World Health Organization Issues New Guidelines on Physical Activity and Sedentary Behavior

Health and social media outlets are telling the tale of the Quarantine 15 or Pandemic 15 in adults referring to the average weight gain during the COVID-19 pandemic. Children have also been impacted by the limitations imposed by the quarantine with changes in activity levels and dietary habits. Dr. Tedros Adhanom Ghegreyesus, director general of the World Health Organization (WHO), highlighted the importance of physical activity as an essential component of physical and mental health, as he introduced the new guidelines on physical activity and sedentary behavior. Eighty percent of teens do not get enough physical activity.¹ Teens are also particularly susceptible to poor eating habits, placing them at increased risk for obesity, diabetes, and cardiovascular disease. The COVID-19 quarantine modified dietary habits, specifically with respect to fried foods, sweet foods, legumes, vegetables, and fruits.² Zachary et al.³ identified insufficient sleep and physical activity along with stress eating, snacking after dinner, and lack of dietary restraint as risk factors for weight gain. The new WHO guidelines on Physical Activity and Sedentary Behavior strongly recommend at least an average of 60 min per day of moderate to vigorous intensity physical activity across the week and further recommend that it is mostly aerobic exercise. Increased sedentary behaviors, such as have been reported during the pandemic have been associated with overweight and obesity, poor cardiovascular health, and fitness as well as poor sleep and behavioral issues. Recreational screen time is a major factor. For children who are not meeting these goals physicians should suggest “safe and equitable opportunities and encouragement to participate in physical activities that are enjoyable, offer variety and are appropriate to their age and ability.”⁴

A recent systematic review and meta-analysis of severe COVID-19 infection and pediatric comorbidities suggest that childhood obesity likely leads to a worse COVID-19 prognosis,⁵ whereas the Zachariah report found obesity was the most significant risk factor associated with mechanical ventilation in children age 2 years and above who were hospitalized with COVID-19.⁶ Therefore, it is prudent for pediatricians, educators, and public health officers to include healthy weight and physical activity into messaging during the COVID-19 pandemic.

At a time when the cumulative number of cases of COVID-19 continues to rise globally,⁷ it is important to explore our options to prevent, address risk factors, facilitate early identification, offer effective therapies, and learn more about long-term outcomes.