TY - JOUR
T1 - Pooled Analysis of Physical Activity, Sedentary Behavior, and Sleep Among Children From 33 Countries
AU - Chong, Kar Hau
AU - Suesse, Thomas
AU - Cross, Penny L.
AU - Ryan, Sarah T.
AU - Aadland, Eivind
AU - Aoko, Oluwayomi
AU - Byambaa, Ankhmaa
AU - Carson, Valerie
AU - Chaput, Jean Philippe
AU - Christian, Hayley
AU - Cliff, Dylan P.
AU - De Craemer, Marieke
AU - de Lucena Martins, Clarice Maria
AU - Delisle Nyström, Christine
AU - Draper, Catherine E.
AU - El Hamdouchi, Asmaa
AU - Florindo, Alex Antonio
AU - Guan, Hongyan
AU - Ha, Amy S.
AU - Hamzavi Zarghani, Najmeh
AU - Hesketh, Kylie D.
AU - Hossain, Mohammad Sorowar
AU - Jajat, Jajat
AU - Kim, Thanh
AU - Koh, Denise
AU - Kontsevaya, Anna V.
AU - Kuzik, Nicholas
AU - Leppänen, Marja H.
AU - Löf, Marie
AU - Lubree, Himangi
AU - Meredith-Jones, Kim
AU - Mwase-Vuma, Tawonga W.
AU - Ng, Johan Y.Y.
AU - Novotny, Rachel
AU - Nusurupia, Jackline Jema
AU - Pham, Bang N.
AU - Poh, Bee Koon
AU - Reilly, John J.
AU - Staiano, Amanda E.
AU - Sultoni, Kuston
AU - Tanaka, Chiaki
AU - Tang, Hong K.
AU - Taylor, Rachael W.
AU - Tomaz, Simone A.
AU - Tremblay, Mark S.
AU - Trost, Stewart G.
AU - Turab, Ali
AU - Vale, Susana
AU - Wickramasinghe, V. Pujitha
AU - Okely, Anthony D.
PY - 2024/11/4
Y1 - 2024/11/4
N2 - Importance: The prevalence estimates of physical activity, sedentary behavior, and sleep (collectively known as movement behaviors) in 3- and 4-year-old children worldwide remains uncertain. Objective: To report the proportion of 3- and 4-year-old children who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep across 33 countries. Design, Setting, and Participants: Pooled analysis of data from 14 cross-sectional studies (July 2008 to September 2022) identified through systematic reviews and personal networks. Thirty-three countries of varying income levels across 6 geographical regions. Each study site needed to have at least 40 children aged 3.0 to 4.9 years with valid accelerometry and parent-/caregiver-reported screen time and sleep duration data. Data were analyzed from October 2022 to February 2023. Exposures: Time spent in physical activity was assessed by reanalyzing accelerometry data using a harmonized data-processing protocol. Screen time and sleep duration were proxy reported by parents or caregivers. Main Outcomes and Measures: The proportion of children who met the World Health Organization guidelines for physical activity (≥180 min/d of total physical activity and ≥60 min/d of moderate- to vigorous-intensity physical activity), screen time (≤1 h/d), and sleep duration (10-13 h/d) was estimated across countries and by World Bank income group and geographical region using meta-analysis. Results: Of the 7017 children (mean [SD] age, 4.1 [0.5] years; 3585 [51.1%] boys and 3432 [48.9%] girls) in this pooled analysis, 14.3% (95% CI, 9.7-20.7) met the overall guidelines for physical activity, screen time, and sleep duration. There was no clear pattern according to income group: the proportion meeting the guidelines was 16.6% (95% CI, 10.4-25.3) in low- and lower-middle-income countries, 11.9% (95% CI, 5.9-22.5) in upper-middle-income countries, and 14.4% (95% CI, 9.6-21.1) in high-income countries. The region with the highest proportion meeting the guidelines was Africa (23.9%; 95% CI, 11.6-43.0), while the lowest proportion was in North and South America (7.7%; 95% CI, 3.6-15.8). Conclusions and Relevance: Most 3- and 4-year-old children in this pooled analysis did not meet the current World Health Organization guidelines for physical activity, sedentary behavior, and sleep. Priority must be given to understanding factors that influence these behaviors in this age group and to implementing contextually appropriate programs and policies proven to be effective in promoting healthy levels of movement behaviors.
AB - Importance: The prevalence estimates of physical activity, sedentary behavior, and sleep (collectively known as movement behaviors) in 3- and 4-year-old children worldwide remains uncertain. Objective: To report the proportion of 3- and 4-year-old children who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep across 33 countries. Design, Setting, and Participants: Pooled analysis of data from 14 cross-sectional studies (July 2008 to September 2022) identified through systematic reviews and personal networks. Thirty-three countries of varying income levels across 6 geographical regions. Each study site needed to have at least 40 children aged 3.0 to 4.9 years with valid accelerometry and parent-/caregiver-reported screen time and sleep duration data. Data were analyzed from October 2022 to February 2023. Exposures: Time spent in physical activity was assessed by reanalyzing accelerometry data using a harmonized data-processing protocol. Screen time and sleep duration were proxy reported by parents or caregivers. Main Outcomes and Measures: The proportion of children who met the World Health Organization guidelines for physical activity (≥180 min/d of total physical activity and ≥60 min/d of moderate- to vigorous-intensity physical activity), screen time (≤1 h/d), and sleep duration (10-13 h/d) was estimated across countries and by World Bank income group and geographical region using meta-analysis. Results: Of the 7017 children (mean [SD] age, 4.1 [0.5] years; 3585 [51.1%] boys and 3432 [48.9%] girls) in this pooled analysis, 14.3% (95% CI, 9.7-20.7) met the overall guidelines for physical activity, screen time, and sleep duration. There was no clear pattern according to income group: the proportion meeting the guidelines was 16.6% (95% CI, 10.4-25.3) in low- and lower-middle-income countries, 11.9% (95% CI, 5.9-22.5) in upper-middle-income countries, and 14.4% (95% CI, 9.6-21.1) in high-income countries. The region with the highest proportion meeting the guidelines was Africa (23.9%; 95% CI, 11.6-43.0), while the lowest proportion was in North and South America (7.7%; 95% CI, 3.6-15.8). Conclusions and Relevance: Most 3- and 4-year-old children in this pooled analysis did not meet the current World Health Organization guidelines for physical activity, sedentary behavior, and sleep. Priority must be given to understanding factors that influence these behaviors in this age group and to implementing contextually appropriate programs and policies proven to be effective in promoting healthy levels of movement behaviors.
UR - http://www.scopus.com/inward/record.url?scp=85208515110&partnerID=8YFLogxK
U2 - 10.1001/jamapediatrics.2024.3330
DO - 10.1001/jamapediatrics.2024.3330
M3 - Article
C2 - 39348138
AN - SCOPUS:85208515110
SN - 2168-6203
VL - 178
SP - 1199
EP - 1207
JO - JAMA Pediatrics
JF - JAMA Pediatrics
IS - 11
ER -