Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries: An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017

Stephen Whiting; Marta Buoncristiano; Peter Gelius; Karim Abu-Omar; Mary Pattison; Jolanda Hyska; Vesselka Duleva; Sanja Musić Milanović; Hana Zamrazilová; Tatjana Hejgaard; Mette Rasmussen; Eha Nurk; Lela Shengelia; Cecily C. Kelleher; Mirjam M. Heinen; Angela Spinelli; Paola Nardone; Akbota Abildina; Shynar Abdrakhmanova; Gulmira Aitmurzaeva; Zhamyila Usuopva; Iveta Pudule; Aušra Petrauskiene; Victoria Farrugia Sant'Angelo; Enisa Kujundzic; Stevo Popovic; Anne Siri Fismen; Ingunn Holden Bergh; Anna Fijalkowska; Ana Isabel Rito; Alexandra Cucu; Lacramioara Aurelia Brinduse; Valentina Peterkova; Andrea Gualtieri; Marta García-Solano; Enrique Gutiérrez-González; Zulfinissio Abdurrahmonova; Khadichamo Boymatova; Nazan Yardim; Maya Tanrygulyyeva; Daniel Weghuber; Karin Schindler; Dragana Stojisavljević; Aida Filipović Hadžiomeragić; Eliza Markidou Ionnaidu; Wolfgang Ahrens; Maria Hassapidou; Viktoria Anna Kovacs; Sergej M. Ostojic; Lubica Ticha; Gregor Starc; Kenisha Russell Jonsson; Igor Spiroski; Harry Rutter; Romeu Mendes; Julianne Williams; Ivo Rakovac; João Breda

doi:10.1159/000511263

Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries: An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017

Stephen Whiting, Marta Buoncristiano, Peter Gelius, Karim Abu-Omar, Mary Pattison, Jolanda Hyska, Vesselka Duleva, Sanja Musić Milanović, Hana Zamrazilová, Tatjana Hejgaard, Mette Rasmussen, Eha Nurk, Lela Shengelia, Cecily C. Kelleher, Mirjam M. Heinen, Angela Spinelli, Paola Nardone, Akbota Abildina, Shynar Abdrakhmanova, Gulmira AitmurzaevaZhamyila Usuopva, Iveta Pudule, Aušra Petrauskiene, Victoria Farrugia Sant'Angelo, Enisa Kujundzic, Stevo Popovic, Anne Siri Fismen, Ingunn Holden Bergh, Anna Fijalkowska, Ana Isabel Rito, Alexandra Cucu, Lacramioara Aurelia Brinduse, Valentina Peterkova, Andrea Gualtieri, Marta García-Solano, Enrique Gutiérrez-González, Zulfinissio Abdurrahmonova, Khadichamo Boymatova, Nazan Yardim, Maya Tanrygulyyeva, Daniel Weghuber, Karin Schindler, Dragana Stojisavljević, Aida Filipović Hadžiomeragić, Eliza Markidou Ionnaidu, Wolfgang Ahrens, Maria Hassapidou, Viktoria Anna Kovacs, Sergej M. Ostojic, Lubica Ticha, Gregor Starc, Kenisha Russell Jonsson, Igor Spiroski, Harry Rutter, Romeu Mendes, Julianne Williams, Ivo Rakovac, João Breda

Research output: Contribution to journal › Article › peer-review

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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.

Original language	English
Pages (from-to)	32–44
Journal	Obesity Facts
Volume	14
Issue number	1
Early online date	22 Dec 2020
DOIs	https://doi.org/10.1159/000511263
Publication status	Published - 1 Mar 2021

