Background: Physical inactivity is a leading risk factor for global mortality and a contributor to the increase in overweight and obesity. The Commission on Ending Childhood Obesity identified the need for guidance on physical activity, particularly for early childhood (<5 y), a period of rapid physical and cognitive development. Methods: The World Health Organization (WHO) has developed the first global guidelines on physical activity, sedentary, and sleep behaviors, building upon high-quality systematic reviews. The WHO guideline process is a rigorous, systematic, and transparent method for the development of recommendations, using the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework. It takes into consideration the strength of the evidence as well as values and preferences, benefits and harms, equity and human rights. Results: The authors summarize the first global guidelines on time spent in physical activity, sedentary behavior (including screen time and time spent restrained), and sleep patterns in infants (birth to 1 y of age), toddlers (1–2.9 y of age), and preschoolers (3–4.9 y of age). Conclusions: WHO is actively disseminating and supporting implementation of these guidelines by national adoption and adaptation, through links with early childhood development and the Global Action Plan on Physical Activity 2018–2030.
Juana Willumsen and Fiona Bull
Paddy C. Dempsey, Christine M. Friedenreich, Michael F. Leitzmann, Matthew P. Buman, Estelle Lambert, Juana Willumsen, and Fiona Bull
Background: In 2020, the World Health Organization (WHO) released global guidelines on physical activity (PA) and sedentary behavior, for the first time providing population-based recommendations for people living with selected chronic conditions. This article briefly presents the guidelines, related processes and evidence, and, importantly, considers how they may be used to support research, practice, and policy. Methods: A brief overview of the scope, agreed methods, selected chronic conditions (adults living with cancer, hypertension, type 2 diabetes, and human immunodeficiency virus), and appraisal of systematic review evidence on PA/sedentary behavior is provided. Methods were consistent with World Health Organization protocols for developing guidelines. Results: Moderate to high certainty evidence (varying by chronic condition and outcome examined) supported that PA can reduce the risk of disease progression or premature mortality and improve physical function and quality of life in adults living with chronic conditions. Direct evidence on sedentary behavior was lacking; however, evidence extrapolated from adult populations was considered applicable, safe, and likely beneficial (low certainty due to indirectness). Conclusions: Clinical and public health professionals and policy makers should promote the World Health Organization 2020 global guidelines and develop and implement services and programs to increase PA and limit sedentary behavior in adults living with chronic conditions.
Areekul Amornsriwatanakul, Kasem Nakornkhet, Piyawat Katewongsa, Chairat Choosakul, Tippawan Kaewmanee, Kurusart Konharn, Atchara Purakom, Anoma Santiworakul, Patraporn Sitilertpisan, Sonthaya Sriramatr, Araya Yankai, Michael Rosenberg, and Fiona C. Bull
Physical activity (PA) is recognized as one of the core modifiable risk factors of noncommunicable diseases. However, little is known about PA in the Thai population, particularly in children. The report card (RC) project provided Thailand with an opportunity to assess PA behaviors in children. This paper summarizes the methodology, grading process, and the final grades of the Thai RC.
A school-based survey was conducted to collect data from a nationally representative sample of children aged 6 to 17 years. Survey results provided the primary source for the RC. Nine indicators were graded using the Global Matrix 2.0 framework. Grading was undertaken by a national committee comprising experts from key stakeholders.
Grades ranged from F to B. Overall PA and Sedentary Behaviors both received the grade D-. Organized Sport Participation scored a C. Active Play scored the grade F. Active Transport and support from Family and Peers were both graded B. School, Community, and Government indicators were scored C.
In Thai children, participation in PA and active play is very low; conversely, sedentary behaviors are high. These first data on patterns of activity for the Thailand RC will serve to guide national actions and advocacy aimed at increasing PA in children.
Catherine Carty, Hidde P. van der Ploeg, Stuart J.H. Biddle, Fiona Bull, Juana Willumsen, Lindsay Lee, Kaloyan Kamenov, and Karen Milton
Background: The World Health Organization has released the first global public health guidelines on physical activity and sedentary behavior for people living with disability. This paper presents the guidelines, related processes, and evidence, and elaborates upon how the guidelines can support inclusive policy, practice, and research. Methods: Methods were consistent with the World Health Organization protocols for developing guidelines. Systematic reviews of the evidence on physical activity for health for people living with disability were appraised, along with a consideration of the evidence used to inform the general 2020 World Health Organization guidelines. Results: Evidence supported the development of recommendations for people living with disability, stressing that there are no major risks to engaging in physical activity appropriate to an individual’s current activity level, health status, and physical function, and that the health benefits accrued generally outweigh the risks. They also emphasize the benefits of limiting sedentary behavior. Conclusions: The guidelines mark a positive step forward for disability inclusion, but considerable effort is needed to advance the agenda. This paper highlights key considerations for the implementation of the new recommendations for people living with disability, in line with the human rights agenda underpinning the Global Action Plan on Physical Activity 2018–2030 and allied policies.