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Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep
Open accessAbstract
Leaders from the Canadian Society for Exercise Physiology convened representatives of national organizations, content experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children and youth aged 5-17 years respect the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and systematic reviews of evidence informing the guidelines were assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Four systematic reviews (physical activity, sedentary behaviour, sleep, integrated behaviours) examining the relationships between and among movement behaviours and several health indicators were completed and interpreted by expert consensus. Complementary compositional analyses were performed using Canadian Health Measures Survey data to examine the relationships between movement behaviours and health indicators. A stakeholder survey was employed (n = 590) and 28 focus groups/stakeholder interviews (n = 104) were completed to gather feedback on draft guidelines. Following an introductory preamble, the guidelines provide evidence-informed recommendations for a healthy day (24 h), comprising a combination of sleep, sedentary behaviours, light-, moderate-, and vigorous-intensity physical activity. Proactive dissemination, promotion, implementation, and evaluation plans have been prepared in an effort to optimize uptake and activation of the new guidelines. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed.
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In the citing paper
“In order to preserve both overall mental health and cognitive functioning, both Canada's 15 and Australia's 16 24-Hour Movement Guidelines have adopted a 'whole day time-use' paradigm for young people, recommending that each day should include at least 60 min of moderate-to-vigorous exercise, several hours of light physical activity, no more than two hours of sedentary leisure activities, and 8-11”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [15]
In the citing paper
“Recent 24-h movement guidelines have promoted whole-day movement patterns that target both enhanced MVPA and restriction of sedentary time (ST).6”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [6]
In the citing paper
“A specific policy in Japan (limiting the distance between the children and youth homes and the public elementary and junior high schools) 77 and the high density of Hong Kong, Japanese, and South Korean cities, allow children and youth to live a short trip away from their school, which can minimize the use of cars or other forms of motorized vehicles, and promote active travel.25,78,79”
From Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries (2018) · cites this paper as [78]
In the citing paper
“the Canadian 24-Hour Movement Guidelines for Children and Youth (aged 5 to 17 years) have been released in 2016 and recommend ≥60 min/day of moderate-to-vigorous physical activity (MVPA), ≤2 h/day of recreational screen time, and 9 to 11 h of sleep per day for 5- to 13-year-olds or 8 to 10 h of sleep per day for 14- to 17-year-olds to support healthy development [17].”
In the citing paper
“To our knowledge, this is the first time the relationship between 24-h movement guidelines and mental health indicators in children and adolescents has been systematically reviewed since the release of aforementioned guidelines in 2016 [17].”
In the citing paper
“This is in line with current recommendations and previous research showing that MVPA, screen time and sleep duration are the components of the 24-h day that are more strongly associated with obesity and other health outcomes [2, 4, 11, 14].”
From Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study (2016) · cites this paper as [4]
Citations
Cites
Rogers, E. M., Singhal, A., & Quinlan, M. M. (2019) · Routledge eBooks · doi:10.4324/9780203710753-35 · Cited by 37,670
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., Mullany, E. C., Biryukov, S., Abbafati, C., Abera, S. F., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60460-8 · Cited by 11,952 · cited 1×
“…2016; Poitras et al. 2016), sedentary behaviour (Carson et al. 2016a; Colley et al. 2011; ParticipACTION 2015, 2016), sleep (Chaput et al. 2016; Owens 2014; Matricciani et al. 2012; ParticipACTION 2016), and obesity (Gotay et al. 2013; Ng et al. 2014) have galvanized attention and established…”
BackgroundGRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables
Guyatt, G., Oxman, A. D., Akl, E. A., Kunz, R., Vist, G., Brozek, J., Norris, S., Falck-Ytter, Y., Glasziou, P., & deBeer, H. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.04.026 · Cited by 10,681 · cited 3×
“The guideline development procedures used here followed comprehensive, rigorous, and transparent processes (Brouwers et al. 2010a; Guyatt et al. 2011; Tremblay and Haskell 2012) incorporating systematic review findings, consultation findings, compositional analysis findings, and expert, stakeholder, and end-user input…”
MethodGRADE guidelines: 3. Rating the quality of evidence
Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.015 · Cited by 8,285 · cited 2×
“For all systematic reviews, the quality of evidence was assessed by outcome/indicator and study design, using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach (Balshem et al. 2011; Guyatt et al. 2011).”
