Canada Releases Sedentary Behaviour Guidelines for Children Aged 0-4

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March 20, 2012
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SBRN is pleased to host regular summaries of peer-reviewed research in the area of sedentary behaviour, written by graduate students and young investigators working in a range of disciplines. Information on the author of today’s article can be found at the bottom of this post.  If you are interested in writing a summary of an article that you found interesting, please contact us here.

The full-text of today’s study is available for free through the website of Applied Physiology, Nutrition and Metabolism.  The article can be accessed here.


Sedentary behaviour among children in the early years (defined in the paper as aged 0-4 years) is gaining increasing attention. Accumulating evidence suggests that the sedentary behaviour habits formed in this age group, in particular screen-based sedentary behaviour habits, have potential short- and long-term health implications. This evidence combined with the recognized public health importance of growth and development during this time period led the Canadian Society for Exercise Physiology to develop the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These guidelines addressed a need established by health care professionals, child care providers, and other stakeholders in Canada regarding guidance on sedentary behaviour in the early years. The purpose of this paper was to outline the process and outcomes for the development of these new national guidelines, which have just been released.

What was done?

The paper outlines three main steps that were involved in developing the guidelines. First, a systematic review was conducted to identify the best available evidence regarding sedentary behaviour and six health outcomes (adiposity, bone health, motor development, psychosocial health, cognitive development, cardio-metabolic health) among infants (<1 year), toddlers (1-2 years), and preschoolers (3-4 years). The evidence from the systematic review was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Second, a consensus meeting was held in December 2011with the Guideline Development and Research Committee to discuss the evidence from the systematic review and draft the guidelines. Third, in addition to the stakeholder input that was acquired throughout the process, a stakeholder consultation was conducted through an on-line survey to obtain feedback on the draft guidelines. All components were guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which assessed the scientific rigour and transparency of the entire guideline development process.

What was found?

In terms of the systematic review, the detailed results are published in a separate paper. In summary, 23 papers were included in the review that examined the effects of television viewing on adiposity, cognitive development, or psychosocial health. Overall, there was low to high quality evidence across the infant, toddler, and preschool age groups to suggest that television viewing is positively associated with adiposity and negatively associated with cognitive development and psychosocial health. However, consistent dose-response evidence was lacking; therefore, expert consensus, international harmonization, and stakeholder input was used to inform the guidelines. In terms of the stakeholder consultation, 925 stakeholders completed the survey and 92% completely agreed or agreed with the guideline documents. Furthermore, the 212 additional comments provided by the stakeholders were used to make revisions to the final guideline documents.

What are the guidelines?

“For healthy growth and development, caregivers should minimize the time infants (aged<1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4years, screen time should be limited to under 1 hr per day; less is better.”

The guidelines paper can be found at the link below, while information sheets can be accessed at


Tremblay MS, LeBlanc AG, Carson V, Choquette L, Connor Gorber S, Dillman C, Duggan M, Gordon MJ, Hicks A, Janssen I, Kho ME, Latimer-Cheung AE, LeBlanc C, Murumets K, Okely AD, Reilly JJ, Stearns JA, Timmons BW, & Spence JC. Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). Appl. Physiol. Nutr. Metab. 2012.

Valerie Carson


About the author: Valerie Carson is in the final year of her PhD in the School of Kinesiology and Health Studies at Queen’s University. Her current research focuses on sedentary behaviour and health in young people.


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