UK physical activity guidelines

1. UK physical activity guidelines • UK-wide (joint CMOs) • Global evidence of the health benefits • Life course • Includes sedentary • Recommended amount for general health benefit • Apply to all

2. Why the need for UK physical activity guidelines for the early years? • New evidence available • Follow lead of other major countries • Previous children and young people guidelines not appropriate for early years

3. UK physical activity guidelines: Early years1 Guideline 1 (infants who cannot yet walk unaided) Physical activity should be encouraged from birth, particularly through floor-based play and water-based activities in safe environments.

4. Types of physical activity: Non-walkers1 Guideline 1 • Crawl, roll, play on floor • ‘Tummy time’ • New movements using large muscle groups • Reaching for and grasping objects, pulling, pushing and playing with other people • ‘Parent and baby’ swim sessions

5. UK physical activity guidelines: Early years1 Guideline 2 Children of pre-school age who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.

6. Types of physical activity: Walkers1 Guideline 2 • Unstructured, physically active play • Energetic play • Develop motor skills (locomotor, stability and object control) • Active travel and everyday activities

7. UK physical activity guidelines: early years1 Guideline 3 All under-fives should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods (except time spent sleeping).

8. Sedentary behaviour1 • Sedentary behaviour refers to a group of behaviours that occur whilst sitting or lying down and that typically require very low energy expenditure. • Research is at an early stage and consequences are not fully understood. • A risk factor for poor health independent of physical activity.

9. Minimising sedentary behaviour1 Guideline 3 • Reducing time spent in highchairs, infant carriers or buggies. • Reducing time spent in front of the TV or other screens. • Replacing motorised travel with active travel all or part of the way.

10. Active children… Active adults? • Physical activity patterns established in the early years persist at a moderate level into the primary school years • Establishing a high level of physical activity early on in life may have implications for activity levels in later childhood and beyond

11. Impact of physical activity on whole child1 Health and wellbeing • Improves cardiovascular health • Promotes healthy weight • Enhances bone and muscular development • Develops motor skills, movement and co-ordination • Improves cognitive development • Supports learning of social skills • Improves self-confidence

12. Impact of physical activity on the whole child2-4 Health and wellbeing • Essential component for energy balance and weight control. • Higher levels of inactivity are associated with increased levels of obesity. • Critical role in the brain development of young children.

13. Impact of physical activity on the whole child Cognitive ‘thinking’ • Creativity and discovery • Problem solving skills • Good listening skills • Enhanced memory skills

14. Impact of physical activity on the whole child Physical development • Stamina • Strength • Mobility • Motor skills

15. Impact of physical activity on the whole child Personal, social and emotional outcomes • Fair play • Co-operation • Language and communication • Confidence • Optimism • Resilience • Sense of self belief • Behavioural flexibility

16. Key messages: Early years1 Frequency:daily Intensity:no specific intensity Time:at least 3 hours Type:physically active play

17. Factors influencing physical activity • Physical activity is a complex, multi-dimensional behaviour influenced by a wide range of factors. • Young children have relatively little control over their behaviours. • Understanding the correlates of physical activity is important in changing behaviour.

18. Factors influencing physical activity: Early years5,6,7 Demographic factors • Boys are generally more active than girls. • Activity levels in this age group are generally stable and do not change significantly with age. • Unclear whether a child’s ethnicity or BMI/weight has an impact on their activity levels between the ages of 0-5 years.

19. Factors influencing physical activity: Early years6,7,8 Social/cultural factors • A child who watches more television or spends much of their time sitting may have lower overall physical activity levels. • Parent-child interactions and role modelling appear to encourage higher levels of physical activity in young children. • A parent’s weight and physical activity levels have mixed effects on their children’s physical activity levels.

20. Factors influencing physical activity: Early years6,7,8,9 Environmental factors • Fewer children within a setting, shorter breaks and more time between breaks can increase levels of physical activity. • Children who spend more time playing outdoors have higher levels of physical activity.

