Background The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children’s daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children’s movement behaviours before and during the COVID-19 pandemic. Methods Parents of children aged 3–5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined. Results Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9). Conclusion PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents’ mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

Introduction24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap.Methods and analysisSUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study.Ethics and disseminationThe SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

Background Several cross‐sectional studies have reported an association between childhood constipation and exposure to stressful events. We planned to systematically review the literature on constipation and its associated stressful events. Methods PubMed, Embase, and PsycINFO databases were searched (until February 2021) using standard search terms related to “constipation” and “stress” from 0 to 18 years that describe the association between psychological stressors and constipation. Studies were screened using pre‐designed eligibility criteria. Studies that fulfilled the criteria were reviewed in a full‐text format. The quality assessment of selected articles was conducted using standard methods. Key Results Of 2296 titles and abstracts screened, 38 were included in the full‐text review. Out of that, 15 articles were included in this systematic review. There were 2954 children with constipation, and the age range was from 6 months to 16 years. Exposure to home‐related stressors (divorce or separation of parents, severe illness in family, and parental job loss) school‐related stressors (including being bullied at school, change in school, separation from the best friend at school, and failure in an examination), exposure to child maltreatments and exposure to war/civil unrest were associated with childhood constipation. Conclusions and Inferences Exposure to day‐to‐day home‐ and school‐related stressors, to child maltreatment, and to civil unrest is associated with constipation in children and adolescents. These factors need to be explored during clinical evaluation of children with constipation.

Background: The 2020 COVID-19 pandemic has placed unprecedented restrictions on children’s ability to participate in adequate movement behaviours. This international longitudinal study compared young children’s physical activity, sedentary behaviour and sleep behaviours before and during the COVID-19 pandemic.Methods: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in physical activity, sedentary behaviour (screen-time) and sleep and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). PA, sedentary screen time (SST) and sleep were assessed via parent questionnaire. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Results: 948 parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (AdjOR=2.0, 95%CI 1.0 to 3.8) and SST (2.2, CI 1.2 to 3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO recommendations (AdjOR 3.3, CI 1.1 to 9.8) than those who were not. Children of caregivers with higher compared to lower stress were less likely to meet all three guidelines (0.5, CI 0.3 to 0.9). Conclusion: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting caregivers’ mental health are important prevention strategies.