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      World Health Organization 2020 guidelines on physical activity and sedentary behaviour

      research-article
      1 , 2 , , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 1
      British Journal of Sports Medicine
      BMJ Publishing Group
      prevention, health promotion, non-communicable disease, physical activity, public health

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          Abstract

          Objectives

          To describe new WHO 2020 guidelines on physical activity and sedentary behaviour.

          Methods

          The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations.

          Results

          The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold.

          Conclusion

          These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.

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          Most cited references28

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          GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

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            Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants

            Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends.
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              Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants

              Summary Background Physical activity has many health benefits for young people. In 2018, WHO launched More Active People for a Healthier World, a new global action on physical activity, including new targets of a 15% relative reduction of global prevalence of insufficient physical activity by 2030 among adolescents and adults. We describe current prevalence and trends of insufficient physical activity among school-going adolescents aged 11–17 years by country, region, and globally. Methods We did a pooled analysis of cross-sectional survey data that were collected through random sampling with a sample size of at least 100 individuals, were representative of a national or defined subnational population, and reported prevalence of of insufficient physical activity by sex in adolescents. Prevalence had to be reported for at least three of the years of age within the 10–19-year age range. We estimated the prevalence of insufficient physical activity in school-going adolescents aged 11–17 years (combined and by sex) for individual countries, for four World Bank income groups, nine regions, and globally for the years 2001–16. To derive a standard definition of insufficient physical activity and to adjust for urban-only survey coverage, we used regression models. We estimated time trends using multilevel mixed-effects modelling. Findings We used data from 298 school-based surveys from 146 countries, territories, and areas including 1·6 million students aged 11–17 years. Globally, in 2016, 81·0% (95% uncertainty interval 77·8–87·7) of students aged 11–17 years were insufficiently physically active (77·6% [76·1–80·4] of boys and 84·7% [83·0–88·2] of girls). Although prevalence of insufficient physical activity significantly decreased between 2001 and 2016 for boys (from 80·1% [78·3–81·6] in 2001), there was no significant change for girls (from 85·1% [83·1–88·0] in 2001). There was no clear pattern according to country income group: insufficient activity prevalence in 2016 was 84·9% (82·6–88·2) in low-income countries, 79·3% (77·2–87·5) in lower–middle-income countries, 83·9% (79·5–89·2) in upper–middle-income countries, and 79·4% (74·0–86·2) in high-income countries. The region with the highest prevalence of insufficient activity in 2016 was high-income Asia Pacific for both boys (89·0%, 62·8–92·2) and girls (95·6%, 73·7–97·9). The regions with the lowest prevalence were high-income western countries for boys (72·1%, 71·1–73·6), and south Asia for girls (77·5%, 72·8–89·3). In 2016, 27 countries had a prevalence of insufficient activity of 90% or more for girls, whereas this was the case for two countries for boys. Interpretation The majority of adolescents do not meet current physical activity guidelines. Urgent scaling up of implementation of known effective policies and programmes is needed to increase activity in adolescents. Investment and leadership at all levels to intervene on the multiple causes and inequities that might perpetuate the low participation in physical activity and sex differences, as well as engagement of youth themselves, will be vital to strengthen the opportunities for physical activity in all communities. Such action will improve the health of this and future young generations and support achieving the 2030 Sustainable Development Goals. Funding WHO.
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                December 2020
                23 November 2020
                : 54
                : 24
                : 1451-1462
                Affiliations
                [1 ] departmentPhysical Activity Unit, Department of Health Promotion , World Health Organization , Geneva, Switzerland
                [2 ] departmentSchool of Human Sciences , The University of Western Australia , Perth, Western Australia, Australia
                [3 ] Health Promotion Center , Riyadh, Saudi Arabia
                [4 ] departmentCentre for Health Research , University of Southern Queensland , Toowoomba, Queensland, Australia
                [5 ] Age Institute , Helsinki, Finland
                [6 ] departmentPublic Health Evaluation and Projection Unit , Finnish Institute for Health and Welfare , Helsinki, Uusimaa, Finland
                [7 ] departmentCollege of Health Solutions , Arizona State University , Phoenix, Arizona, USA
