The adherence to 24-hour movement guidelines from preschool to adolescence in China: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Shihua ¹ , HU Zhongxu ² , YE Yijun ¹ , REN Yingying ¹ , ZHU Yaolei ¹ , ZHU Chao ¹ , HAN Ronghua ³ , ZHU Zheng ⁴ ,  GAO Xibin ¹

1. Physical Education, Shanghai University of Sport, Shanghai 200438, P. R. China;
2. Moray House School of Education and Sport, University of Edinburgh, Edinburgh EH89AQ, UK;
3. Physical Education, Beijing Sport University, Beijing 100084, P. R. China;
4. Sports Medicine, Shanghai University of Sport, Shanghai 200438, P. R. China;

Corresponding?author：

GAO Xibin, Email: gaoxibin@sus.edu.cn

Keywords：

24-hour movement guidelines; Preschool children; Children; Adolescents; Adherence rate; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202507102

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the adherence rate to the 24-hour movement guidelines among Chinese children and adolescents from preschool to high school age, and to analyze the characteristics of high-risk groups and influencing factors. Methods The CNKI, WanFang Data, VIP, Web of Science, PubMed and EBSCOHost databases were electronically searched to collect studies related to the objectives from inception to March 2025. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 18.0 software. Results A total of 62 studies were included. The overall adherence rate to all three guidelines among Chinese children and adolescents was 5.78% (95%CI 4.54% to 7.17%), while the non-adherence rate to all three was 17.28% (95%CI 12.29% to 22.93%). Subgroup analysis showed that compliance rate decreased with increasing educational stage. The compliance rate of high-intensity physical activity in males was higher than that in females, and the compliance rate of screen exposure duration in females was slightly better than that in males. The compliance rate of physical activity among urban preschool to adolescent groups was higher than that of the same group in rural areas. The physical activity and sleep adherence rates of ethnic minorities were higher than those of the Han ethnic group. Conclusion Overall adherence to the 24-hour movement guidelines among Chinese children and adolescents is low, with significant disparities across age, gender, urban-rural residence, and ethnicity.

Citation： JIANG Shihua, HU Zhongxu, YE Yijun, REN Yingying, ZHU Yaolei, ZHU Chao, HAN Ronghua, ZHU Zheng, GAO Xibin. The adherence to 24-hour movement guidelines from preschool to adolescence in China: a systematic review. Chinese Journal of Evidence-Based Medicine, 2026, 26(5): 533-538. doi: 10.7507/1672-2531.202507102 Copy

