Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis

Abstract

Background The impact of declining physical activity and increased sedentary behaviour in children and adolescents globally prompted the development of national and international physical activity guidelines. This research aims to systematically identify and compare national and international physical activity guidelines for children and adolescents and appraise the quality of the guidelines to promote best practice in guideline development. Methods This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Only national, or international physical activity and/or sedentary behaviour guidelines were included in the review. Included guidelines targeted children and adolescents aged between 5 and 18 years. A grey literature search was undertaken incorporating electronic databases, custom Google search engines, targeted websites and international expert consultation. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). Results The search resulted in 50 national or international guidelines being identified. Twenty-five countries had a national guideline and there were three international guidelines (European Union, Nordic countries (used by Iceland, Norway and Sweden), World Health Organization (WHO)). Nineteen countries and the European Union adopted the WHO guidelines. Guidelines varied in relation to date of release (2008 to 2019), targeted age group, and guideline wording regarding: type, amount, duration, intensity, frequency and total amount of physical activity. Twenty-two countries included sedentary behaviour within the guidelines and three included sleep. Total scores for all domains of the AGREE II assessment for each guideline indicated considerable variability in guideline quality ranging from 25.8 to 95.3%, with similar variability in the six individual domains. Rigorous guideline development is essential to ensure appropriate guidance for population level initiatives. Conclusions This review revealed considerable variability between national/international physical activity guideline quality, development and recommendations, highlighting the need for rigorous and transparent guideline development methodologies to ensure appropriate guidance for population-based approaches. Where countries do not have the resources to ensure this level of quality, the adoption or adolopment (framework to review and update guidelines) of the WHO guidelines or guidelines of similar quality is recommended. Trial registration Review registration: PROSPERO 2017 CRD42017072558.

Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)

“…The consensus includes an overview of the current national and international physical activity guidelines for young people 39 that serve as a principal premise for the consensus, including those issued by the WHO and other leading countries. This overview is followed by a description of the objectives and processes from which the current consensus was developed.…”

Mediterranean Diet and the Emotional Well-Being of Students of the Campus of Melilla (University of Granada)

“…A healthy lifestyle is a key component in fostering healthy aging and in reducing the risk of cardiovascular events, which requires, among other aspects, participating in regular physical activity, reducing sedentary behavior, and maintaining a good quality of life [ 12 ]. Some studies [ 13 , 14 , 15 ] have connected the impact of physical activity and physical inactivity with quality of life.…”

Levels of Physical Activity during School Hours in Children and Adolescents: A Systematic Review

“…A few studies have measured the compliance rate of this recommendation and have obtained mixed results [7][8][9]. This recommendation, in fact, sets a goal in an absolute value (minutes of MVPA), and school hours are not the same in all countries [9][10][11][12] Traditionally, school leisure time (i.e., time periods of noncurricular activities in school, such as recess, breaks or lunchtime) and physical education lessons have been considered the most propitious periods to help students meet the aforementioned school-based PA recommendations [13][14][15]. For this reason, levels of PA during both periods have received considerable attention and have been the subject of prior systematic reviews [16,17].…”

“…A few studies have measured the compliance rate of this recommendation and have obtained mixed results [ 7 , 8 , 9 ]. This recommendation, in fact, sets a goal in an absolute value (minutes of MVPA), and school hours are not the same in all countries [ 9 , 10 , 11 , 12 ]…”