. 2017 Nov 20;17(Suppl 5):874.

doi: 10.1186/s12889-017-4859-6.

Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Mark S Tremblay¹, Jean-Philippe Chaput², Kristi B Adamo³, Salomé Aubert², Joel D Barnes², Louise Choquette⁴, Mary Duggan⁵, Guy Faulkner⁶, Gary S Goldfield², Casey E Gray², Reut Gruber⁷, Katherine Janson⁸, Ian Janssen⁹, Xanne Janssen¹⁰, Alejandra Jaramillo Garcia¹¹, Nicholas Kuzik¹², Claire LeBlanc¹³, Joanna MacLean¹⁴, Anthony D Okely¹⁵, Veronica J Poitras², Mary-Ellen Rayner¹⁶, John J Reilly¹⁰, Margaret Sampson^{2

17}, John C Spence¹², Brian W Timmons¹⁸, Valerie Carson¹²

Affiliations

¹ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. mtremblay@cheo.on.ca.
² Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
³ School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 1A2, Canada.
⁴ Best Start Resource Centre, Health Nexus, Toronto, ON, M5G 1Z8, Canada.
⁵ Canadian Society for Exercise Physiology, Ottawa, ON, K1R 6Y6, Canada.
⁶ School of Kinesiology, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
⁷ Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, H3A 1A1, Canada.
⁸ ParticipACTION, Toronto, ON, M5S 1M2, Canada.
⁹ School of Kinesiology and Health Studies, and Department of Community Health and Epidemiology, Queen's University, Kingston, ON, K7L 3N6, Canada.
¹⁰ University of Strathclyde, School of Psychological Science and Health, Glasgow, Scotland, G1 1QE, UK.
¹¹ Public Health Agency of Canada, Ottawa, ON, K1A 0K9, Canada.
¹² Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada.
¹³ Montreal Children's Hospital, Montreal, QC, H3H 1P3, Canada.
¹⁴ Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
¹⁵ Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
¹⁶ The Sandbox Project, Toronto, ON, M5C 2C5, Canada.
¹⁷ Library Services, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada.
¹⁸ Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON, L8S 4K1, Canada.

PMID: 29219102
PMCID: PMC5773896
DOI: 10.1186/s12889-017-4859-6

Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Mark S Tremblay et al. BMC Public Health. 2017.

. 2017 Nov 20;17(Suppl 5):874.

doi: 10.1186/s12889-017-4859-6.

Authors

Affiliations

¹ Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. mtremblay@cheo.on.ca.
² Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
³ School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 1A2, Canada.
⁴ Best Start Resource Centre, Health Nexus, Toronto, ON, M5G 1Z8, Canada.
⁵ Canadian Society for Exercise Physiology, Ottawa, ON, K1R 6Y6, Canada.
⁶ School of Kinesiology, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
⁷ Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, H3A 1A1, Canada.
⁸ ParticipACTION, Toronto, ON, M5S 1M2, Canada.
⁹ School of Kinesiology and Health Studies, and Department of Community Health and Epidemiology, Queen's University, Kingston, ON, K7L 3N6, Canada.
¹⁰ University of Strathclyde, School of Psychological Science and Health, Glasgow, Scotland, G1 1QE, UK.
¹¹ Public Health Agency of Canada, Ottawa, ON, K1A 0K9, Canada.
¹² Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada.
¹³ Montreal Children's Hospital, Montreal, QC, H3H 1P3, Canada.
¹⁴ Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
¹⁵ Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
¹⁶ The Sandbox Project, Toronto, ON, M5C 2C5, Canada.
¹⁷ Library Services, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada.
¹⁸ Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON, L8S 4K1, Canada.

PMID: 29219102
PMCID: PMC5773896
DOI: 10.1186/s12889-017-4859-6

Abstract

Background: The Canadian Society for Exercise Physiology convened representatives of national organizations, research experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day (24-h period).

Methods: The development process was guided by the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Four systematic reviews (physical activity, sedentary behaviour, sleep, combined behaviours) examining the relationships within and among movement behaviours and several health indicators were completed and interpreted by a Guideline Development Panel. The systematic reviews that were conducted to inform the development of the guidelines, and the framework that was applied to develop the recommendations, followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Complementary compositional analyses were performed using data from the Canadian Health Measures Survey to examine the relationships between movement behaviours and indicators of adiposity. A review of the evidence on the cost effectiveness and resource use associated with the implementation of the proposed guidelines was also undertaken. A stakeholder survey (n = 546), 10 key informant interviews, and 14 focus groups (n = 92 participants) were completed to gather feedback on draft guidelines and their dissemination.

Results: The guidelines provide evidence-informed recommendations as to the combinations of light-, moderate- and vigorous-intensity physical activity, sedentary behaviours, and sleep that infants (<1 year), toddlers (1-2 years) and preschoolers (3-4 years) should achieve for a healthy day (24 h). Proactive dissemination, promotion, implementation, and evaluation plans were prepared to optimize uptake and activation of the new guidelines.

Conclusions: These guidelines represent a sensible evolution of public health guidelines whereby optimal health is framed within the balance of movement behaviours across the whole day, while respecting preferences of end-users. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed.

Keywords: Adiposity; Cognitive development; Guideline development; Infants; Motor development; Preschoolers; Public health; Recommendations; Toddlers.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained for the stakeholder survey, key informant interviews and focus groups as described in the manuscript.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 1**
Timelines and sequence of events involved in the development of the *Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep*

**Fig. 2**
Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): *An Integration of Physical Activity, Sedentary Behaviour, and Sleep* – English Preamble. © Canadian Society for Exercise Physiology, 2017. All rights reserved

**Fig. 3**
Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): *An Integration of Physical Activity, Sedentary Behaviour, and Sleep* – English Guidelines. © Canadian Society for Exercise Physiology, 2017. All rights reserved

**Fig. 4**
Directives canadiennes en matière de mouvement sur 24 heures pour les enfants de 0 à 4 ans: *une approche intégrée regroupant l’activité physique, le comportement sédentaire et le sommeil* - French Preamble. © Société canadienne de physiologie de l'exercice, 2017. Tous les droits sont réservés

**Fig. 5**
Directives canadiennes en matière de mouvement sur 24 heures pour les enfants de 0 à 4 ans: *une approche intégrée regroupant l’activité physique, le comportement sédentaire et le sommeil* - French Guidelines. © Société canadienne de physiologie de l'exercice, 2017. Tous les droits sont réservés

See this image and copyright information in PMC

References

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Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Affiliations

Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Molecular Biology Databases