Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries

Okely A.D., Kariippanon K.E., Guan H., Taylor E.K., Suesse T., Cross P.L., Chong K.H., Suherman A., Turab A., Staiano A.E., Ha A.S., El Hamdouchi A., Baig A., Poh B.K., Del Pozo-Cruz B., Chan C.H.S., Nyström C.D., Koh D., Webster E.K., Lubree H., Tang H.K., Baddou I., Del Pozo-Cruz J., Wong J.E., Sultoni K., Nacher M., Löf M., Cui M., Hossain M.S., Chathurangana P.W.P., Kand U., Wickramasinghe V.P.P., Calleia R., Ferdous S., Van Kim T., Wang X., Draper C.E.

Early Start, School of Health and Society, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia; Department of Early Childhood Development, Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China; Early Start, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia; NIASRA – National Institute for Applied Statistics Research Australia, School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Jawa Barat, Indonesia; Precision Health Consultants (PHC Global), Karachi, Pakistan; Pennington Biomedical Research Center, 6400 Perkins Rd Baton Rouge Louisiana, Pennington, 70808, United States; Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong; Unité Mixte de Recherche Nutrition et Alimentation, CNESTEN – Université Ibn Tofail (URAC-39), Regional Designated Center of Nutrition Associated with AFRA/IAEA, Pennington, United States; Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia; Department of Sports Science and Clinical Biomechanics, Centre for Active and Healthy Ageing, University of Southern Denmark, Odense, Denmark; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183, Sweden; Centre of Community Education and Well-being, Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, 43600 UKM, Malaysia; Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA 30912, United States; Vadu Rural Health Program, KEM Hospital Research Centre, Rasta Peth, Pune, India; Department of Epidemiology, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam; Departamento de Educación Física y Deporte, Universidad de Sevilla, Sevilla, Spain; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 581 83, Sweden; Biomedical Research Foundation, Dhaka, Bangladesh; Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Witwatersrand, South Africa


Background: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children’s daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children’s movement behaviours before and during the COVID-19 pandemic. Methods: Parents of children aged 3–5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined. Results: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9). Conclusion: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents’ mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines. © 2021, The Author(s).

24-h movement behaviours; Low- and middle-income countries; Outdoors; Play; Preschool; Quarantine


BMC Public Health

Publisher: BioMed Central Ltd

Volume 21, Issue 1, Art No 940, Page – , Page Count

Journal Link:

doi: 10.1186/s12889-021-10852-3

Issn: 14712458

Type: All Open Access, Gold, Green


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