1.	Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020, 54(24): 1451-1462.
2.	Tremblay MS, Carson V, Chaput JP, et al. Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab, 2016, 41(6 Suppl 3): S311-S327.
3.	Tremblay MS, Chaput JP, Adamo KB, et al. Canadian 24-hour movement guidelines for the early years (0-4 years): an integration of physical activity, sedentary behaviour, and sleep. BMC Public Health, 2017, 17(Suppl 5): 874.
4.	Okely AD, Ghersi D, Hesketh KD, et al. A collaborative approach to adopting/adapting guidelines - The Australian 24-hour movement guidelines for the early years (birth to 5 years): an integration of physical activity, sedentary behavior, and sleep. BMC Public Health, 2017, 17(Suppl 5): 869.
5.	Loo BKG, Okely AD, Pulungan A, et al. Asia-Pacific consensus statement on integrated 24-hour activity guidelines for children and adolescents. Br J Sports Med, 2022, 56(10): 539-545.
6.	杜文雯, 房紅蕓, 周瑋瑋, 等. 1982-2016年中國6-17歲兒童青少年體質指數和腰圍變化趨勢. 衛生研究, 2025, 54(2): 175-180.
7.	胡霄, 李麗, 歐陽一非, 等. 2000-2018年中國十六省(自治區、直轄市)7-17歲兒童青少年超重與肥胖流行趨勢. 衛生研究, 2022, 51(4): 568-573.
8.	中國心血管健康與疾病報告2022概要. 中國循環雜志, 2023, 38(6): 583-612.
9.	中國居民營養與慢性病狀況報告(2020年). 營養學報, 2020, 42(6): 521.
10.	Pan W, Saw SM, Wong TY, et al. Prevalence and temporal trends in myopia and high myopia children in China: a systematic review and meta-analysis with projections from 2020 to 2050. Lancet Reg Health West Pac, 2025, 55: 101484.
11.	中共中央、國務院印發《“健康中國2030”規劃綱要》. 中華人民共和國國務院公報, 2016, (32): 5-20.
12.	陳元, 王麗娟, 梁果, 等. 兒童青少年24 h活動與肥胖進展的關系-基于上海市318名小學生2年的前瞻性隊列研究. 上海體育學院學報, 2022, 46(6): 41-51.
13.	黃梨煜, 郭丹丹, 喻穎杰, 等. 北京市3-12年級學生睡眠狀況及其影響因素分析. 中國健康教育, 2025, 41(2): 99-104.
14.	王路, 趙海, 孫冰潔, 等. 北京市中小學生睡眠不足與篩查性近視的關聯. 中國學校衛生, 2025, 46(1): 14-17.
15.	殷小雅, 翟婭妮, 袁琳琳, 等. 上海市中學生飲食行為與睡眠時長的關聯. 中國學校衛生, 2024, 45(8): 1140-1143.
16.	Tapia-Serrano MA, Sevil-Serrano J, Sánchez-Miguel PA, et al. Prevalence of meeting 24-hour movement guidelines from pre-school to adolescence: a systematic review and meta-analysis including 387, 437 participants and 23 countries. J Sport Health Sci, 2022, 11(4): 427-437.
17.	Chen ST, Liu Y, Tremblay MS, et al. Meeting 24-h movement guidelines: prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents. J Sport Health Sci, 2021, 10(3): 349-359.
18.	Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 2021, 372: n160.
19.	Hutton B, Catalá-López F, Moher D. The PRISMA statement extension for systematic reviews incorporating network meta-analysis: PRISMA-NMA. Med Clin (Barc), 2016, 147(6): 262-266.
20.	Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev, 2019, (10): ED000142.
21.	National Heart, Lung, and Blood Institute. Quality assessment tool for observational cohort and cross-sectional studies. 2025.
22.	Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Health, 2014, 72(1): 39.
23.	Newcombe RG. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med, 1998, 17(8): 857-872.
24.	Barendregt JJ, Doi SA, Lee YY, et al. Meta-analysis of prevalence. J Epidemiol Community Health, 2013, 67(11): 974-978.
25.	Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021, 372: n71.
