Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries

Anthony D. Okely, Katharina E. Kariippanon, Hongyan Guan, Ellie K. Taylor, Thomas Suesse, Penny L. Cross, Kar Hau Chong, Adang Suherman, Ali Turab, Amanda E. Staiano, Amy S. Ha, Asmaa El Hamdouchi, Aqsa Baig, Bee Koon Poh, Borja Del Pozo-Cruz, Cecilia H.S. Chan, Christine Delisle Nyström, Denise Koh, E. Kipling Webster, Himangi LubreeHong Kim Tang, Issad Baddou, Jesus Del Pozo-Cruz, Jyh Eiin Wong, Kuston Sultoni, Maria Nacher, Marie Löf, Mingming Cui, Mohammad Sorowar Hossain, P. W.Prasad Chathurangana, Uddhavi Kand, V. P.Pujitha Wickramasinghe, Rebecca Calleia, Shameema Ferdous, Thanh Van Kim, Xiaojuan Wang, Catherine E. Draper

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Background: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children’s daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children’s movement 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 movement behaviours 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). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined. Results: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9). 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 parents’ mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

Original languageEnglish (US)
Article number940
JournalBMC public health
Issue number1
StatePublished - Dec 2021


  • 24-h movement behaviours
  • Low- and middle-income countries
  • Outdoors
  • Play
  • Preschool
  • Quarantine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries'. Together they form a unique fingerprint.

Cite this