Preschool children in Greece, but also throughout Europe, are not as physically active as they should be and spend a lot of time in front of screens, two behaviors with negative consequences for their healthy development. At the same time, researchers find that states in Europe have not created national policies to protect the short- and long-term health of their future citizens.

In 2019, the World Health Organization (WHO) issued for the first time 24-hour guidelines concerning the physical movement of children under the age of five, giving guidelines for three inextricably linked behaviors: physical activity, sedentary behaviors (with an emphasis on screen time ) and the sleep. Specifically, according to the guidelines, a child under the age of five in order to develop healthily should have at least three hours of physical activity every day, with one of these hours being moderate to intense. Also, no screen time at all if under two years of age and no more than one hour a day of screen time between ages 2-5. Finally, to have 10-13 hours per 24 hours of quality sleep at the age of 3-5 years (12-17 hours for infants under one year old and 11-14 hours for children 1-3 years old).

The guidelines were preceded by the finding that a common myth has been dispelled. Children of infant and preschool age, all over the world, are no longer sufficiently physically active and the current lifestyle has trapped them in unconstructive sedentary behaviors and especially in a lot of time in front of screens.

In Greece, research by scientific groups, led by the associate professor of the Faculty of Physical Education and Sports of the EKPA, Fotini Venetsanou, published in 2019 and 2020, formed the same picture: preschool children are not sufficiently physically active, and in fact, on weekends when they spend free time with their parents, physical activity is lower than on weekdays when they go to school. Also, three out of ten children spend more than two hours a day in front of screens. In fact, screen time has been found to determine physical activity.

“We looked for whether physical activity is determined by parents’ educational or economic level and children’s body mass index. None of these showed a consistent relationship, except for screen time which appears to determine physical activity. In other words, it seems that as screen time increases, physical activity decreases, with the result that children lose their innate tendency to be physically active,” explains Ms. Venetsanou speaking to APE-MPE.

However, the reduction in physical activity has implications for children’s wider development. “A very large body of research demonstrates the importance of physical activity especially for this age. As movement is an expression and focus of children’s lives, through movement and their bodies, preschool children perceive the world around them, which is why movement contributes greatly to both their cognitive and emotional development. So the lack of physical activity has negative effects on children’s health and development. Especially with the screens, they receive too much information, which to a very large extent cannot be processed, as a result of which many of their functions are blocked”, points out the associate professor of EKPA.

Interestingly, a pooled analysis by researchers led by the University of Wollongong in Australia found that around 75% of preschool children in Europe did not meet WHO guidelines, with the rate likely to be even higher in some subgroups of population, such as children with chronic conditions and/or disabilities. The survey was conducted before the coronavirus pandemic, with the researchers noting that little has changed since then, and for the worse, as lockdowns have further reduced physical activity and increased children’s screen time.

Official policies for children

Five years after the publication of the 24-hour WHO guidelines, members of the SUNRISE international research team, including Ms. Venetsanou in Greece, evaluated the implementation of the guidelines in 13 European countries: Greece, Albania, England, Belgium , Spain, Netherlands, Poland, Portugal, Russia, Scotland, Sweden, Turkey and Finland. The results of their research were published in the journal “The Lancet”.

Specifically, the researchers looked at three areas: whether states have adopted these guidelines (or created their own), whether they have organized a system to monitor children’s physical movement behaviors, and whether they have specific policies in place on this issue.

The results were disappointing. In the vast majority of the countries studied, the WHO guidelines have not been adopted and there are no national 24-hour guidelines for children under the age of five, with the sole exception of Portugal and Finland and from Belgium only in Flanders. Also, compliance with the 24-hour guidelines is only monitored in Finland and only for children aged 4-6 years. The researchers note, in fact, that the lack of surveillance of children’s movement behaviors means that these problems in young children’s habits are actually invisible, and the lack of visibility leads to policy inaction. Finally, planning and implementation of policies to comply with the 24-hour directives was not identified in any of the 13 participating countries.

In Greece, through the research carried out by Mrs. Venetsanou and the communication she had with competent bodies, she found, as she reports in APE-MPE, that “the 24-hour guidelines of the WHO have not been adopted, there is no official program that monitors or to advise parents, teachers and pediatricians to monitor the behaviors highlighted by the WHO and there is no national policy that is officially implemented to encourage parents, teachers and the whole network around children to implement the physical activity guidelines, the sedentary behaviors and sleep of children up to five years old”.

Recently in Greece, the implementation of the National Action to combat childhood obesity began, a program implemented in collaboration with the Ministry of Health and UNICEF. Mrs. Venetsanou points out that this program “is an important step, but the policies of the state should be broader, with training of teachers and parents and with the implementation of programs to change spaces and create parks, where they can parents to take their children to play”. “The state and agencies should turn to what is ultimately important and invest in tomorrow’s citizens,” she adds.

The SUNRISE research project is an international research project involving researchers from 60 countries around the world and led by the University of Wollongong in Australia. The aim of the program is to reduce the levels of childhood obesity and the healthy development of children. The Greek research team of EKPA joined the program about a year ago and is currently implementing the pilot phase of research on 100 children attending daycare centers and kindergartens in Athens and villages in Thrace, with the aim of investigating physical activity, time screen time and children’s sleep time. The study will be followed by a main study with a sample of more than 500 children from all over Greece. The aim is to identify the habits of preschool children in Greece in relation to the WHO guidelines for physical activity, sedentary behaviors and screen time, as well as sleeping hours.