Bibliographical note

Publisher Copyright:
© 2020

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Funding

Ethics approval was provided by the following countries: Albania (Scientific Committee of Institute of Public Health, decision No. 953, 13/07/2015), Bulgaria (Commission of Medical Ethics at the National Center of Public Health and Analyses, Sofia, Bulgaria, Project identification code – 060 – MΠ 325 -68 COSI, 25.02.2016), Croatia (Ethics Committee of the Croatian Institute for Public Health, registry No. 80–2660/1–15, 25.9.2015), Czechia (Ethics Committee of the Institute of Endocrinology, Prague, Czech Republic, AZV MZČR 17–31670 A, 20/06/2016), Denmark (Research and Innovation Organization, SDU, 10.829, 27/06/2016), Estonia (Tallinn Medical Research Ethics Committee, TMEK decision No. 1376, 28/03/2016), Georgia (Bioethics Council at National Center for Disease Control and Public Health of Georgia, project identification code: 2019–52, 4 November, 2019), Ireland (University College Dublin Human Research Ethics Committee – Sciences, Project identification code: LS-15–43-Heinen-Kelleher, date of approval: 26 August 2015), Italy (National Institute of Health, Prot. PRE – 739/15, 10 November 2015), Kazakhstan (Scientific and technical program “Development and implementation of modern technologies for healthy lifestyle promotion and prevention of diseases based on the study of non-medical determinants of health among children,” 2015), Kyrgyzstan (The Ethics Committee on compliance of research to ethical norms for medical research, project identification code: No. 1/1, Date of approval: 22 February 2018), Latvia (Central Medical Ethics Committee, project identification code: 01–29.1/6, date of approval: 25.09.2015), Lithuania (Lithuanian Bioethics Committee (Lietuvos bioetikos komitetas); project identification code: 08–02–19; 19 February, 2008. After the approval we received renewal of a bioethics authorization in 2010 (on 2010–01–04), 2013 (on 2013–01–09) and 2019 (on 2019–03–12), Montenegro (Ethics Committee of the Institute of Public Health of Montenegro Project identification code: WHO 2016/627456–0, date of approval: 28th April 20), Poland (Bioethics Committee of the Institute of Mother and Child, Warsaw, Poland, project identification No. 22/2015, date of approval: 26 November 2015), Portugal (National Commission of Data Protection; Aut n°5418/2016 for all rounds of COSI Portugal, 7 June 2016), Romania (Intern Ethics Committee of the National Institute of Public Health, Romania , project identification code: WHO 2016/650301– 0, date of approval: 6 April 2016), Russian Federation (National Institute of Health., Prot. PRE – 739/15, November 2015 National Institute of Health, Prot. PRE – 739/15, November 2015), Tajikistan (Ministry of Health and Social Protection of Tajikistan, project identification code: #858, date of approval: 18 November 2016), Turkey (Kecioren Training and Research Hospital, Clinical Researches Ethics Committee; approval date: 26.10.2016, project identification code: Health System Strengthening and Support Project, LN: 8531-TR, date of approval 2015: L.2.12. Obesity Fighting Project, subcomponent 1.1, L.2.11). In Turkmenistan, ethics approval was granted from the Ministry of Healthcare and Medical Industry (MOHMI). Malta did not go through an ethics committee as all the work involved in COSI data collection and analysis is part and parcel of the existing School Health Service, which is an ongoing process. Data for COSI in Spain was collected as part of the ALADINO Spanish study, which did not ask for an ethics committee approval, since this is not mandatory in Spain. However, the principal investigators confirm that the study was conducted in accordance with the Declaration of Helsinki and all parents/guardians of subjects participating in the 4 rounds gave their informed consent for inclusion before they participated in the study. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the following countries was made possible through funding. Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children” (the Millennium Development Goals Achievement Fund) and the Institute of Public Health; Bulgaria: Ministry of Health, National Centre of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: grants AZV MZČR 17–31670 A and MZČR – RVO EÚ 00023761; Denmark: Danish Ministry of Health; Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42–2), WHO Country Office, and National Institute for Health Development; France: Sante Publique France, the French Agency for Public Health; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: WHO; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; San Marino: Health Ministry, Educational Ministry, Social Security Institute and Health Authority; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and the World Bank.

Keywords

Active play
Active transport
Physical inactivity
Sedentary behaviour
Surveillance

ASJC Scopus subject areas

Health(social science)
Physiology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1159/000511263Licence: CC BY-NC

Whiting et al 2020_Physical activity, screen time and sleep of children aged 6-9 in EuropeFinal published version, 388 KB

Cite this

Whiting, S., Buoncristiano, M., Gelius, P., Abu-Omar, K., Pattison, M., Hyska, J., Duleva, V., Musić Milanović, S., Zamrazilová, H., Hejgaard, T., Rasmussen, M., Nurk, E., Shengelia, L., Kelleher, C. C., Heinen, M. M., Spinelli, A., Nardone, P., Abildina, A., Abdrakhmanova, S., ... Breda, J. (2021). Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries: An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017. Obesity Facts, 14(1), 32–44. https://doi.org/10.1159/000511263

Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries: An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017. / Whiting, Stephen; Buoncristiano, Marta; Gelius, Peter et al.
In: Obesity Facts, Vol. 14, No. 1, 01.03.2021, p. 32–44.

