A recent analysis of results from the WHO Childhood Obesity Surveillance Initiative (COSI) provides a unique overview of the physical activity habits of children in the WHO European Region. The study shows that more can be done to increase physical activity, reduce screen time and ensure quality sleep among children in the Region and that there are clear differences in the prevalence of these behaviours between countries.

Across the Region, Portugal had the lowest levels of children cycling or walking to school, with nearly 80% being driven by their parents or using public transport – compared to just 6% in Tajikistan, where the vast majority actively travel to class.

Stephen Whiting, one of the authors, said that the “Physical activity, screen time and sleep” report could help guide policy-makers, schools and parents to improve the well-being of children.

“The findings are interesting as they show clear differences between countries in the ways that children are active. Governments can use these results to guide their efforts to increase physical activity levels of children, to set them up for an active and healthy future.”

Active children become active adults

Physical activity is an important determinant in the prevention and management of childhood obesity, which is associated with many serious health problems during childhood and increases the risk for noncommunicable diseases.

Our physical and socio-cultural environments largely determine where and how we can be active. Physical activity habits during childhood tend to track into adolescence and adulthood; establishing physically active behaviours early on can reap dividends in later life.

One pattern highlighted in the study is that children in central Asian countries are more likely to walk or cycle to school, but less likely to be a member of a sports club than those from northern or southern Europe.

“There is a big gap in the understanding of parents and the community of the importance of including physical activity as a natural part of their children’s lives,” says Shynar Abdrakhmanova, the Principal Investigator for Kazakhstan.

Ana Rito, the study’s Principal Investigator for Portugal, who has 3 teenage boys herself, says that this is a different world from the one she knew as a child.

“When I was growing up, we didn’t have any screens to distract us. We would naturally look to go outside and play with our friends. This is a different environment now, but it doesn’t mean that because it is different that it can’t work. There are new ways of being physically active.”

The challenge of addressing sedentary behaviour and screen time

Active play (unstructured, outdoor physical activity in children’s free time), active transport (cycling or walking) and participation in sports, are the major contributors to total physical activity among children.

It is important that as children grow and develop that, in addition to high levels of physical activity, they also achieve low levels of sedentary behaviour and sufficient sleep each day.

Time spent using screen-based devices increases sedentary behaviour, which has been linked with a higher intake of energy-dense snacks, drinks and fast foods, and overall higher energy intake.

The lure of screens and devices is a particularly difficult one for parents to overcome. Shynar Abdrakhmanova, who has 4 children, points out that simply restricting them might not work. Rather, children need something more exciting to replace them with.

“Children should be doing something more interesting than, for example, merely being outside or just doing something active that isn’t on a screen. Something should attract them to do physical activity. This could involve doing something in the community, or organized physical activity. But schools are crucial – they spend a lot of time there and more lessons should be based around physical activity, and more time given to organized sport.”

Ana Rito says that while modern life has meant there are fewer ways for children to get physical activity as part of a normal daily routine, simply finding the right solution can overcome the problem – and even make them more physically active than previous generations.

The differences in the prevalence between countries shows that there are opportunities for national policy-makers to learn from experiences across the Region and to adopt what works.

Countries can use these findings to guide the development of policies and interventions to increase physical activity, reduce screen time and stop the rise in childhood obesity.