Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Abstract

BackgroundThe Canadian Society for Exercise Physiology convened representatives of national organizations, research experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day (24-h period).MethodsThe development process was guided by the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Four systematic reviews (physical activity, sedentary behaviour, sleep, combined behaviours) examining the relationships within and among movement behaviours and several health indicators were completed and interpreted by a Guideline Development Panel. The systematic reviews that were conducted to inform the development of the guidelines, and the framework that was applied to develop the recommendations, followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Complementary compositional analyses were performed using data from the Canadian Health Measures Survey to examine the relationships between movement behaviours and indicators of adiposity. A review of the evidence on the cost effectiveness and resource use associated with the implementation of the proposed guidelines was also undertaken. A stakeholder survey (n = 546), 10 key informant interviews, and 14 focus groups (n = 92 participants) were completed to gather feedback on draft guidelines and their dissemination.ResultsThe guidelines provide evidence-informed recommendations as to the combinations of light-, moderate- and vigorous-intensity physical activity, sedentary behaviours, and sleep that infants (<1 year), toddlers (1–2 years) and preschoolers (3–4 years) should achieve for a healthy day (24 h). Proactive dissemination, promotion, implementation, and evaluation plans were prepared to optimize uptake and activation of the new guidelines.ConclusionsThese guidelines represent a sensible evolution of public health guidelines whereby optimal health is framed within the balance of movement behaviours across the whole day, while respecting preferences of end-users. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4859-6) contains supplementary material, which is available to authorized users.

Association of total sedentary behaviour and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose–response meta‐analysis

“…Meanwhile, sedentary behaviour is prevalent and pervasive in modern society, and data from adults in high‐income countries suggest that most time awake is spent being sedentary . Currently, the United States and other high‐income countries have mainly focused on physical activity promotion and have issued health guidelines, but few guidelines exist for sedentary behaviour . This absence represents an important gap in public health guidelines because of the severe consequences and profound burden of total sedentary behaviour.…”

Interventions to increase physical activity in children 0–5 years old: a systematic review, meta‐analysis and realist synthesis

“…Some studies suggest that young children's objectively assessed physical activity may be as low as 4% of the day . Assuming a 13‐h waking day for a young child , this falls below the guideline of 180 min of light, moderate or vigorous‐intensity physical activity (LMVPA) per day recommended by government bodies internationally .…”

Associations of physical activity and gross motor skills with executive function in preschool children from low‐income South African settings

“…For instance, guideline recommendations suggest that children aged 3‐5 years of age should be doing at least 180 min of physical activity per day, which should include 60 min of moderate and vigorous physical activity (MVPA) (Okely et al, ; Tremblay et al, ). The inclusion of 60 min of MVPA in the most recent guidelines was driven by findings that physical activity performed at a light intensity was not associated with a range of health outcomes.…”

“…Available evidence suggests that preschool children in South Africa are highly active (Draper et al, ; Jones, Hendricks, & Draper, ), and have adequate gross motor skills (Draper, Achmat, Forbes, & Lambert, ; Draper et al, ). These studies, mostly from low‐income settings, have reported that South African preschoolers are not only meeting the guidelines for physical activity (Okely et al, ; Tremblay et al, ), but are exceeding them – with some children accumulating more than 400 min of total physical activity and over 100 min of MVPA per day. This is a very different context to those from which the majority of physical‐cognitive findings are derived, in which habitual physical activity levels are substantially lower (Beets, Bornstein, Dowda, & Pate, ; Hinkley, Salmon, Okely, Crawford, & Hesketh, ; Tucker, ).…”