MethodAGREE II: advancing guideline development, reporting and evaluation in health care
Brouwers, M. C., Kho, M. E., Browman, G. P., Burgers, J. S., Cluzeau, F., Feder, G., Fervers, B., Graham, I. D., Grimshaw, J., Hanna, S. E., et al. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.090449 · Cited by 3,790 · cited 4×
“The guideline development procedures used here followed comprehensive, rigorous, and transparent processes (Brouwers et al. 2010a; Guyatt et al. 2011; Tremblay and Haskell 2012) incorporating systematic review findings, consultation findings, compositional analysis findings, and expert,…”
MethodInfluentialSelf-citationPoitras, V. J., Gray, C. E., Borghese, M. M., Carson, V., Chaput, J.-P., Janssen, I., Katzmarzyk, P. T., Pate, R. R., Connor Gorber, S., Kho, M. E., et al. (2016) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2015-0663 · Cited by 2,217
Self-citationSystematic review of sedentary behaviour and health indicators in school-aged children and youth.
Tremblay, M. S., LeBlanc, A. G., Kho, M. E., Saunders, T. J., Larouche, R., Colley, R. C., Goldfield, G., & Gorber, S. (2011) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-8-98 · Cited by 2,085
Self-citationPhysiological and health implications of a sedentary lifestyle
Tremblay, M. S., Colley, R. C., Saunders, T. J., Healy, G. N., & Owen, N. G. (2010) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h10-079 · Cited by 1,572 · cited 4×
“…seem inappropriate or counter-intuitive to include sedentary behaviour and sleep in a list of “movement behaviours”, we do so throughout this paper and the guidelines in the context of a movement continuum (Tremblay et al. 2010a) and to succinctly capture the relevant components of the whole day.”
BackgroundInfluentialSelf-citationManaging Clinical Knowledge for Health Care Improvement
Balas, E. A., & Boren, S. A. (2000) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1637943 · Cited by 1,479
Insufficient Sleep in Adolescents and Young Adults: An Update on Causes and Consequences
Owens, J., ADOLESCENT SLEEP WORKING GROUP, COMMITTEE ON ADOLESCENCE, Au, R., Carskadon, M., Millman, R., Wolfson, A., Braverman, P. K., Adelman, W. P., Breuner, C. C., et al. (2014) · Pediatrics · doi:10.1542/peds.2014-1696 · Cited by 1,413 · cited 2×
“2011; ParticipACTION 2015, 2016), sleep (Chaput et al. 2016; Owens 2014; Matricciani et al. 2012; ParticipACTION 2016), and obesity (Gotay et al.”
Background
Research works printed but not linked: 3
- Colley R.C., 2011, Health Rep., 22, 15
- Pedisic Z., 2014, Kinesiology, 46, 135
- Tremblay M.S., 2007, Health Rep., 18, 7
Cited by
Sorted by citations
Sedentary Behavior Research Network (SBRN)—Terminology Consensus Project process and outcome
on behalf of SBRN Terminology Consensus Project Participants, Tremblay, M. S., Aubert, S., Barnes, J. D., Saunders, T. J., Carson, V., Latimer-Cheung, A. E., Chastin, S. F. M., Altenburg, T. M., & Chinapaw, M. J. M. (2017) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-017-0525-8 · Cited by 3,793
Self-citationPoitras, V. J., Gray, C. E., Borghese, M. M., Carson, V., Chaput, J.-P., Janssen, I., Katzmarzyk, P. T., Pate, R. R., Connor Gorber, S., Kho, M. E., et al. (2016) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2015-0663 · Cited by 2,217
Self-citationChaput, J.-P., Willumsen, J., Bull, F., Chou, R., Ekelund, U., Firth, J., Jago, R., Ortega, F. B., & Katzmarzyk, P. T. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-01037-z · Cited by 1,277
“A systematic review of the literature on the association between sedentary behaviour and health indicators in school-aged children and adolescents conducted by Carson et al. [18] as part of the process for developing the Canadian 24-Hour Movement Guidelines for Children and Youth [17].”
