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Global childhood obesity is of great concern. In 2019, the World Health Organization released global guidelines on movement behaviors for the children under 5 y of age to combat this epidemic. This study aimed to estimate the prevalence of Vietnamese preschoolers meeting the guidelines, and examined whether guideline compliance is associated with adiposity and motor development. A cross-sectional study was conducted on 103 healthy preschoolers who were conveniently sampled from preschools in urban and rural areas around Ho Chi Minh city. Time spent in different intensities of physical activity and sedentary behavior was measured using Actigraph GT3X + accelerometers over three consecutive days. Sleep and screen time were obtained via parent questionnaires. Children were classified as meeting or not meeting the global guidelines. Height, weight, and motor skills were measured by the research staff. Regression models were applied to quantify the association between guideline compliance and adiposity and motor development, adjusting for age and sex. While 17.5% of children met all three guidelines, 5.8% met no guidelines. The prevalences of children who met guidelines for physical activity time, sleep duration, and screen time were 50.4%, 81.4%, and 44.7%, respectively. There was no association between guideline compliance and adiposity and motor development. This study found a low proportion of children who met the global guidelines, whereas a high proportion of those with overweight and obesity was reported. Health programs should promote more physical activities of various intensities in young children.

Purpose There is a paucity of global data on sedentary behavior during early childhood. The purpose of this study was to examine how device-measured sedentary behavior in young children differed across geographically, economically, and sociodemographically diverse populations, in an international sample. Methods This multinational, cross-sectional study included data from 1071 children 3-5 yr old from 19 countries, collected between 2018 and 2020 (pre-COVID). Sedentary behavior was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation, and seated transport duration were calculated. Linear mixed models were used to examine the differences in sedentary behavior variables between sex, country-level income groups, urban/rural settings, and population density. Results Children spent 56% (7.4 h) of their waking time sedentary. The longest average bout duration was 81.1 +/- 45.4 min, and an average of 61.1 +/- 50.1 min center dot d(-1) was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, compared with children from low-income and lower-middle-income countries. Sex and urban/rural residential setting were not associated with any outcomes. Higher population density was associated with several higher sedentary behavior measures. Conclusions These data advance our understanding of young childrens sedentary behavior patterns globally. Country income levels and population density appear to be stronger drivers of the observed differences, than sex or rural/urban residential setting. Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China; Biomedical Research Foundation, Dhaka, Bangladesh; Canadian Institutes of Health Research Planning and Dissemination Grant; Conselho Nacional de Pesquisa e Desenvolvimento Cientifico e Tecnologico CNPq Research; Department of National Planning and Monitoring, PNG Government; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Global Challenges Program, University of Wollongong, Australia; Harry Crossley Foundation, South Africa; National Health and Medical Research Council, Australia; NIH-International Research Training Grant; Pham Ngoc Thach University of Medicine, Vietnam; Research University Grant (GUP), Universiti Kebangsaan Malaysia; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan; Stella de Silva Research Grant, Sri Lanka College of Pediatricians, Sri Lanka; DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program

Background: There is a paucity of data from low- and middle-income countries on sedentary behaviour (SB) levels and patterns during early childhood. The purpose of this study was to examine how device-measured SB in young children differed across geographically, economically, and socio-demographically diverse populations, in an international sample. Methods: This multinational, cross-sectional pilot study included data from 1071 3–5-year-old children from 19 countries, collected between 2018 and 2020 (pre-COIVID). SB was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation and seated transport duration were calculated using PAL Analysis Algorithms and a custom-made analysis program. Linear mixed models were used to examine the differences in SB variables between sex, country-level income groups, caregiver education levels, urban/rural settings, and population density. Findings: Children spent 56% (7.4 hrs) of their waking time sedentary, and 42% accrued at least one sedentary bout/day lasting ≥60 min. The longest average bout duration was 81.1±45.4 min, and an average of 61.1±50.1 min/day was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, than children from low- and lower-middle-income countries. Few differences were found in SB patterns between urban/rural settings and caregiver education levels within each country-level income group, while multiple significant differences were found when comparing between country-level income groups. Higher population density was correlated with several higher SB measures. Interpretation: These data advance our understanding of young children’s SB patterns globally and the influences of country income, urban/rural setting, caregiver education levels, and population density. Country income levels and population density appear to be stronger drivers of the observed differences, than sex, rural or urban residential setting or caregiver educational attainment. Funding: American Council on Exercise, USA Beijing Health System High Level Talents Training Project, China 13 Biomedical Research Foundation, Dhaka, Bangladesh Canadian Institutes of Health Research Planning and Dissemination Grant Conselho Nacional de Pesquisa e Desenvolvimento Cientifico e Tecnologico - CNPq Research Department of National Planning and Monitoring, PNG Government Early Start, University of Wollongong, Australia Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa Global Challenges Program, University of Wollongong, Australia Harry Crossley Foundation, South Africa National Health and Medical Research Council, Australia NIH - International Research Training Grant Pham Ngoc Thach University of Medicine, Vietnam Research University Grant (GUP), Universiti Kebangsaan Malaysia Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan Stella de Silva Research Grant, Sri Lanka College of Paediatricians, Sri Lanka The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa The International Society of Behavioral Nutrition and Physical Activity, Pioneers Program Declaration of Interest: The authors have no competing financial or personal interests to declare. Ethical Approval: Ethical approval was obtained from the University of Wollongong, Australia (ref: 2018/044) and the appropriate ethics committee(s) in each country.

Background: The 2020 COVID-19 pandemic has placed unprecedented restrictions on children’s ability to participate in adequate movement behaviours. This international longitudinal study compared young children’s physical activity, sedentary behaviour and sleep behaviours before and during the COVID-19 pandemic.Methods: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in physical activity, sedentary behaviour (screen-time) and sleep and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). PA, sedentary screen time (SST) and sleep were assessed via parent questionnaire. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Results: 948 parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (AdjOR=2.0, 95%CI 1.0 to 3.8) and SST (2.2, CI 1.2 to 3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO recommendations (AdjOR 3.3, CI 1.1 to 9.8) than those who were not. Children of caregivers with higher compared to lower stress were less likely to meet all three guidelines (0.5, CI 0.3 to 0.9). Conclusion: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting caregivers’ mental health are important prevention strategies.