Stephen Whiting1,2, Marta Buoncristiano3, Peter Gelius4, Karim Abu-Omar4, Mary Pattison3, Jolanda Hyska5, Vesselka Duleva6, Sanja Musić Milanović7, Hana Zamrazilová8, Tatjana Hejgaard9, Mette Rasmussen10, Eha Nurk11, Lela Shengelia12, Cecily C Kelleher13, Mirjam M Heinen13, Angela Spinelli14, Paola Nardone14, Akbota Abildina15, Shynar Abdrakhmanova15, Gulmira Aitmurzaeva16, Zhamyila Usuopva16, Iveta Pudule17, Aušra Petrauskiene18, Victoria Farrugia Sant'Angelo19, Enisa Kujundzic20, Stevo Popovic21, Anne-Siri Fismen22, Ingunn Holden Bergh23, Anna Fijalkowska24, Ana Isabel Rito25, Alexandra Cucu26, Lacramioara Aurelia Brinduse27, Valentina Peterkova28, Andrea Gualtieri29, Marta García-Solano30, Enrique Gutiérrez-González30, Zulfinissio Abdurrahmonova31, Khadichamo Boymatova32, Nazan Yardim33, Maya Tanrygulyyeva34, Daniel Weghuber35, Karin Schindler36, Dragana Stojisavljević37, Aida Filipović Hadžiomeragić38, Eliza Markidou Ionnaidu39, Wolfgang Ahrens40, Maria Hassapidou41, Viktoria Anna Kovacs42, Sergej M Ostojic43, Lubica Ticha44, Gregor Starc45, Kenisha Russell Jonsson46, Igor Spiroski47, Harry Rutter48, Romeu Mendes3,49, Julianne Williams3, Ivo Rakovac3, João Breda3. 1. WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation, whitings@who.int. 2. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, whitings@who.int. 3. WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation. 4. Department of Sport Science and Sport, FAU, Erlangen, Germany. 5. Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania. 6. National Center of Public Health and Analyses, Sofia, Bulgaria. 7. School of Medicine, University of Zagreb, Croatian Institute of Public Health, Zagreb, Croatia. 8. Institute of Endocrinology, Obesity Management Centre, Prague, Czechia. 9. Danish Health Authority, Copenhagen, Denmark. 10. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 11. National Institute for Health Development, Tallinn, Estonia. 12. National Center for Disease Control and Public Health, Tbilisi, Georgia. 13. National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland. 14. Italian National Institute of Health, Rome, Italy. 15. National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan. 16. Republican Centre for Health Promotion, Bishkek, Kyrgyzstan. 17. Ministry of Health, Centre for Disease Prevention and Control, Riga, Latvia. 18. Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine, Kaunas, Lithuania. 19. Primary Health Care, Floriana, Malta. 20. Institute of Public Health of Montenegro, Podgorica, Montenegro. 21. Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro. 22. Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway. 23. Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway. 24. Department of Cardiology, Institute of Mother and Child, Warsaw, Poland. 25. National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal. 26. National Institute of Public Health, Bucharest, Romania. 27. University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. 28. The Endocrine Research Centre, Moscow, Russian Federation. 29. Health Authority San Marino, San Marino, San Marino. 30. Spanish Agency for Food Safety and Nutrition, Ministry of Health, Madrid, Spain. 31. Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Duschanbe, Tajikistan. 32. WHO Tajikistan Country Office, Dushanbe, Duschanbe, Tajikistan. 33. Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution, Ankara, Turkey. 34. Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan. 35. Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria. 36. Medical University of Vienna, Vienna, Austria. 37. Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina. 38. Institute of Public Health of Federation of Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina. 39. Ministry of Health, Limassol, Cyprus. 40. Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Institute of Statistics, University of Bremen, Bremen, Germany. 41. International Hellenic University, Thessaloniki, Greece. 42. Hungarian School Sport Federation, Budapest, Hungary. 43. Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia. 44. National Institute of Children Diseases, Medical Faculty of Comenius University, Bratislava, Slovakia. 45. Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia. 46. Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden. 47. Department of Physiology and Monitoring of Nutrition, Institute of Public Health, Skopje, North Macedonia. 48. Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom. 49. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
Abstract
BACKGROUND: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. OBJECTIVES: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). METHOD: The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. RESULTS: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night. CONCLUSIONS: The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.
BACKGROUND:Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. OBJECTIVES: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). METHOD: The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. RESULTS: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night. CONCLUSIONS: The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.
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