U.S. Children Meeting Physical Activity, Screen Time, and Sleep Guidelines

Introduction: Physical inactivity, high screen time, and short sleep are targets of public health initiatives for children. However, few data exist on how many U.S. children meet guidelines for these behaviors-data vital to inform which needs greater targeting. This study describes national prevalence estimates of U.S. children who meet physical activity, screen time, and sleep guidelines alone or in combination across each childhood year.

Methods: This analysis (completed in 2019) used cross-sectional data from the 2016-2017 National Survey of Children's Health, a nationally representative sample of U.S. children. Child physical activity (days per week with ≥60 minutes), recreational screen time (hours per day of TV viewing and electronic device use), and sleep duration (hours per day) were assessed through parental report. Guidelines recommend ≥60 minutes per day of physical activity, ≤2 hours per day of screen time, and 9-12 hours per day of sleep for individuals aged 6-12 years (8-10 hours for those aged 13-17 years).

Results: Only 8.8% (95% CI=8.2%, 9.5%) of U.S. children meet all the 3 guidelines combined. Majority of children/adolescents attain the sleep guideline (86.0%, 95% CI=85.2%, 86.7%), but a lower proportion meet physical activity (23.0%, 95% CI=22.1%, 23.9%) or screen time (32.9%, 95% CI=31.9%, 33.8%) guidelines. A substantial age effect was identified, with prevalence of meeting each distinct guideline and all the 3 declining with age (p<0.001).

Conclusions: Few U.S. children meet all the 3 movement guidelines, with prevalence rates of children meeting guidelines declining with age. Although many meet sleep guidelines, few meet physical activity or screen time guidelines. Initiatives targeting physical activity and screen time, especially for adolescents, should be pursued.