21. Physical activity levels in England: Survey data10 Based on the 2011 UK physical activity guidelines, in England, in 2012: • 9% of boys and10% of girlsaged 2-4 years were classified as meeting the current guidelines for children aged under 5 of at least three hours of physical activity per day. • 84% of children of this age were classified in the ‘low activity’ group.*

22. Sedentary levels in the early years • In the UK, for children aged 3 and 4 years, the average time spent being sedentary is 10-11 hours a day11. • In the early years, typical sedentary behaviours might include watching TV, travelling by car, bus or train,or being strapped into a buggy.

23. Key recommendations for promoting physical activity Early years • Planning and developing physical activity initiatives. • Working with parents and carers. • Increasing physical activity in early years settings.

24. Planning and developing physical activity initiatives Recommendation 1 • Develop initiatives that target adults who interact with children in the early years. Recommendation 2 • Consult with parents and carers to identify their needs and barriers.

25. Planning and developing physical activity initiatives Recommendation 3 • Use an integrated approach to help target information at parents and carers. Recommendation 4 • Use multi-component approaches when delivering information.

26. Working with parents and carers Recommendation 1 • Provide parents and carers with information on the importance of physical activity and the adverse effects of too much sitting time. Recommendation 2 • Educate parents and carers about what counts as physical activity. Recommendation 3 • Create age inclusive promotional materials for education and activity sessions.

27. Increasing physical activity in early years settings Recommendation 1 • Ensure appropriate levels of practitioner training and support are in place. Recommendation 2 • Partner with external agencies to help practitioners develop their physical activity knowledge and expertise.

28. Increasing physical activity in early years settings Recommendation 3 • Involve parents and carers both directly and indirectly in the activities to ensure they are also carried out in the home environment. Recommendation 4 • Offer more frequent short periods of outdoor play. Recommendation 5 • Provide more ‘activity friendly’ portable equipment.

29. Increasing physical activity in early years settings Recommendation 6 • Include adult-led activities to improve motor skills. Recommendation 7 • Use physical activity as a medium through which to integrate all areas of learning and development. Recommendation 8 • Ensure a balance of free play and adult-led physical activity opportunities.

30. Policy levers Health risk of sedentary behaviour Sedentary behaviour in the early years is associated with overweight and obesity and lower cognitive development. Overweight and obesity Children who are overweight and obese in the early years are more likely to grow up to be overweight and obese as adults.

31. Policy levers Health and wellbeing benefits Physical activity is central to optimal growth and development in the under fives. Physical development Physical development is now recognised as being important to children’s overall development in the early years in all four UK early years curriculums.

32. Policy levers4 Brain development Physically active play can contribute to the development of many important brain structures ‘In the early life period, interactions and experiences determine whether a child’s brain architecture provides a strong or weak foundation for their future health, wellbeing and development’18

33. Implications for policy makers • Promote physical activity through new policy measures. • Review early years curriculums and consider how to incorporate physical activity sessions. • Ensure all families are able to use suitable play areas in the local communities.

34. Implications for practitioners • Provide children with opportunities to learn new skills. • Ensure children have regular access to equipment and the outdoor environment/space. • Modify break times to encourage more focused sessions of outdoor play.

35. Implications for parents/carers • Provide opportunities for children to be active daily, in a variety of outside environments. • Be an active role model by participating in physical activity with and without their child. • Give both boys and girls the same chance to try a variety of active play experiences.

36. BHFNC resource: Early years guidelines • These booklets provide early years professionals with: • an overview of the guidelines and the importance of physical activity • examples of the types of activity suitable for infants who are walking and not walking • ways to reduce sedentary behaviour and promote physical activity. To download these resources visit www.bhfactive.org.uk/earlyyearsguidelines

37. BHFNC resource: Practice briefing This practice briefing is designed to give practitioners and managers of early years settings practical ideas for promoting physical activity with the under fives To download this resource visit www.bhfactive.org.uk/earlyyearsguidelines

38. BHFNC resources: Fact sheets This series of three BHFNC fact sheets provide on overview of the facts on physical activity for the under fives. To download these resources visitwww.bhfactive.org.uk go to early years --> our resources --> fact sheets

