Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Mark S Tremblay; Valerie Carson; Jean-Philippe Chaput; Sarah Connor Gorber; Thy Dinh; Mary Duggan; Guy Faulkner; Casey E Gray; Reut Gruber; Katherine Janson; Ian Janssen; Peter T Katzmarzyk; Michelle E Kho; Amy E Latimer-Cheung; Claire LeBlanc; Anthony D Okely; Timothy Olds; Russell R Pate; Andrea Phillips; Veronica J Poitras; Sophie Rodenburg; Margaret Sampson; Travis J Saunders; James A Stone; Gareth Stratton; Shelly K Weiss; Lori Zehr

doi:10.1139/apnm-2016-0151

Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Appl Physiol Nutr Metab. 2016 Jun;41(6 Suppl 3):S311-27. doi: 10.1139/apnm-2016-0151.

Authors

Mark S Tremblay^{1

2}, Valerie Carson³, Jean-Philippe Chaput^{1

2}, Sarah Connor Gorber⁴, Thy Dinh⁵, Mary Duggan⁶, Guy Faulkner⁷, Casey E Gray¹, Reut Gruber⁸, Katherine Janson⁹, Ian Janssen^{10

11}, Peter T Katzmarzyk¹², Michelle E Kho¹³, Amy E Latimer-Cheung^{1

10}, Claire LeBlanc¹⁴, Anthony D Okely¹⁵, Timothy Olds¹⁶, Russell R Pate¹⁷, Andrea Phillips¹⁸, Veronica J Poitras¹, Sophie Rodenburg¹⁸, Margaret Sampson¹, Travis J Saunders¹⁹, James A Stone²⁰, Gareth Stratton²¹, Shelly K Weiss²², Lori Zehr^{6

23}

Affiliations

¹ a Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.
² b Department of Pediatrics, University of Ottawa, ON K1H 8L1, Canada.
³ c Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada.
⁴ d Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada.
⁵ e The Conference Board of Canada, Ottawa, ON K1H 8M7, Canada.
⁶ f Canadian Society for Exercise Physiology, Ottawa, ON K1R 6Y6, Canada.
⁷ g School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
⁸ h Attention, Behavior, and Sleep Laboratory, Douglas Mental Health University Institute, Verdun, QC H4H 1R3, Canada.
⁹ i ParticipACTION, Toronto, ON M5S 1M2, Canada.
¹⁰ j School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.
¹¹ k Department of Public Health Sciences, Queen's University, Kingston, ON K7L 3N6, Canada.
¹² l Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
¹³ m School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada.
¹⁴ n Department of Pediatrics, McGill University, Montreal, QC H4A 3J1, Canada.
¹⁵ o Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales 2522, Australia.
¹⁶ p Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute of Health Research, University of South Australia, Adelaide 5001, Australia.
¹⁷ q Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
¹⁸ r No affiliation.
¹⁹ s Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada.
²⁰ t Cardiovascular Health and Stroke Strategic Clinical Network, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
²¹ u Applied Sport Technology Exercise and Medicine Research Centre, College of Engineering, Swansea University, Wales, SA2 8PP, UK.
²² v Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada.
²³ w Camosun College, Victoria, BC V9E 2C1, Canada.

PMID: 27306437
DOI: 10.1139/apnm-2016-0151

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.

Keywords: GRADE; clinical practice guidelines; directives pour la pratique clinique; exercice physique; exercise; healthy living; lifestyle; mode de vie; public health; recommandations; recommendations; santé publique; vie saine.

MeSH terms

Adolescent
Adolescent Behavior
Canada
Child
Child Behavior
Child, Preschool
Cross-Sectional Studies
Exercise*
Focus Groups
Guidelines as Topic*
Health Behavior
Humans
Sedentary Behavior*
Sleep*