                [8 ] departmentDepartment of Movement and Sports Sciences , Ghent University , Belgium
                [9 ] Institute of Technology Tralee , Tralee, Co Kerry, Ireland
                [10 ] departmentUNESCO Chair of Transforming the Lives of People with Disabilities, their Families and Communities, Through Physical Education, Sport, Recreation and Fitness
                [11 ] departmentHealthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Department of Pediatrics , University of Ottawa , Ottawa, Ontario, Canada
                [12 ] departmentSchool of Health and Life Sciences , Glasgow Caledonian University , Glasgow, UK
                [13 ] departmentDepartments of Medicine, and Medical Informatics & Clinical Epidemiology , Oregon Health & Science University , Portland, Oregon, USA
                [14 ] departmentMRC Epidemiology Unit, School of Clinical Medicine , University of Cambridge , Cambridge, Cambridgeshire, UK
                [15 ] Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; Diabetes Research Centre, University of Leicester, Leicester General Hospital , Leicester, UK
                [16 ] departmentDepartment of Exercise and Nutrition Science, Milken Institute School of Public Health , The George Washington University , Washington, DC, USA
                [17 ] departmentDepartment of Sport Medicine , Norwegian School of Sport Science , Oslo, Norway
                [18 ] Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health , Oslo, Norway
                [19 ] departmentNICM Health Research Institute , Western Sydney University , Penrith, New South Wales, Australia
                [20 ] Division of Psychology and Mental Health, University of Manchester , Manchester, UK
                [21 ] departmentDepartment of Cancer Epidemiology and Prevention Research, CancerControl Alberta , Alberta Health Services , Calgary, Alberta, Canada
                [22 ] departmentCentre for Public Health , Queen's University Belfast , Belfast, UK
                [23 ] departmentDepartment of Non-Commuicable Diseases , Ministry of Health , Nairobi, Kenya
                [24 ] departmentCentre for Exercise, Nutrition & Health Science, School for Policy Studies , University of Bristol , Bristol, UK
                [25 ] departmentPopulation and Public Health Sciences , Pennington Biomedical Research Center , Baton Rouge, Louisiana, USA
                [26 ] departmentResearch Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences , University of Cape Town , Cape Town, South Africa
                [27 ] departmentDepartment ofEpidemiology and Preventive Medicine , University of Regensburg , Germany
                [28 ] departmentFaculty of Medicine and Health Sciences, Norwich Medical School , University of East Anglia Faculty of Medicine and Health Sciences , UK
                [29 ] departmentPROFITH (PROmoting FITness and Health through physical activity) research group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health , University of Granada , Spain
                [30 ] departmentSports and Exercise Medicine Unit and Department of Allied Health Sciences, Faculty of Medicine , University of Colombo , Colombo, Sri Lanka
                [31 ] departmentCharles Perkins Centre, University of Sydney, School of Health Sciences, Faculty of Medicine and Health , The University of Sydney , Sydney, New South Wales, Australia
                [32 ] departmentInstitute for Musculoskeletal Health , The University of Sydney , Sydney, New South Wales, Australia
                [33 ] departmentEpidemiology and Genomics Research Program , National Cancer Institute , Bethesda, Maryland, USA
                [34 ] departmentDepartment of Public and Occupational Health, Amsterdam Public Health Research Institute , Amsterdam Vrije Universiteit , Amsterdam, The Netherlands
                [35 ] departmentPrevention Research Collaboration, School of Public Health , The University of Sydney , Sydney, New South Wales, Australia
                [36 ] National Department of Health , Port Moresby, Papua New Guinea
                Author notes
                [Correspondence to ] Professor Fiona C Bull, Physical Activity Unit, Department of Health Promotion, World Health Organization, Geneva, GE, Switzerland; bullf@ 123456who.int
                Author information
                http://orcid.org/0000-0001-8035-4973
                http://orcid.org/0000-0002-5130-3162
                http://orcid.org/0000-0002-5607-5736
                http://orcid.org/0000-0003-1421-9348
                http://orcid.org/0000-0003-2115-9267
                http://orcid.org/0000-0002-3394-0176
                http://orcid.org/0000-0003-4315-9153
                http://orcid.org/0000-0002-0506-2214
                http://orcid.org/0000-0001-7323-3225
                http://orcid.org/0000-0002-6807-989X
                Article
                bjsports-2020-102955
                10.1136/bjsports-2020-102955
                7719906
                33239350
                b9598559-eb29-4af4-a977-1d839484c01a
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 07 September 2020
                Funding
                Funded by: The Public Health Agency of Canada and the Government of Norway provided financial support, without which this work could not have been completed;
                Categories
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                Sports medicine
                prevention,health promotion,non-communicable disease,physical activity,public health

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