What proportion of Finnish children aged 3 to 4 years meet the global recommendations for physical activity, digital media use and sleep compared to children of the same age in other countries? And how are their motor and cognitive skills?
Sunrise Finland websiteWhy is it important to study movement behaviours in the early years?
The early years of life (ages 0-5) are undoubtedly the most critical period for the development of important physical, motor and cognitive skills. If the living conditions in the early years are unfavorable, the child's healthy development may be jeopardized, which in turn affects the course of life. On the other hand, this sensitive period can also be exploited by positively influencing the development and shaping of the above-mentioned skills, and thereby, healthy growth.
Let’s think of a young child’s physical and motor development from the perspective of how they move during the day. Most often, a child’s day consists of a combination of sleeping, sitting, standing, and physical activities, the latter mostly consisting of play and other daily activities. According to research, physical activity in the early years is related to e.g. better motor skills and skeletal health. Adequate sleep is associated with more favorable body composition and growth, while a large amount of sedentary time appears to be associated with negative health outcomes. However, we know relatively little about how young children’s physical activity, sedentary behaviour and sleep relate to each other, and how their interplay relate to children’s motor and cognitive skills, and health.
The World Health Organization (WHO) has identified the prevention of overweight in children as one of its key priorities, in which movement behaviours, i.e. physical activity, sedentary behaviour and sleep, play a major role. Indeed, in 2019, the WHO published global 24-hour recommendations on physical activity, sedentary behaviour and sleep for children in the early years. According to the recommendations, children aged 3 to 4 years should be physically active for at least three hours a day, of which at least one hour should be activities of moderate or vigorous intensity. In addition, children should have no more than one hour of sedentary digital media use per day and long periods of sedentary time should be avoided. It is recommended that children of this age get 10 to 13 hours of sleep a day, including a night's sleep and daytime naps.
Altogether 41 countries from around the world
The international SUNRISE study gathers global data to compare children’s movement behaviours and motor and cognitive skills across countries, and to identify factors associated with movement behaviours in early childhood in different cultures.
The SUNRISE Finland study at Folkhälsan Research Center is part of the international SUNRISE study (International Study of Movement Behaviors in the Early Years), the ambitious main aim of which is to find out what proportion of children aged 3 to 4 years around the world meet the WHO 24-hour movement behavior guidelines. Another aim of the study is to investigate children’s gross and fine motor as well as cognitive skills and the prevalence of overweight. A total of 41 low-, middle- and high-income countries are included in the study. The international SUNRISE study is coordinated by the University of Wollongong in Australia.
Who do not meet the movement behaviour recommendations?
What factors related to children themselves, the family and the environment affect children’s physical activity, digital media use and sleep?
The individual develops in dynamic interaction with the environment. In order to understand, for example, a child's movement behaviours, the phenomenon could be considered at the level of the individual, family, kindergarten, city or, more broadly, society as a whole. These levels, in turn, interact with each other. For example, family wealth or community culture may affect how physically active a child is regardless of his or her gender or motor development. Indeed, the SUNRISE study examines the factors associated with young children’s physical activity, sedentary behaviour and sleep, and the fulfillment of their recommendations, at each of these levels.
Mental well-being of the parents
In addition to the aims of the international study, SUNRISE Finland study examines parents' mental well-being and how it relates to children's movement behaviours. Mental health problems are one of the biggest global health challenges and their prevalence continues to rise. Some studies suggest that increased maternal stress and depressive symptoms are associated with less physical activity and more sedentary screen time among young children. Children of happier parents, on the other hand, seem to engage in multiple healthy behaviours. Investing in the mental well-being of parents could therefore be an effective way of influencing children's healthy lifestyle as well, but more research is needed on this topic.
Families from both urban and rural areas
SUNRISE Finland study consists of two phases; the pilot study and the main study. The purpose of the pilot study is to test the feasibility of the measurement methods with a smaller number of participants for the main study. Altogether 100 children and their parents from Folkhälsan day care centers in Uusimaa and Southwest Finland will participate in the pilot phase during the autumn and winter of 2021. The study collects information from two parents or guardians of the children, as in most cases only the children's mothers tend to participate in studies, in which case the perspective of the other guardian is ignored.
The main study is much broader than the pilot study, as a total of 1,000 children and their parents from the cities of Helsinki, Turku, Kuopio and Oulu and the surrounding countryside will participate in it during the year 2022. The study examines the differences in movement behaviours of Finnish young children between urban and rural environments.
The SUNRISE Finland study is a sport science research project funded by the Ministry of Education and Culture and conducted in the Folkhälsan Research Center in cooperation with the Universities of Turku, Eastern Finland and Oulu, and the Oulu Deaconess Institute Foundation. The extensive data produces representative information on Finnish children’s movement behaviours, and motor and cognitive skills during their early life years, and enables involvement in the international SUNRISE study.
Tests for children and surveys for parents
In the study, children’s physical activity, sedentary time, and sleep are measured with accelerometers that are placed on their hip and wrist. In addition, children get to do a variety of tests and tasks that measure motor skills and physical fitness, such as standing long jump and one leg standing balance test. The children will also play two games on an iPad that assess cognitive skills; working memory and inhibitory control. In addition to the measurements, the parents will fill in questionnaires concerning e.g. the child's food consumption, and their own and their child's use of digital media, and nature visits. In the SUNRISE Finland study, parents will also respond to surveys that assess symptoms of depression, stress, anxiety and insomnia, as well as problematic use of digital media.
