1. The UK physical activity guidelines for early years and the benefits of physical activity for this age group

2. 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
This set of guidelines, first published in July 2011 and titled Start Active, Stay Active, is the first time all four home countries have had the same guidelines – first joint report endorsed by all four Chief Medical Officers.
The guidelines are based on comprehensive reviews of research evidence and take account of publications which consider the revised guidelines in other developed countries such as USA, Australia and Canada.
These guidelines cover all age groups across the lifespan and for the first time include guidelines for early years (0-5 years).
The recommendations are based on prescribing a minimum level of physical activity to benefit health and focus on prevention of disease and are therefore not disease specific.
These guidelines apply to all, irrespective of gender, race, or socio-economic status, but should be interpreted with consideration of individual physical and mental capabilities.

3. Why the need for UK physical activity guidelines for the early years?
Follow lead of other major countries
Previous children and young people guidelines not appropriate for early years
The early years, ie, children aged 0-5 years, has not previously been included as their own population group in UK public health guidelines for physical activity.
These guidelines reflect a growing awareness that early life experiences impact upon future health outcomes, and draw on notable recent advances in the science of physical activity and health.
The UK has followed the lead of other countries including USA and Australia who published early years guidelines in 2009, prior to the release of the 2011 CMO UK physical activity guidelines.
5-18 years guidelines specify an intensity – not developmentally appropriate for the early years. Early years need time to develop fundamental movement skills and master their physical environment. This cannot be accomplished in one hour. They need ample time spread throughout the day and to reflect the sporadic nature of this age group’s activity patterns.

4. UK physical activity guidelines: Early years
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.
There is considerable expert opinion from many international sources that letting children crawl, play and roll around on the floor in the home or childcare setting is essential during the early years, particularly for children who cannot yet walk.

5. Types of physical activity: Non-walkers
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
Crawl, roll, play on floor
- lots of unrestricted time to move and play on the floor. Important for development of children’s early motor skills, to learn how to control their bodies and move well, to discover their hands and feet and space around them - ‘making sense of the world’.
Tummy time
- as well as time on their back, it is important to have daily opportunities to move on their tummies. This is important for strengthening the muscles in babies’ arms, legs, back and neck. ‘Little and often’ is best as some babies find it hard to tolerate this position for too long. Back to sleep campaign due to cot death fears have meant babies are spending much less time on their fronts than they used to. Remember tummy time is only for when babies are awake and supervised. Babies should always be placed on their backs to sleep.
New movements
- need time to practise new movements. Babies learn new skills when their bodies are ready – physically strong enough but also when the brain and nerves are developed enough to send the right messages to the muscles. This will vary in different children. Development is age related but not age-determined. Tend to develop movements in the same order, although differences in how and when, eg, bottom shufflers vs crawlers and how long it takes to walk.
Reaching for and grasping objects, pulling and pushing objects
- Later, children need opportunities to practise rolling, creeping and crawling before being able to pull up, cruise around furniture and walk unaided.
Playing with other people
- Important for bonding, visual and language development. Movements such as gently spinning, swinging and rocking a baby, help to develop their balance (vestibular) system (how we deal with gravity and remain upright while moving).
Parent and baby swim sessions
- Offered at many local leisure centres.

6. UK physical activity guidelines: Early years
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.
Recommendations for the early years refer to all levels of physical activity, ie, light, moderate or vigorous (more energetic activity) without specific reference to intensity. Recommendations specifying a particular intensity of activity are not developmentally appropriate for this age group.
For this age group, it is the amount and nature of activity that is important, not the intensity.
Physical activity can be accumulated throughout a whole day and suits the intermittent nature of children’s play of this age. Also helps to break up too much ‘sitting time’.
By ‘physical activity’ we are referring to activities that involve movements of all the major muscle groups, ie, the legs, buttocks, shoulders and arms, and movement of the trunk (body) from one place to another.

7. Types of physical activity: Walkers
Guideline 2
Unstructured, physically active play
Energetic play
Develop motor skills (locomotor, stability and object control)
Active travel and everyday activities
Unstructured physically active play
- Likely to make up the most of the 180 minutes.
- Should involve using large muscle groups and practising a wide range of movements
- Experience a wide range of play equipment
- Have fun and feel good about themselves
- Self exploratory
Some structured activity such as dancing, gymnastic-type movements and swimming can also make a valuable contribution.
Energetic play
- eg, running and chasing games which make children ‘huff and puff’ in short bouts are good for the development of the heart and lungs
- burns calories (important for maintaining healthy weight).
Developmental activities
- Locomotor - ie, travelling, eg, running, jumping, hopping, galloping, sliding
- Stability, eg, balancing activities, riding a bike, climbing, scooting
- Object control, eg, rolling, kicking, catching, throwing, striking a ball
Active travel
- Walking, cycling, scooting - even part way to places can help to build up stamina.
Everyday activities
- Both at the setting and in the home, encourage these activities
- Eg, setting the table and tidying away after meal times, tidying up and putting away toys, self-care activities (dressing, buttoning, putting on and taking off shoes).

