Abstract: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.

Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.Key words: physical activity, body composition, cardiometabolic biomarkers, fitness, behavioural conduct, bone health, academic achievement, quality of life, well-being, children.Résumé : L'activité physique d'intensité moyenne à vigoureuse (« MVPA ») est essentielle à la prévention des maladies et à la promotion de la santé. D'après de récentes données, l'activité physique (« PA ») pratiquée à d'autres intensités telles que légères (« LPA ») s'avère aussi importante, mais il n'y a pas d'évaluation rigoureuse de ces faits. Cette analyse documentaire systématique a pour objectif d'examiner la relation entre l'activité physique mesurée objectivement (totale et à chacune des intensités) et des indicateurs de la santé chez des enfants et des jeunes d'âge scolaire. On a cherché dans des bases de données en ligne pour identifier des études révisées par des pairs et présentant a priori les critères d'inclusion suivants : population (apparemment en santé, sujets âgés de 5 à 17 ans), intervention/exposition/comparateur (volume, durée, fréquence, intensité et types de mesure objective de PA) et le résultat (composition c...

This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5-17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a prioridetermined population (apparently healthy children and youth, mean age: 5-17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from "very low" to "moderate" quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.Key words: sitting, TV, screen time, body composition, fitness, metabolic syndrome, cardiovascular disease, self-esteem, pro-social behaviour, academic achievement. Résumé :Cette analyse documentaire systématique est une mise à jour de la relation entre la mesure objective/subjective des comportements sédentaires et les indicateurs de santé chez les enfants et les jeunes âgés de 5 à 17 ans. En décembre 2014, on cherche dans ASE, PsycINFO et Medline, mais on impose une limite de date (≥février 2010). Les études retenues sont sanctionnées par des pairs et sont conformes aux critères a priori déterminés dans l'étude : la population (des jeunes apparemment en bonne santé âgés de 5 à 17 ans), l'intervention (durée, habitudes et types de comportement sédentaire), la comparaison (durées variées, habitudes et types de comportement sédentaire) et le résultat (essentiel : composition corporelle, syndrome métabolique/ facteurs de risque de maladie cardiovasculaire, comportement/comportement prosocial, rendement scolaire; important : condition physique, estime de soi). La qualité des données probantes est évaluée pour chaque résultat pa...

The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection, CINAHL Plus with Full Text, Child Development & Adolescent Studies, Education Resources Information Center, SPORTDiscus, ClinicalTrials.gov and the Trip Database from inception up to 6 January 2017. Primary studies of any design were eligible, except case studies. Results were limited to English-language, Spanish-language or French-language materials. Articles related to maternal physical activity during pregnancy reporting on maternal, fetal or neonatal morbidity, or fetal mortality were eligible for inclusion. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The Guidelines Consensus Panel solicited feedback from end users (obstetric care providers, exercise professionals, researchers, policy organisations, and pregnant and postpartum women). The development of these guidelines followed the Appraisal of Guidelines for Research and Evaluation II instrument. The benefits of prenatal physical activity are moderate and no harms were identified; therefore, the difference between desirable and undesirable consequences (net benefit) is expected to be moderate. The majority of stakeholders and end users indicated that following these recommendations would be feasible, acceptable and equitable. Following these recommendations is likely to require minimal resources from both individual and health systems perspectives.

Abstract:The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.Key words: sleep duration, adiposity, body weight, emotional regulation, mental health, cognition, academic achievement, quality of life, well-being, injuries.Résumé : Cette analyse systématique a pour objectif d'examiner la relation entre la mesure objective et subjective de la durée du sommeil et d'autres indicateurs sanitaires chez des enfants et des jeunes âgés de 5 à 17 ans. En janvier 2015, une recherche est faite dans les bases de données en ligne sans contrainte de date et de devis utilisé. Les études retenues sont sanctionnées par des pairs et sont conformes aux critères a priori déterminés : la population (des jeunes apparemment en bonne santé âgés de 5 à 17 ans), l'intervention/exposition/comparaison (durées variées du sommeil) et le résultat (adiposité, contrôle des émotions, cognition/ rendement scolaire, qualité de vie/bien-être, préjudices/blessures et biomarqueurs cardiométaboliques). À cause du haut niveau d'hétérogénéité des études, on utilise des synthèses narratives. Au total, 141 articles (110 échantillons originaux) incluant 592 215 participants distincts de 40 pays différents sont conformes aux critères d'inclusion. Globalement, une plus longue durée de sommeil est associée aux indicateurs de ...