Research output: Contribution to journal › Article › peer-review

Whiting, S, Buoncristiano, M, Gelius, P, Abu-Omar, K, Pattison, M, Hyska, J, Duleva, V, Musić Milanović, S, Zamrazilová, H, Hejgaard, T, Rasmussen, M, Nurk, E, Shengelia, L, Kelleher, CC, Heinen, MM, Spinelli, A, Nardone, P, Abildina, A, Abdrakhmanova, S, Aitmurzaeva, G, Usuopva, Z, Pudule, I, Petrauskiene, A, Sant'Angelo, VF, Kujundzic, E, Popovic, S, Fismen, AS, Bergh, IH, Fijalkowska, A, Rito, AI, Cucu, A, Brinduse, LA, Peterkova, V, Gualtieri, A, García-Solano, M, Gutiérrez-González, E, Abdurrahmonova, Z, Boymatova, K, Yardim, N, Tanrygulyyeva, M, Weghuber, D, Schindler, K, Stojisavljević, D, Filipović Hadžiomeragić, A, Markidou Ionnaidu, E, Ahrens, W, Hassapidou, M, Kovacs, VA, Ostojic, SM, Ticha, L, Starc, G, Russell Jonsson, K, Spiroski, I, Rutter, H, Mendes, R, Williams, J, Rakovac, I & Breda, J 2021, 'Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries: An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017', Obesity Facts, vol. 14, no. 1, pp. 32–44. https://doi.org/10.1159/000511263

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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. ",

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doi = "10.1159/000511263",

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T1 - Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries

T2 - An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017

AU - Whiting, Stephen

AU - Buoncristiano, Marta

AU - Gelius, Peter

AU - Abu-Omar, Karim

AU - Pattison, Mary

AU - Hyska, Jolanda

AU - Duleva, Vesselka

AU - Musić Milanović, Sanja

AU - Zamrazilová, Hana

AU - Hejgaard, Tatjana

AU - Rasmussen, Mette

AU - Nurk, Eha

AU - Shengelia, Lela

AU - Kelleher, Cecily C.

AU - Heinen, Mirjam M.

AU - Spinelli, Angela

AU - Nardone, Paola

AU - Abildina, Akbota

AU - Abdrakhmanova, Shynar

AU - Aitmurzaeva, Gulmira

AU - Usuopva, Zhamyila

AU - Pudule, Iveta

AU - Petrauskiene, Aušra

AU - Sant'Angelo, Victoria Farrugia

AU - Kujundzic, Enisa

AU - Popovic, Stevo

AU - Fismen, Anne Siri

AU - Bergh, Ingunn Holden

AU - Fijalkowska, Anna

AU - Rito, Ana Isabel

AU - Cucu, Alexandra

AU - Brinduse, Lacramioara Aurelia

AU - Peterkova, Valentina

AU - Gualtieri, Andrea

AU - García-Solano, Marta

AU - Gutiérrez-González, Enrique

AU - Abdurrahmonova, Zulfinissio

AU - Boymatova, Khadichamo

AU - Yardim, Nazan

AU - Tanrygulyyeva, Maya

AU - Weghuber, Daniel

AU - Schindler, Karin

AU - Stojisavljević, Dragana

AU - Filipović Hadžiomeragić, Aida

AU - Markidou Ionnaidu, Eliza

AU - Ahrens, Wolfgang

AU - Hassapidou, Maria

AU - Kovacs, Viktoria Anna

AU - Ostojic, Sergej M.

AU - Ticha, Lubica

AU - Starc, Gregor

AU - Russell Jonsson, Kenisha

AU - Spiroski, Igor

AU - Rutter, Harry

AU - Mendes, Romeu

AU - Williams, Julianne

AU - Rakovac, Ivo

AU - Breda, João

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Y1 - 2021/3/1

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AB - 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.

KW - Active play

KW - Active transport

KW - Physical inactivity

KW - Sedentary behaviour

KW - Surveillance

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Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries: An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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