Promoting healthy movement behaviors in children under five in Europe

The SUNRISE European Study Group, led by experts in physical activity and children's health, is urgently appealing to countries across Europe to take specific measures to promote healthy movement behaviors in children aged under five years.

Under the leadership of Jesús del Pozo, an expert in the Epidemiology of Physical Activity and (children's) health and leader of the EPAFit (Epidemiology of Physical Activity and Fitness Across Lifespan) Research Group at the University of Seville and the leader of the SUNRISE study in Spain, specific actions are being taken to tackle this public health crisis.

The World Health Organization (WHO) guidelines for "24-hour movement behaviors" (physical activity (PA), sedentary behavior (SB), including screen time and sleep) in children aged under five were published in April 2019. The guidelines were developed as a response to the childhood obesity pandemic to help ensure that children under five engage in healthy levels of physical activity, screen time, and sleep.

The review and synthesis of the evidence showed that these behaviors influenced a wide range of other outcomes (cognitive, social, and emotional development; language development; cardiometabolic health; bone and skeletal health; motor development; physical fitness, growth, and well-being), and had substantial short- and long-term consequences.

Five years on, it is now time to review whether key steps have been taken in response to these guidelines across Europe and to explore ways to increase the impact of the WHO Guidelines across Europe over the next five years. The members of the SUNRISE group have published a paper in The Lancet Regional Health - Europe in which they set out their conclusions and recommendations.

The researchers acknowledge that the development of physical activity policies for school-aged children and adolescents is reasonably good across Europe, and many countries in the SUNRISE Study Group have already set physical activity guidelines for children aged under five years.

However, it is stressed that policy development in this field is inadequate and should be extended to cover sedentary behavior, including screen time and sleep. Moreover, emphasis is placed on the need for adequate policy implementation and assessment, which are often lacking.

According to experts, policy implementation must address "bottom-up" influences on movement behaviors in recognition that they are strongly influenced by the wider environment, including the physical, built, sociocultural, and political environment. It is especially crucial to address early childhood education and care settings, since they are central to developing healthy movement behaviors in children aged under five years.

The researchers insist that effective policies targeting upstream environmental influences are required to change movement behaviors among European populations equitably. The SUNRISE Study Group urges European countries to take specific actions and work together to secure a healthier and more prosperous future for children across Europe.