39. BHF resources: Parent leaflets These leaflets are designed for parents and carers and include information on why being active is important, what types of activity are best and ideas for active play at home. To download these resources visit www.bhfactive.org.uk and put Help your child moveand play or Help your baby move and play into the search box You can also order hard copies by emailing orderline@bhf.org.uk or calling 0870 600 65 66

40. BHF resources: Early movers Helps early years practitioners plan and organise physically active play environments for children under five.It supports a whole setting approach to physical activity and also provides innovative ideas to extend physical activity provision. To download this resource visit www.bhfactive.org.uk and search Early movers You can also order these resources by emailing orderline@bhf.org.uk or calling 0870 600 65 66

41. References • Department of Health. Start Active, Stay Active – A report on physical activity for health from the four home countries’ Chief Medical Officers. London: Department of Health; 2011. • Chaput J, Klingenberg L, Rosenkilde M, Gilbert J, Tremblay A, Sjodin A. Physical activity plays an important role in body weight regulation. J Obes. 2011;2011(Article ID 360257). • Monasta L, Batty GD, Cattaneo A, Lutje V, Ronfani L, van Lenthe FJ, et al. Early-life determinants of overweight and obesity: A review of systematic reviews. Obes Rev. 2010;11(10):695-708. • OECD (2007). Understanding the brain: the birth of a learning science. OECD 2007. ISBN 978-92-64-02912-5. • Rudolf M. Tackling obesity through the healthy child programme: a framework for action. National Obesity Observatory; 2009. • Hinkley T, Crawford D, Salmon J, Okely AD, Hesketh K. Preschool Children and Physical Activity: A Review of Correlates. Am J Prev Med 2008 May;34(5): 435-41. • De Craemer M, De Decker E, De Bourdeaudhuij I, Vereecken C, Deforche, B, Manois Y, Cardon G, on behalf of the ToyBox-study group. Correlates of energy balance-related behaviours in preschool children: a systematic review. Obesity reviews 2012;13 Suppl 1:13-28. • Okely AD, Salmon J, Trost SG, Hinkley T. Discussion paper for the development of physical activity recommendations for children under five years. Canberra, ACT, Australia; Australian Department of Health and Ageing, Government of Australia; 2008. • Ridgers ND, Fairclough SJ, Stratton G. Variables associated with children's physical activity levels during recess: the A-CLASS project. Int J Behav Nutr Phys Act 2010, 7:74.

42. References • Health and Social Care Information Centre. Health Survey for England 2012. Volume 1: Chapter 3 - Physical activity in children. Health and Social Care Information Centre: Leeds; 2013. • Reilly JJ, Okely AD, Almond L et al. Making the Case for UK Physical Activity Guidelines for Early Years: Recommendations and draft summary statements based on the current evidence. Working paper. 2009. • The Health and Social Care Information Centre, Lifestyles Statistics. National Child Measurement Programme: England, 2012/13 school year. Leeds: NHS Information Centre; 2013. • Okely AD, Salmon J, TrostSG, Hinkley T. Discussion paper for the development of physical activity recommendations for children under five years. Canberra: Department of Health and Ageing, Government of Australia; 2008. • Timmons BW, Naylor P, Pfeiffer KA . Physical activity for preschool children: How much and how? Applied Physiology, Nutrition, and Metabolism, 32, 122–134; 2007. • Department for Children, Schools and Families. Statutory Framework for the Early Years foundation Stage - Setting the Standards for Learning, Development and Care for children from birth to five. Nottingham: Department for Children, Schools and Families; 2008. • Northern Ireland Council for Curriculum, Examinations and Assessment. Understanding the Foundation Stage. Belfast: Early Years Interboard Group; 2006. • Wales Assembly Government. Framework for Children’s Learning for 3-7-year-olds in Wales. Cardiff: Wales Assembly Government; 2008. • Allen G. Early Intervention: the Next Steps, An Independent Report to her Majesty’s Government. London: HM Government; 2011.