8. UK physical activity guidelines: early years
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).
Although there is limited research exploring the health consequences of sedentary behaviour in children under five, there is emerging evidence that sedentary behaviour in the early years is associated with overweight and obesity as well as lower cognitive development.
Sedentary behaviour goes against the child’s natural tendencies to be active. Physical restraint, such as long periods in pushchairs or highchairs, is a common barrier to physical activity that is unique to this age group.
Reducing sedentary time can influence health but also provides more time to be active.

9. Sedentary behaviour
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.
Research into the health consequences of sedentary behaviour is at an early stage. The main evidence references overweight and obesity across the life course. There is emerging evidence of a link between sedentary behaviour and lower cognitive development in the early years.
Patterns of sedentary behaviour are relatively stable over time so it’s important to minimise this type of behaviour from an early age.
Sedentary behaviour is a risk factor for poor health independent of physical activity (ie, being sufficiently active whilst being sedentary for long periods in between can still have negative health consequences). Therefore it is important to limit sedentary behaviours AND be physically active throughout the day.

10. Minimising sedentary behaviour
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.
There are times when children will need to sit in a buggy, highchair or car seat. Reduce these times and break them up where possible. Some suggestions could be:
allow extra time on long journeys and take regular breaks
try not using the car for short trips
try just using the highchair at mealtimes
think about not leaving the TV on during mealtimes or when children are playing
children copy adults so care must be taken with how often they see adults watching television or playing with the computer.

11. 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
Data from tracking studies show support for a link between higher levels of physical activity leading to more sustained participation in physical activity in later years.
It is important to establish a high level of physical activity at the earliest age in order to provide the best start, to encourage physical activity patterns and habits later in childhood that are sufficient to benefit long term health. It is also understood that as activity levels tend to decline with age, it is important to establish high levels during early childhood in order that activity levels in later childhood are sufficient to benefit health.

12. Impact of physical activity on whole child
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 and emotional skills
Improves self-confidence
Evidence from observational research and a small number of experimental studies indicates that regular physical activity is valuable in developing motor skills, promoting healthy weight, enhancing bone and muscular development, and for the learning of social skills. Physical activities involving the use of large muscle groups are likely to be more energetic activities and especially good for the development of the heart and lungs.
The physical activity guidelines highlight the essential role of physical activity in promoting physical and psychological development during these years and contributing towards establishing patterns of behaviour that may persist into later childhood and adulthood.

13. Impact of physical activity on the whole child
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.
Obesity
Strongest evidence of health benefits in the early years is around preventing obesity and maintaining a healthy weight.
Brain development
In recent years, there has been a growing awareness about the importance of physical activity for babies and young children - through increased research and knowledge, especially around the neurosciences and the effects of early life experiences on the brain.
This evidence is telling us that the critical time for the development of the brain is between birth and the age of three.

14. Impact of physical activity on the whole child
Cognitive ‘thinking’
Creativity and discovery
Problem solving skills
Good listening skills
Enhanced memory skills
Creativity and discovery - experimentation and exploration, developing imagination, thinking in different ways. FREE PLAY.
Problem solving skills - thinking critically and making choices for themselves; ability to set challenges and desire to seek solutions to problems and challenges.
Good listening skills - the ability to listen in a range of situations, listening to others and responding appropriately.
Enhanced memory skills - repetition and practice of different movements help to develop this.

15. Impact of physical activity on the whole child
Physical development
Stamina
Strength
Mobility
Motor skills
Stamina – developed through continuous bouts, eg, walking and more energetic activity, eg, running, scooting.
Strength and mobility – developed through exposure to a wide variety of different play experiences and equipment.
Motor skills – learning to move with confidence and control including: stability (core, shoulder, hand), agility, hand-eye-foot co-ordination, rhythm and timing (musicality), balance and spatial awareness.

16. 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
Fair play – knowing how to behave and what is acceptable
Cooperation – taking turns, sharing, playing by the rules in play and games situations.
Language and communication – listening attentively, responding with comments, questions or actions, speaking confidently in a familiar group, understanding movement vocabulary.
Confidence – trying new activities, working in a group, asking for help if needed.
Optimism – enjoying their own achievements, wanting to try out new activities even if they sense they may not achieve success first time but willingness to ‘have a go’.
Resilience – coping with stressful situations.
Sense of self belief – adopting a ‘can do’ approach and perseverance that they will be able to achieve in the end.
Behavioural flexibility – being able to adapt emotionally to new situations without becoming stressed.