BackgroundMethodInfluentialSelf-citationFirth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., Gilbody, S., Torous, J., Teasdale, S. B., Jackson, S. E., et al. (2020) · World Psychiatry · doi:10.1002/wps.20773 · Cited by 1,242
Moore, S. A., Faulkner, G., Rhodes, R. E., BRUSSONI, M. J., Chulak-Bozzer, T., Ferguson, L. J., Mitra, R., O’Reilly, N., Spence, J. C., Vanderloo, L. M., et al. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00987-8 · Cited by 1,247
“It is recommended that children and youth aim to accumulate 60 min per day of moderate-to-vigorous physical activity and play outdoors regularly [3, 4, 6, 7].”
BackgroundMethodInfluentialSelf-citation
Metadata
- Authors
- Tremblay, M. S., Carson, V., Chaput, J.-P., Connor Gorber, S., Dinh, T., Duggan, M., Faulkner, G., Gray, C. E., Gruber, R., Janson, K., Janssen, I., Katzmarzyk, P. T., Kho, M. E., Latimer-Cheung, A. E., LeBlanc, C., Okely, A. D., Olds, T., Pate, R. R., Phillips, A., Poitras, V. J., Rodenburg, S., Sampson, M., Saunders, T. J., Stone, J. A., Stratton, G., Weiss, S. K., & Zehr, L.
- Affiliations
- University of Ottawa (CA)
- University of Alberta (CA)
- Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada.
- Conference Board of Canada (CA)
- Canadian Society for Exercise Physiology (CA)
- University of British Columbia (CA)
- Children's Hospital of Eastern Ontario (CA)
- Douglas Mental Health University Institute (CA)
- ParticipACTION (CA)
- Queen's University (CA)
- Pennington Biomedical Research Center (US)
- McMaster University (CA)
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
- McGill University (CA)
- University of Wollongong (AU)
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute of Health Research, University of South Australia, Adelaide 5001, Australia.
- University of South Carolina (US)
- No affiliation.
- University of Prince Edward Island (CA)
- University of Calgary (CA)
- Swansea University (GB)
- University of Toronto (CA)
- Camosun College (CA)
- ORCID
- Venue
- Applied Physiology, Nutrition, and Metabolism
- Publisher
- Canadian Science Publishing
- Published
- 2016-06
- Volume
- 41
- Issue
- 6 (Suppl. 3)
- Pages
- S311-S327
- ISSN
- 1715-5312 (ISSN-L)
- 1715-5320
- OpenAlex
- W2435437921
- Cited by
- 2,024
- References
- 49
- Citations by year
- 2026: 178 · 2025: 241 · 2024: 246 · 2023: 264 · 2022: 285 · 2021: 270 · 2020: 223 · 2019: 129 · 2018: 108 · 2017: 61 · 2016: 19
- FWCI
- 84.97
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Applied Physiology, Nutrition, and Metabolism (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- IslandScholar (University of Prince Edward Island) (submittedVersion)
- QSpace (Queen's University Library) (submittedVersion, cc-by)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- 24-hour movement guidelines, children and young people, physical activity, sedentary behavior, sleep, light physical activity, moderate physical activity, high-intensity exercise, health indicators, AGREE II, GRADE, Canadian Health Measures Survey, stakeholder engagement
- MeSH terms
- Adolescent, Adolescent Behavior, Canada, Child, Child Behavior, Child, Preschool, Cross-Sectional Studies, Humans, Sleep, Health Behavior, Exercise, Focus Groups, Guidelines as Topic, Sedentary Behavior
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