Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 10;17(1):16.
doi: 10.1186/s12966-020-0914-2.

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

Anne-Maree Parrish  1   2   3 , Mark S Tremblay  4 , Stephanie Carson  4 , Sanne L C Veldman  5 , Dylan Cliff  6   7   8 , Stewart Vella  6   7 , Kar Hau Chong  6   7 , Maria Nacher  7 , Borja Del Pozo Cruz  9 , Yvonne Ellis  6 , Salome Aubert  4 , Billie Spaven  6 , Mohd Jamil Sameeha  10 , Zhiguang Zhang  6   7 , Anthony D Okely  6   7   8
Affiliations

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

Anne-Maree Parrish et al. Int J Behav Nutr Phys Act. .

Erratum in

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.

Keywords: AGREE II; Adolescents; Children; Grey literature; Guideline; Movement; Physical activity; Recommendation; Sedentary behaviour; Youth.

PubMed Disclaimer

Conflict of interest statement

AMP, AO, MT, DC, KHC, ZZ, MNE, BPC, YE were involved in the Australian guideline development group; AO and MT were involved in the Canadian guideline development group MT was involved in the WHO guideline development. To address potential conflict associated with the AGREE II quality assessment relating to these countries guidelines; authors SC and SA assessed the Australian guidelines and the WHO guidelines and SC and AMP assessed the Canadian guidelines. The remaining authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of study selection
Fig. 2
Fig. 2
Map of countries with guidelines
See this image and copyright information in PMC

References

    1. Poitras VJ, Gray CE, Borghese MM, Carson V, Chaput J-P, Janssen I, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6 Suppl 3):197–239. doi: 10.1139/apnm-2015-0663. - DOI - PubMed
    1. Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput J-P, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab. 2016;41(6:Suppl 3):240–265. doi: 10.1139/apnm-2015-0630. - DOI - PubMed
    1. Liu M, Wu L, Yao S. Dose–response association of screen time-based sedentary behaviour in children and adolescents and depression: a meta-analysis of observational studies. Br J Sports Med. 2016;50(20):1252. doi: 10.1136/bjsports-2015-095084. - DOI - PMC - PubMed
    1. Blair SN, LaMonte MJ, Nichaman MZ. The evolution of physical activity recommendations: how much is enough? Am J Clin Nutr. 2004;79(5):913S–920S. doi: 10.1093/ajcn/79.5.913S. - DOI - PubMed
    1. Pate RR. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402–407. doi: 10.1001/jama.1995.03520290054029. - DOI - PubMed

Publication types