26.	鄭卿勇, 許建國, 周姿余, 等. PRISMA報告規范體系的演進、應用與挑戰. 中國循證醫學雜志, 2025, 25(12): 1452-1462.
27.	李穎, 程千吉, 楊秋玉, 等. 以家庭為基礎干預措施對兒童青少年屏幕暴露干預效果的網狀Meta分析. 中國循證醫學雜志, 2025, 25(7): 818-826.
28.	蔣世華, 朱政, 任盈盈, 等. 中國兒童青少年近視患病率及影響因素的Meta分析. 中國全科醫學, 2025, (5): 1-10.
29.	倪亞紅, 馬陸亭, 趙富春. 中小學減負政策執行力反思與出路. 中國教育學刊, 2018, (6): 39-43.
30.	張丹青, 路瑛麗, 劉陽. 身體活動和靜態生活方式的影響因素-基于我國兒童青少年的系統綜述. 體育科學, 2019, 39(12): 62-75.
31.	李波, 王駿, 黃斌. 作業時間對學生學業成績的影響及其機制研究-兼論“雙減”政策背景下的最優作業量. 教育經濟評論, 2022, 7(2): 44-64.
32.	孫曉敏, 楊舒婷, 孔小杉, 等. 時間貧困內涵及其對幸福感的影響: 稀缺理論視角. 心理科學進展, 2024, 32(1): 27-38.
33.	王軍. 鄉村振興視閾下城鄉體育融合發展的動因、條件與對策. 西安體育學院學報, 2019, 36(1): 65-69.
34.	張磊, 倪勝利. 身體視域下的勞動教育: 文化內涵、價值意蘊與實踐路向. 國家教育行政學院學報, 2019, (10): 88-95.
35.	Chen S, Liang K, López-Gil JF, et al. Association between meeting 24-h movement guidelines and academic performance in a sample of 67 281 Chinese children and adolescents. Eur J Sport Sci, 2024.
36.	Hong Y, Ullah R, Wang JB, et al. Trends of obesity and overweight among children and adolescents in China. World J Pediatr, 2023, 19(12): 1115-1126.
37.	Jebeile H, Kelly AS, O'Malley G, et al. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol, 2022, 10(5): 351-365.
38.	Jee D, Morgan IG, Kim EC. Inverse relationship between sleep duration and myopia. Acta Ophthalmol, 2016, 94(3): e204-e210.
39.	樊澤民, 劉立京, 王海濤. 扎實推進全國兒童青少年近視防控工作. 中國學校衛生, 2018, 39(11): 1605-1608, 1612.
40.	Feng J, Zheng C, Sit CH, et al. Associations between meeting 24-hour movement guidelines and health in the early years: a systematic review and meta-analysis. J Sports Sci, 2021, 39(22): 2545-2557.
41.	Rollo S, Antsygina O, Tremblay MS. The whole day matters: understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan. J Sport Health Sci, 2020, 9(6): 493-510.
42.	Sampasa-Kanyinga H, Colman I, Goldfield GS, et al. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review. Int J Behav Nutr Phys Act, 2020, 17(1): 72.
43.	de Lucena Martins CM, Lemos LFGBP, de Souza Filho AN, et al. Adherence to 24-hour movement guidelines in low-income Brazilian preschoolers and associations with demographic correlates. Am J Hum Biol, 2021, 33(4): e23519.
44.	Tapia-Serrano MA, Sevil-Serrano J, Sánchez-Miguel PA. Adherence to 24-hour movement guidelines among spanish adolescents: differences between boys and girls. Children (Basel), 2021, 8(2): 95.
45.	毛振明, 楊多多. 《“健康中國2030”規劃綱要》與學校體育改革施策(一)-目標: 青少年熟練掌握一項以上體育運動技能. 武漢體育學院學報, 2018, 52(2): 5-10.
46.	梁鳳波, 毛振明, 程天佑, 等. 《“健康中國2030”規劃綱要》與學校體育改革施策(3)目標: 確保學生校內每天體育活動時間不少于一小時. 武漢體育學院學報, 2018, 52(7): 82-87.
47.	張加林, 唐炎, 胡月英. 我國兒童青少年體育環境特征與存在問題研究. 體育科學, 2017, 37(3): 21-34, 97.
48.	季瀏, 馬德浩. 新時代我國學校體育改革與發展. 體育科學, 2019, 39(3): 3-12.
49.	專家組. “雙減”政策與學校體育發展. 上海體育學院學報, 2021, 45(11): 1-15.
50.	李彥龍, 常鳳. “雙減”政策下我國中小學課后延時體育服務時效與保障. 體育學研究, 2022, 36(2): 33-40.
51.	楊曼麗, 張吾龍, 胡德剛, 等. “雙減”政策下我國中小學課后延時體育服務的演進歷程、機遇挑戰及實現路徑. 體育學研究, 2022, 36(2): 21-32.
52.	許弘, 李先雄. 體教融合背景下青少年體育活動開展的困境與思考. 體育學刊, 2021, 28(2): 7-12.
53.	王先茂, 王健, 魯長芬, 等. 學校、社區、家庭體育一體化發展困局、域外經驗與發展對策研究. 成都體育學院學報, 2019, 45(3): 112-118, 126.
54.	毛振明, 丁天翠, 藺曉雨. 新時代加強與改進中國學校體育的目標與策略-對2007年以來7個關于學校體育工作重要文件的分析與比較. 北京體育大學學報, 2021, 44(9): 2-12.
55.	劉陽. 基于加速度計的身體活動測量研究前沿. 北京體育大學學報, 2016, 39(8): 66-73.

1. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020, 54(24): 1451-1462.
2. Tremblay MS, Carson V, Chaput JP, et al. Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab, 2016, 41(6 Suppl 3): S311-S327.
3. Tremblay MS, Chaput JP, Adamo KB, et al. Canadian 24-hour movement guidelines for the early years (0-4 years): an integration of physical activity, sedentary behaviour, and sleep. BMC Public Health, 2017, 17(Suppl 5): 874.
4. Okely AD, Ghersi D, Hesketh KD, et al. A collaborative approach to adopting/adapting guidelines - The Australian 24-hour movement guidelines for the early years (birth to 5 years): an integration of physical activity, sedentary behavior, and sleep. BMC Public Health, 2017, 17(Suppl 5): 869.
5. Loo BKG, Okely AD, Pulungan A, et al. Asia-Pacific consensus statement on integrated 24-hour activity guidelines for children and adolescents. Br J Sports Med, 2022, 56(10): 539-545.
6. 杜文雯, 房紅蕓, 周瑋瑋, 等. 1982-2016年中國6-17歲兒童青少年體質指數和腰圍變化趨勢. 衛生研究, 2025, 54(2): 175-180.
7. 胡霄, 李麗, 歐陽一非, 等. 2000-2018年中國十六省(自治區、直轄市)7-17歲兒童青少年超重與肥胖流行趨勢. 衛生研究, 2022, 51(4): 568-573.
8. 中國心血管健康與疾病報告2022概要. 中國循環雜志, 2023, 38(6): 583-612.
9. 中國居民營養與慢性病狀況報告(2020年). 營養學報, 2020, 42(6): 521.
10. Pan W, Saw SM, Wong TY, et al. Prevalence and temporal trends in myopia and high myopia children in China: a systematic review and meta-analysis with projections from 2020 to 2050. Lancet Reg Health West Pac, 2025, 55: 101484.
11. 中共中央、國務院印發《“健康中國2030”規劃綱要》. 中華人民共和國國務院公報, 2016, (32): 5-20.
12. 陳元, 王麗娟, 梁果, 等. 兒童青少年24 h活動與肥胖進展的關系-基于上海市318名小學生2年的前瞻性隊列研究. 上海體育學院學報, 2022, 46(6): 41-51.
13. 黃梨煜, 郭丹丹, 喻穎杰, 等. 北京市3-12年級學生睡眠狀況及其影響因素分析. 中國健康教育, 2025, 41(2): 99-104.
14. 王路, 趙海, 孫冰潔, 等. 北京市中小學生睡眠不足與篩查性近視的關聯. 中國學校衛生, 2025, 46(1): 14-17.
15. 殷小雅, 翟婭妮, 袁琳琳, 等. 上海市中學生飲食行為與睡眠時長的關聯. 中國學校衛生, 2024, 45(8): 1140-1143.
16. Tapia-Serrano MA, Sevil-Serrano J, Sánchez-Miguel PA, et al. Prevalence of meeting 24-hour movement guidelines from pre-school to adolescence: a systematic review and meta-analysis including 387, 437 participants and 23 countries. J Sport Health Sci, 2022, 11(4): 427-437.
17. Chen ST, Liu Y, Tremblay MS, et al. Meeting 24-h movement guidelines: prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents. J Sport Health Sci, 2021, 10(3): 349-359.
18. Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 2021, 372: n160.
19. Hutton B, Catalá-López F, Moher D. The PRISMA statement extension for systematic reviews incorporating network meta-analysis: PRISMA-NMA. Med Clin (Barc), 2016, 147(6): 262-266.
20. Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev, 2019, (10): ED000142.
21. National Heart, Lung, and Blood Institute. Quality assessment tool for observational cohort and cross-sectional studies. 2025.
22. Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Health, 2014, 72(1): 39.
23. Newcombe RG. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med, 1998, 17(8): 857-872.
24. Barendregt JJ, Doi SA, Lee YY, et al. Meta-analysis of prevalence. J Epidemiol Community Health, 2013, 67(11): 974-978.
25. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021, 372: n71.
26. 鄭卿勇, 許建國, 周姿余, 等. PRISMA報告規范體系的演進、應用與挑戰. 中國循證醫學雜志, 2025, 25(12): 1452-1462.
