Du Chenglin, Xu Minjie, Yang Xi, Wang Haoyu, Tong Yanxu, Hou Sen
Physical Education Department, Northeastern University, Shenyang, China.
Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China.
Eur J Pediatr. 2025 Jul 14;184(8):479. doi: 10.1007/s00431-025-06308-0.
Adherence to the 24-h Movement Guidelines (physical activity [PA], screen time [ST], and sleep duration) has been associated with positive health outcomes. However, meta-analyses on overall adherence to these guidelines among children remain limited. This study aimed to report children's adherence to the 24-h Movement Guidelines. Six databases were searched in November 2023, with an update conducted in April 2025. The review followed the PRISMA framework and included studies reporting the prevalence of adherence to the 24-h Movement Guidelines among children aged 5 to 13. A random-effects model was used to pool prevalence rates across studies. Subgroup analyses were conducted using sex, geographical region, and measurement method. Heterogeneity was assessed using the I statistic. This meta-analysis of 29 studies involving 126,129 children aged 5 to 13 revealed a low overall adherence rate of 10.4% (95% CI 8.8-12.0%) among children meeting all three 24-h Movement Guidelines. Subgroup analysis revealed lower adherence in girls (10.0%, 95% CI 6.9-13.1%) than in boys (13.2%, 95% CI 8.9-17.6%). Regarding geographical regions, South America (5.6%, 95% CI 1.3-9.9%) and Asia (6.8%, 95% CI 5.3-8.3%) showed lower adherence rates. For measurement methods, adherence was higher in device-measured (11.9%, 95% CI 8.8-14.9%) than self-reported (8.4%, 95% CI 6.5-10.3%).
These findings highlight the need for sex- and region-specific strategies to promote adequate PA, reduce ST, and ensure sufficient sleep among children. Future research should consider measurement methods when designing interventions to improve adherence to the 24-h Movement Guidelines.
PROSPERO (CRD42024552497) What is known: • Many studies have examined adherence to the 24-h Movement Guidelines among school-aged children. However, a systematic review and meta-analysis of the existing evidence are still lacking.
• Subgroup analyses by sex showed lower adherence in girls than in boys, while analyses by geographic region revealed particularly low adherence in South America and Asia. Moreover, studies using device measures yielded higher adherence estimates than those using self-reports.
坚持24小时运动指南（身体活动[PA]、屏幕时间[ST]和睡眠时间）与积极的健康结果相关。然而，关于儿童对这些指南的总体依从性的荟萃分析仍然有限。本研究旨在报告儿童对24小时运动指南的依从情况。2023年11月检索了六个数据库，并于2025年4月进行了更新。该综述遵循PRISMA框架，纳入了报告5至13岁儿童对24小时运动指南依从率的研究。采用随机效应模型汇总各研究的患病率。使用性别、地理区域和测量方法进行亚组分析。使用I统计量评估异质性。这项对29项研究（涉及126129名5至13岁儿童）的荟萃分析显示，在符合所有三项24小时运动指南的儿童中，总体依从率较低，为10.4%（95%CI 8.8 - 12.0%）。亚组分析显示，女孩的依从率（10.0%，95%CI 6.9 - 13.1%）低于男孩（13.2%，95%CI 8.9 - 17.6%）。在地理区域方面，南美洲（5.6%，95%CI 1.3 - 9.9%）和亚洲（6.8%，95%CI 5.3 - 8.3%）的依从率较低。对于测量方法，通过设备测量的依从率（11.9%，95%CI 8.8 - 14.9%）高于自我报告的依从率（8.4%，95%CI 6.5 - 10.3%）。
这些发现凸显了制定针对性别和地区的策略以促进儿童进行适当的身体活动、减少屏幕时间并确保充足睡眠的必要性。未来的研究在设计干预措施以提高对24小时运动指南的依从性时应考虑测量方法。
PROSPERO（CRD42024552497）已知信息：• 许多研究调查了学龄儿童对24小时运动指南的依从情况。然而，仍然缺乏对现有证据的系统评价和荟萃分析。
• 按性别进行的亚组分析显示女孩的依从率低于男孩，而按地理区域进行的分析显示南美洲和亚洲的依从率特别低。此外，使用设备测量的研究得出的依从性估计值高于使用自我报告的研究。