What do the preliminary results from the world tell us?
Preliminary research on compliance with the WHO movement behaviour recommendations have already been accumulated to some extent from the SUNRISE study, as some of the countries involved in the study have carried out their pilot phase. It is worrying that, on average, less than 20% of children aged 3 to 4 meet the WHO 24-hour recommendations for physical activity, digital media use and sleep, based on the results of the SUNRISE pilot studies in seven countries. Country differences are large; in Bangladesh, 5% of children complied with all three recommendations, while in South Africa, 26% of children complied with the recommendations. As the SUNRISE Finland study progresses, we will find out how physically active Finnish children aged 3 to 4 years are, how much they spend time being sedentarily, use digital media and sleep compared to children from other countries, and what factors are related to the movement behaviours of Finnish children in their early years.
Elina Engberg, Amanda Pulli, Marja Leppänen, Eva Roos
Folkhälsan Research Center, Helsinki, Finland
Follow their research: Twitter, Facebook, Instagram.
References:
Bronfenbrenner U. Ecology of the Family as a Context for Human Development. Research Perspectives. Developmental Psychology 1986. https://doi.org/10.1037/0012-1649.22.6.723
Carson V et al. Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years). BMC Public Health 2017. https://doi.org/10.1186/s12889-017-4860-0
Chaput JP et al. Systematic review of the relationships between sleep duration and health indicators in the early years (0-4 years). BMC Public Health 2017. https://doi.org/10.1186/s12889-017-4850-2
Draper CE et al. Understanding the influence of 24-hour movement behaviours on the health and development of preschool children from low-income South African settings: the SUNRISE pilot study. South African Journal of Sports Medicine 2020. http://dx.doi.org/10.17159/2078-516X/2020/v32i1a8415.
Engberg E et al. Parental happiness associates with the co-occurrence of preschool-aged children’s healthy energy balance-related behaviors. Journal of Happiness Studies 2021. https://doi.org/10.1007/s10902-021-00459-1
Guan H et al. Proportion of kindergarten children meeting the WHO guidelines on physical activity, sedentary behaviour and sleep and associations with adiposity in urban Beijing. BMC pediatrics 2020. https://doi.org/10.1186/s12887-020-1969-6
Hossain MS et al. International Study of 24-hour Movement Behaviors of Early Years (SUNRISE): A Pilot Study from Bangladesh 2021. https://doi.org/10.1186/s40814-021-00912-1
Kim TV et al. Prevalence of Physical Activity, Screen Time, and Sleep, and Associations with Adiposity and Motor Development among Preschool-Age Children in Vietnam: The SUNRISE Vietnam Pilot Study. Indian Journal of Pediatrics 2021. https://doi.org/10.1007/s12098-021-03895-2
Kuzik N et al. Systematic review of the relationships between combinations of movement behaviours and health indicators in the early years (0-4 years). BMC Public Health 2017. https://doi.org/10.1186/s12889-017-4851-1
Nyström CD et al. International study of movement behaviors in the early years (SUNRISE): results from SUNRISE Sweden’s pilot and COVID-19 study. International Journal of Environmental Research and Public Health 2020. https://doi.org/10.3390/ijerph17228491
O’Connor SG et al. Associations of maternal stress with children’s weight-related behaviours: a systematic literature review. Obesity Reviews 2017. https://doi.org/10.1111/obr.12522
Okely AD et al. A collaborative approach to adopting/adapting guidelines - The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): An integration of physical activity, sedentary behavior, and sleep. BMC Public Health 2017. https://doi.org/10.1186/s12889-017-4867-6
Okely T et al. Cross-sectional examination of 24- hour movement behaviours among 3- and 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries: the SUNRISE study protocol. BMJ Open 2021. http://dx.doi.org/10.1136/bmjopen-2021-049267
Poitras VJ et al. Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0-4 years). BMC Public Health 2017. https://doi.org/10.1186/s12889-017-4849-8
Tanaka C et al. Relationship between adherence to WHO “24-Hour Movement Guidelines for the Early Years” and motor skills or cognitive function in preschool children: SUNRISE pilot study. Japanese Journal of Physical Fitness and Sports Medicine 2020. https://doi.org/10.7600/jspfsm.69.327
Tremblay MS et al. Canadian 24-hour movement guidelines for children and youth: An integration of physical activity, sedentary behaviour, and sleep. Applied Physiology Nutrition and Metabolism 2016. https://doi.org/10.1139/apnm-2016-0151
Turner E et al. SUNRISE pilot study: Canadian Surveillance Study of Movement Behaviours in the Early Years. Thesis 2020. https://curve.carleton.ca/system/files/etd/d0951ec1-1934-430c-89ed-4242738f0fa2/etd_pdf/60be3497d7f75d1d171ba1012bb1e131/turner-sunrisepilotstudycanadiansurveillancestudy_r.pdf
World Health Organization. World Health Assembly, 65. Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level: report by the Secretariat 2012. https://apps.who.int/iris/handle/10665/78898
World Health Organization. Report of the commission on ending childhood obesity. World Health Organization 2016. https://apps.who.int/iris/handle/10665/204176
World Health Organization. Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 Years of Age 2019. https://apps.who.int/iris/handle/10665/311664