27. 李穎, 程千吉, 楊秋玉, 等. 以家庭為基礎干預措施對兒童青少年屏幕暴露干預效果的網狀Meta分析. 中國循證醫學雜志, 2025, 25(7): 818-826.
28. 蔣世華, 朱政, 任盈盈, 等. 中國兒童青少年近視患病率及影響因素的Meta分析. 中國全科醫學, 2025, (5): 1-10.
29. 倪亞紅, 馬陸亭, 趙富春. 中小學減負政策執行力反思與出路. 中國教育學刊, 2018, (6): 39-43.
30. 張丹青, 路瑛麗, 劉陽. 身體活動和靜態生活方式的影響因素-基于我國兒童青少年的系統綜述. 體育科學, 2019, 39(12): 62-75.
31. 李波, 王駿, 黃斌. 作業時間對學生學業成績的影響及其機制研究-兼論“雙減”政策背景下的最優作業量. 教育經濟評論, 2022, 7(2): 44-64.
32. 孫曉敏, 楊舒婷, 孔小杉, 等. 時間貧困內涵及其對幸福感的影響: 稀缺理論視角. 心理科學進展, 2024, 32(1): 27-38.
33. 王軍. 鄉村振興視閾下城鄉體育融合發展的動因、條件與對策. 西安體育學院學報, 2019, 36(1): 65-69.
34. 張磊, 倪勝利. 身體視域下的勞動教育: 文化內涵、價值意蘊與實踐路向. 國家教育行政學院學報, 2019, (10): 88-95.
35. Chen S, Liang K, López-Gil JF, et al. Association between meeting 24-h movement guidelines and academic performance in a sample of 67 281 Chinese children and adolescents. Eur J Sport Sci, 2024.
36. Hong Y, Ullah R, Wang JB, et al. Trends of obesity and overweight among children and adolescents in China. World J Pediatr, 2023, 19(12): 1115-1126.
37. Jebeile H, Kelly AS, O'Malley G, et al. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol, 2022, 10(5): 351-365.
38. Jee D, Morgan IG, Kim EC. Inverse relationship between sleep duration and myopia. Acta Ophthalmol, 2016, 94(3): e204-e210.
39. 樊澤民, 劉立京, 王海濤. 扎實推進全國兒童青少年近視防控工作. 中國學校衛生, 2018, 39(11): 1605-1608, 1612.
40. Feng J, Zheng C, Sit CH, et al. Associations between meeting 24-hour movement guidelines and health in the early years: a systematic review and meta-analysis. J Sports Sci, 2021, 39(22): 2545-2557.
41. Rollo S, Antsygina O, Tremblay MS. The whole day matters: understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan. J Sport Health Sci, 2020, 9(6): 493-510.
42. Sampasa-Kanyinga H, Colman I, Goldfield GS, et al. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review. Int J Behav Nutr Phys Act, 2020, 17(1): 72.
43. de Lucena Martins CM, Lemos LFGBP, de Souza Filho AN, et al. Adherence to 24-hour movement guidelines in low-income Brazilian preschoolers and associations with demographic correlates. Am J Hum Biol, 2021, 33(4): e23519.
44. Tapia-Serrano MA, Sevil-Serrano J, Sánchez-Miguel PA. Adherence to 24-hour movement guidelines among spanish adolescents: differences between boys and girls. Children (Basel), 2021, 8(2): 95.
45. 毛振明, 楊多多. 《“健康中國2030”規劃綱要》與學校體育改革施策(一)-目標: 青少年熟練掌握一項以上體育運動技能. 武漢體育學院學報, 2018, 52(2): 5-10.
46. 梁鳳波, 毛振明, 程天佑, 等. 《“健康中國2030”規劃綱要》與學校體育改革施策(3)目標: 確保學生校內每天體育活動時間不少于一小時. 武漢體育學院學報, 2018, 52(7): 82-87.
47. 張加林, 唐炎, 胡月英. 我國兒童青少年體育環境特征與存在問題研究. 體育科學, 2017, 37(3): 21-34, 97.
48. 季瀏, 馬德浩. 新時代我國學校體育改革與發展. 體育科學, 2019, 39(3): 3-12.
49. 專家組. “雙減”政策與學校體育發展. 上海體育學院學報, 2021, 45(11): 1-15.
50. 李彥龍, 常鳳. “雙減”政策下我國中小學課后延時體育服務時效與保障. 體育學研究, 2022, 36(2): 33-40.
51. 楊曼麗, 張吾龍, 胡德剛, 等. “雙減”政策下我國中小學課后延時體育服務的演進歷程、機遇挑戰及實現路徑. 體育學研究, 2022, 36(2): 21-32.
52. 許弘, 李先雄. 體教融合背景下青少年體育活動開展的困境與思考. 體育學刊, 2021, 28(2): 7-12.
53. 王先茂, 王健, 魯長芬, 等. 學校、社區、家庭體育一體化發展困局、域外經驗與發展對策研究. 成都體育學院學報, 2019, 45(3): 112-118, 126.
54. 毛振明, 丁天翠, 藺曉雨. 新時代加強與改進中國學校體育的目標與策略-對2007年以來7個關于學校體育工作重要文件的分析與比較. 北京體育大學學報, 2021, 44(9): 2-12.
55. 劉陽. 基于加速度計的身體活動測量研究前沿. 北京體育大學學報, 2016, 39(8): 66-73.

Chinese Journal of Evidence-Based Medicine

The adherence to 24-hour movement guidelines from preschool to adolescence in China: a systematic review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content