Study shatters myths: Toddlers, including those with health issues, exceed WHO physical activity standards

By Dr. Chinta SidharthanMay 30 2023Reviewed by Benedette Cuffari, M.Sc.

In a recent study published in EClinicalMedicine, researchers investigate the association between physical activity levels in young children and their development, socio-behavioral characteristics, and quality of life.

Study: Physical activity in young children across developmental and health states: the ActiveCHILD study. Image Credit: spass / Shutterstock.com

Background

The health and biopsychosocial well-being of children is closely related to their physical activity levels. In fact, this association has been widely recognized in various health guidelines, including those published by the World Health Organization (WHO).

However, studies show that children’s activity levels start declining as early as when they begin school, with few interventions currently available to address this decline in physical activity levels. Furthermore, some of the gaps in the research on physical activity levels in children include a reliance on parental reports of children’s activity levels rather than quantitative assessments using wearable devices that provide more precise measurements.

Children with health or developmental problems are often not included in the assessments of physical activity, thus resulting in them being studied separately and not being included in population-level surveys and guidelines. Such differential treatment of young children with health and developmental problems can perpetuate inequalities in health guidelines and policies.

About the study

In the present study, researchers report the results of the ActiveCHILD study, which investigated the everyday health behavior of physical activity and movement in young children, irrespective of health status and development. The researchers discussed the patterns and physical activity levels of children between the ages of one and three years, as well as the association between physical activity levels and socio-behavior, development, and overall quality of life.

Longitudinal data were collected for children between the ages of one and three years enrolled in the ActiveCHILD study, recruited from 13 National Health Service organizations in the United Kingdom. Best practice guidelines, including supporting the child’s right to make their own decisions about participating or contributing, enabling them to make informed decisions and sensitivity to the child’s choice to not participate, were followed during the study.

A waist-worn accelerometer was used to collect physical activity data every week from the enrolled participants between July 2017 and August 2018. Validated questionnaires were used to collect information on child development, sociodemographic factors, health-related quality of life of the child, and actions of parents, while health records were used to obtain data on the health of the child.

Height and weight data were used to calculate the body mass index (BMI), while the postcode of the area of residence was obtained to assign ranks related to the Index of Multiple Deprivation. Environmental data, including proximity to a safe outdoor play area and weather data for the area, were also obtained.

All children appear to meet physical activity recommendations

Children between the ages of one and three years regularly met recommended physical activity requirements and levels. Notably, the findings also contradicted the notion that children with health and developmental problems should be subjected to lower expectations regarding physical activity levels as compared to their peers who do not have developmental or health-related problems.

The study included 282 children, and the data covered all indices of multiple deprivation. The physical activity level patterns showed two peaks a day, with 6.44 hours spent doing physical activity of any intensity and 2.78 hours spent on very high levels of physical activity, as recommended by the WHO.

While mobility was the major predictor of intense and total physical activity levels, going outdoors was also one of the main predictors of physical activity levels among children. However, the physical activity levels of children were not associated with their overall health-related quality of life. Likewise, education levels were not associated with the physical activity levels of the participants.

Although other studies have reported that children with developmental problems might not perform similar levels of movement or physical activity as their developmentally unchallenged peers, the study findings indicate that, given the opportunity to be active, children with developmental problems might achieve physical activity levels that exceed current expectations.

Conclusions

Young children between the ages of one and three years were found to meet the WHO recommended standards of physical activity daily, with children with developmental and health problems exceeding current expectations of physical activity levels. These results highlight the need for inclusive expectations and uniform ambitions to promote universal participation in physical activities among children.