New WHO guidelines recommend kids under five need to be active for at least three hours a day

New World Health Organisation (WHO) guidelines state that children under five need to get at least three hours of exercise per day to stay healthy.

The guidelines were developed by a panel of experts, who assessed the effects on young children of inadequate sleep, and time spent sitting watching screens, or restrained in chairs and prams. They also reviewed evidence around the benefits of increased activity levels.

"What we really need to do is bring back play for children," explains Dr Juana Willumsen, WHO focal point for childhood obesity and physical activity. "This is about making the shift from sedentary time to playtime, while protecting sleep."

The team pointed out, though, that "quality sedentary time spent in interactive non-screen-based activities with a caregiver, such as reading, storytelling, singing and puzzles" is still very important for child development.

Child obesity is such a concern in New Zealand, with one in eight children aged two to 12 considered obese, that the Ministry of Health launched a Childhood Obesity Plan in 2015, involving multiple approaches to help reduce childhood obesity nationwide.

Childhood obesity can lead to obesity in adolescence and adulthood, as well as associated diseases such as heart disease later in life.

"Improving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and wellbeing, and help prevent childhood obesity and associated diseases later in life," says Dr Fiona Bull, programme manager for surveillance and population-based prevention of noncommunicable diseases, at WHO.

The WHO recommendations for childhood activity are:

Infants (less than 1 year):
• Be physically active several times a day in a variety of ways, particularly through interactivy
• floor-based play; more is better. For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake.
• Not be restrained for more than 1 hour at a time (e.g. prams/strollers, high chairs, or strapped on a caregiver's back). Screen time is not recommended. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
• Have 14–17 hours (0–3 months of age) or 12–16 hours (4–11 months of age) of good quality sleep, including naps.

Children 1-2 years of age:
• Spend at least 180 minutes in a variety of types of physical activities at any intensity, including moderate-to-vigorous-intensity physical activity, spread throughout the day; more is better.
• Not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs, or strapped on a caregiver's back) or sit for extended periods of time. For 1-year-olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
• Have 11-14 hours of good quality sleep, including naps, with regular sleep and wake-up times.

Children 3-4 years of age:
• Spend at least 180 minutes in a variety of types of physical activities at any intensity, of which at least 60 minutes is moderate- to vigorous intensity physical activity, spread throughout the day; more is better.
• Not be restrained for more than 1 hour at a time (e.g., prams/strollers) or sit for extended periods of time. Sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.
• Have 10–13 hours of good quality sleep, which may include a nap, with regular sleep and wake-up times.

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