Infants under the age of one year should not be exposed to electronic screens at all and “sedentary” screen time for children under five must not be more than an hour a day, according to the WHO’s new guidelines.
The guidelines were issued as part of a campaign to tacklethe global obesity crisis and ensure that young children grow up fit and well,particularly since development in the first five years of life contributes tochildren’s motor and cognitive development and lifelong health.
In recommendations specifically aimed at under-fives for thefirst time, the UN health agency said that about 40 million children around theglobe – around six per cent of the total – are overweight. Of that number, halfare in Africa and Asia, it noted.
The World Health Organization (WHO) said that children underfive must spend less time sitting watching screens, or restrained in prams andseats, get better quality sleep and have more time for active play if they areto grow up healthy.
“Achieving health for all means doing what is best forhealth right from the beginning of people’s lives,” WHO Director-GeneralTedros Adhanom Ghebreyesus said.
“Early childhood is a period of rapid development and atime when family lifestyle patterns can be adapted to boost health gains,”Ghebreyesus said.
The new guidelines on physical activity, sedentary behaviourand sleep for children under 5 years of age were developed by a WHO panel ofexperts.
They assessed the effects on young children of inadequatesleep, and time spent sitting watching screens or restrained in chairs andprams. They also reviewed evidence around the benefits of increased activitylevels.
“Improving physical activity, reducing sedentary timeand ensuring quality sleep in young children will improve their physical,mental health and well-being, and help prevent childhood obesity and associateddiseases later in life,” says Dr Fiona Bull, programme manager forsurveillance and population-based prevention of noncommunicable diseases at WHO.
The guidelines which refer to passive activities such aswatching cartoons, for example, as opposed to going online to talk to agrandparent – build on data gathered in countries including Canada andAustralia, which show that as many as 75 per cent of children do not havehealthy lifestyles.
“Sedentary behaviours, whether riding motorisedtransport rather than walking or cycling, sitting at a desk in school, watchingTV or playing inactive screen-based games are increasingly prevalent andassociated with poor health outcomes,” says WHO’s guidelines on physicalactivity, sedentary behaviour and sleep for children under five.
Noting the emergence of on-screen applications that helpusers understand how long they are spending on their devices, Bull noted thatthere was still much uncertainty about their health impacts.
“This is a recent development and I think it is asignal that the digital industry is also wary about the addictive nature thetime that’s being spent using these in different ways.
“Of course, all of us are using them for work, we’reusing them in schools for education, we’re using them at home for education.It’s about managing the use of these valuable tools and about watching both thebenefits and the risks,” she said.
The guidelines recommended that infants (less than one year)should be physically active several times a day in a variety of ways,particularly through interactive floor-based play. They should not berestrained for more than one hour at a time, whether in prams/strollers, high chairs,or strapped on a caregiver’s back.
Screen time for them is not recommended at all. For youngchildren aged two years, sedentary screen time such as watching TV or videosshould be no more than 60 minutes and the less is better.
Children 3-4 years of age should spend at least 180 minutesin a variety of types of physical activities at any intensity, of which atleast 60 minutes is moderate- to vigorous intensity physical activity, spreadthroughout the day. Sedentary screen time for this group of children under age5 should be no more than one hour and less is better.
The WHO said that failure to meet current physical activityrecommendations is responsible for more than 5 million deaths globally eachyear across all age groups.
Currently, over 23 per cent of adults and 80 per cent ofadolescents are not sufficiently physically active. If healthy physicalactivity, sedentary behaviour and sleep habits are established early in life,this helps shape habits through childhood, adolescence and into adulthood, theagency said.
“What we really need to do is bring back play forchildren. This is about making the shift from sedentary time to playtime, whileprotecting sleep,” says Juana Willumsen, WHO focal point for childhoodobesity and physical activity.
The pattern of overall 24-hour activity is key: replacingprolonged restrained or sedentary screen time with more active play, whilemaking sure young children get enough good-quality sleep.
Quality sedentary time spent in interactive non-screen-basedactivities with a caregiver such as reading, storytelling, singing and puzzlesis very important for child development.
Further, the important interactions between physicalactivity, sedentary behaviour and adequate sleep time, and their impact onphysical and mental health and wellbeing, were recognised by the Commission onEnding Childhood Obesity, which called for clear guidance on physical activity,sedentary behaviour and sleep in young children.
“More is better,” the WHO report maintains,suggesting that carers should engage in interactive floor-based play and ensurethat babies who are not yet walking spend at least 30 minutes on their stomach,rather than sitting in a chair.
“The advice is where possible, to move from sedentary, passivescreen time to more physical activity while at the same time protecting thatvery important quality sleep.
“And what’s particularly important is that qualityinteractive play with a caregiver that’s so important for early childhooddevelopment that sedentary time should also be protected,” Willumsenadded.