Practical implications: Understanding key factors and implementing contextually appropriate and effective programs and policies are essential to promote healthy movement behaviours in preschool age group.

Funding: No funding was received for conducting this pooled analysis.

Additional Authors

Name: Thomas Suesse

Affiliation: National Institute for Applied Statistics Research Australia, School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.

Presenting Author: no

Name: Penny L. Cross

Affiliation: Research Services Office, Research and Innovation Division, University of Wollongong, NSW 2522, Australia.

Presenting Author: no

Name: Sarah T. Ryan

Affiliation: School of Health and Society, Early Start, Faculty of the Arts, Social Science and Humanities, University of Wollongong, NSW 2522, Australia.

Presenting Author: no

Name: Eivind Aadland

Affiliation: Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.

Presenting Author: no

Name: Oluwayomi Aoko

Affiliation: Human Kinetics and Health Education Department, University of Lagos, Lagos, Nigeria.

Presenting Author: no

Name: Ankhmaa Byambaa

Affiliation: National Centre for Public Health, Ulaanbaatar 13381, Mongolia.

Presenting Author: no

Name: Valerie Carson

Affiliation: Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada.

Presenting Author: no

Name: Cecilia H. S. Chan

Affiliation: Department of Sports Science and Physical Education, Kwok Sports Building, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Presenting Author: no

Name: Jean-Philippe Chaput

Affiliation: Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.

Presenting Author: no

Name: Hayley Christian

Affiliation: Telethon Kids Institute, University of Western Australia, Nedlands WA 6009, Australia.

Presenting Author: no

Name: Dylan P. Cliff

Affiliation: School of Education, Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Northfields Ave, Wollongong NSW 2522, Australia.

Presenting Author: no

Name: Marieke De Craemer

Affiliation: Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.

Presenting Author: no

Name: Clarice Maria de Lucena Martins

Affiliation: Research Centre in Physical Activity, Health and Leisure, and Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal.

Presenting Author: no

Name: Christine Delisle Nyström

Affiliation: Department of Biosciences and Nutrition, Karolinska Institutet, Neo, 141 83, Huddinge, Sweden.

Presenting Author: no

Name: Catherine E. Draper

Affiliation: South African MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Presenting Author: no

Name: Asmaa El Hamdouchi

Affiliation: Unité de Recherche en Nutrition et Alimentation, CNESTEN.

Presenting Author: no

Name: Alex Antonio Florindo

Affiliation: School of Arts, Sciences, and Humanities, University of Sao Paulo, Brazil.

Presenting Author: no

Name: Fazlollah Ghofranipour

Affiliation: Department of Health Education and Health Promotion, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.

Presenting Author: no

Name: Hongyan Guan

Affiliation: Child Healthcare Centre, Nurturing Care Research and Guidance Center, Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China.

Presenting Author: no

Name: Amy S. Ha

Affiliation: Department of Sports Science and Physical Education, Kwok Sports Building, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Presenting Author: no

Name: Najmeh Hamzavi Zarghani

Affiliation: Department of Health Education and Health Promotion, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.

Presenting Author: no

Name: Kylie D. Hesketh

Affiliation: Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.

Presenting Author: no

Name: Mohammad Sorowar Hossain

Affiliation: Department of Emerging and Neglected Diseases, Biomedical Research Foundation, Bangladesh.

Presenting Author: no

Name: Jajat Jajat

Affiliation: Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Jawa Barat, Indonesia.

Presenting Author: no

Name: Thanh Kim

Affiliation: Department of Epidemiology, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Vietnam.

Presenting Author: no

Name: Denise Koh

Affiliation: Centre for Education and Community Well-being, Faculty of Education, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Malaysia.

Presenting Author: no

Name: Anna V. Kontsevaya

Affiliation: National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia.

Presenting Author: no

Name: Nicholas Kuzik

Affiliation: Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.

Presenting Author: no

Name: Marja H. Leppänen

Affiliation: Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.

Presenting Author: no

Name: Marie Löf

Affiliation: Department of Biosciences and Nutrition, Karolinska Institutet, Neo, 141 83, Huddinge, Sweden.

Presenting Author: no

Name: Himangi Lubree

Affiliation: Vadu Rural Health Program, KEM Hospital Research Centre, Rasta Peth, Pune, India.

Presenting Author: no

Name: Kim Meredith-Jones

Affiliation: Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.

Presenting Author: no

Name: Tawonga W. Mwase-Vuma

Affiliation: Centre for Social Research, University of Malawi, Zomba, Malawi.

Presenting Author: no

Name: Johan Y. Y. Ng

Affiliation: Department of Sports Science and Physical Education, Kwok Sports Building, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Presenting Author: no

Name: Rachel Novotny

Affiliation: Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, 96822, USA.

Presenting Author: no

Name: Jackline Jema Nusurupia

Affiliation: Tanzania Food and Nutrition Centre, 22 Barack Obama Road, Dar es salaam, Tanzania.

Presenting Author: no

Name: Bang N. Pham

Affiliation: Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.

Presenting Author: no

Name: Bee Koon Poh

Affiliation: Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.

Presenting Author: no

Name: John J. Reilly

Affiliation: Department of Psychological Sciences & Health, University of Strathclyde, Glasgow, Scotland.

Presenting Author: no

Name: Amanda E. Staiano

Affiliation: Division of Population and Public Health Science, Pennington Biomedical Research Center, Baton Rouge, LA United States.

Presenting Author: no

Name: Adang Suherman

Affiliation: Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Jawa Barat, Indonesia.

Presenting Author: no

Name: Kuston Sultoni

Affiliation: Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Jawa Barat, Indonesia.

Presenting Author: no

Name: Chiaki Tanaka

Affiliation: Department of Human Nutrition, Tokyo Kasei Gakuin University, 22 Sanbancho, Chiyoda-ku, Tokyo, 102-8341 Japan.

Presenting Author: no

Name: Hong K. Tang

Affiliation: Department of Epidemiology, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Vietnam.

Presenting Author: no

Name: Rachael Taylor

Affiliation: Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.

Presenting Author: no

Name: Simone A. Tomaz

Affiliation: Faculty of Health Sciences and Sport, University of Stirling, UK.

Presenting Author: no

Name: Mark S. Tremblay

Affiliation: Children’s Hospital of Eastern Ontario Research Institute and Department of Pediatrics, University of Ottawa, Ottawa, Canada.

Presenting Author: no

Name: Stewart G. Trost

Affiliation: School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane QLD 4001, Australia

Presenting Author: no

Name: Ali Turab

Affiliation: PHC Global, Karachi, Pakistan.

Presenting Author: no

Name: Susana Vale

Affiliation: School of Education, Polytechnic Institute of Porto, Porto, Portugal.

Presenting Author: no

Name: Pujitha Wickramasinghe

Affiliation: Department of Paediatrics, Faculty of Medicine, University of Colombo, Sri Lanka.

Presenting Author: no

Name: Anthony D. Okely

Affiliation: School of Health and Society, Early Start, Faculty of the Arts, Social Science and Humanities, University of Wollongong, NSW 2522, Australia.

Presenting Author: no

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