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Global Changes in Child and Adolescent Physical Activity During the COVID-19 PandemicA Systematic Review and Meta-analysis

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  To what extent has the COVID-19 pandemic affected the global physical activity levels of children and adolescents?

Findings  In this systematic review and meta-analysis of 22 international longitudinal studies that included 14 216 children 18 years and younger, pooled estimates revealed a decrease of 17 minutes per day in children’s moderate-to-vigorous physical activity from prepandemic to during the COVID-19 pandemic.

Meaning  Restrictions implemented during the COVID-19 pandemic have affected children’s levels of physical activity, particularly moderate-to-vigorous physical activity; children’s movement behaviors should be at the forefront of pandemic recovery efforts.

Abstract

Importance  Numerous physical distancing measures were implemented to mitigate the spread of the COVID-19 virus, which could have negatively affected child and adolescent physical activity levels.

Objectives  To conduct a systematic review and meta-analysis of the literature that used validated measures to document changes in child and adolescent physical activity during the COVID-19 pandemic and to estimate whether changes in physical activity differed between participant-level, contextual, and methodological moderators.

Data Sources  PubMed, PsycInfo, SPORTDiscus, Web of Science, Scopus, CINAHL, and MEDLINE were searched (from January 1, 2020, to January 1, 2022). A total of 1085 nonduplicate records were retrieved.

Study Selection  Studies were included if they reported (1) changes in the duration of physical activity at any intensity for children or adolescents (age ≤18 years) comparing before and during the COVID-19 pandemic using validated physical activity measurement tools and were (2) from general population samples, (3) peer-reviewed, and (4) published in English.

Data Extraction and Synthesis  A total of 126 articles underwent full-text review. Data were analyzed using a random-effects meta-analysis, which was conducted in January 2022.

Main Outcomes and Measures  Change in the duration of engagement in physical activity at any intensity comparing before and during COVID-19.

Results  Twenty-two studies including 46 independent samples and 79 effect sizes from 14 216 participants (median age, 10.5 years; range, 3-18 years) were included. The percentage change in the duration of engagement in total daily physical activity from before to during COVID-19 was −20% (90% CI, −34% to −4%). Moderation analyses revealed that changes were larger for higher-intensity activities (−32%; 90% CI, −44% to −16%), corresponding to a 17-minute reduction in children’s daily moderate-to-vigorous physical activity levels. The reduction in physical activity was also larger for samples located at higher latitudes (37%; 90% CI, −1% to 89%) and for studies with a longer duration between physical activity assessments (25%; 90% CI, −0.5% to 58%).

Conclusions and Relevance  Children and adolescents have experienced measurable reductions in physical activity during the COVID-19 pandemic. Findings underscore the need to provide bolstered access to support and resources related to physical activity to ensure good health and social functioning among children and adolescents during pandemic recovery efforts.

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Article Information

Accepted for Publication: May 4, 2022.

Published Online: July 11, 2022. doi:10.1001/jamapediatrics.2022.2313

Corresponding Author: Ross D. Neville, PhD, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland D04 V1W8 (ross.neville@ucd.ie).

Author Contributions: Drs Neville and Hopkins had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Neville, Lakes, Madigan.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Neville, Lakes, Tarantino, Madigan.

Critical revision of the manuscript for important intellectual content: Neville, Lakes, Hopkins, Draper, Beck, Madigan.

Statistical analysis: Neville, Hopkins, Tarantino.

Administrative, technical, or material support: Lakes, Tarantino, Beck, Madigan.

Supervision: Lakes.

Conflict of Interest Disclosures: None reported.

References
1.
Piercy  KL , Troiano  RP , Ballard  RM ,  et al.  The physical activity guidelines for Americans.   JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854PubMedGoogle ScholarCrossref
2.
Dale  LP , Vanderloo  L , Moore  S , Faulkner  G .  Physical activity and depression, anxiety, and self-esteem in children and youth: an umbrella systematic review.   Ment Health Phys Act. 2019;16:66-79. doi:10.1016/j.mhpa.2018.12.001Google ScholarCrossref
3.
Veldman  SLC , Chin A Paw  MJM , Altenburg  TM .  Physical activity and prospective associations with indicators of health and development in children aged <5 years: a systematic review.   Int J Behav Nutr Phys Act. 2021;18(1):6. doi:10.1186/s12966-020-01072-wPubMedGoogle ScholarCrossref
4.
Chaput  JP , Willumsen  J , Bull  F ,  et al.  2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5-17 years: summary of the evidence.   Int J Behav Nutr Phys Act. 2020;17(1):141. doi:10.1186/s12966-020-01037-zPubMedGoogle ScholarCrossref
5.
Telama  R , Yang  X , Viikari  J , Välimäki  I , Wanne  O , Raitakari  O .  Physical activity from childhood to adulthood: a 21-year tracking study.   Am J Prev Med. 2005;28(3):267-273. doi:10.1016/j.amepre.2004.12.003PubMedGoogle ScholarCrossref
6.
Thomas  H , Angrist  N , Cameron-Blake  E ,  et al. Oxford COVID-19 government response tracker. Accessed December 22, 2021. https://covidtracker.bsg.ox.ac.uk/
7.
Sallis  JF , Adlakha  D , Oyeyemi  A , Salvo  D .  An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices.   J Sport Health Sci. 2020;9(4):328-334. doi:10.1016/j.jshs.2020.05.005PubMedGoogle ScholarCrossref
8.
de Lannoy  L , Rhodes  RE , Moore  SA , Faulkner  G , Tremblay  MS .  Regional differences in access to the outdoors and outdoor play of Canadian children and youth during the COVID-19 outbreak.   Can J Public Health. 2020;111(6):988-994. doi:10.17269/s41997-020-00412-4PubMedGoogle ScholarCrossref
9.
Gustafsson  M . Pandemic-related disruptions to schooling and impacts on learning proficiency indicators: a focus on the early grades. UNESCO Institute for Statistics. Accessed February 8, 2022. https://reliefweb.int/report/world/pandemic-related-disruptions-schooling-and-impacts-learning-proficiency-indicators
10.
UNESCO. Framework for re-opening schools supplement: from re-opening to recovery–key resources. March 2021. Accessed February 8, 2022. https://www.unicef.org/media/94871/file/Framework%20for%20Reopening%20Schools%20Supplement-From%20Reopening%20to%20Recovery-Key%20Resources.pdf
11.
Li  X , Vanderloo  LM , Keown-Stoneman  CDG ,  et al.  Screen use and mental health symptoms in Canadian children and youth during the COVID-19 pandemic.   JAMA Netw Open. 2021;4(12):e2140875. doi:10.1001/jamanetworkopen.2021.40875PubMedGoogle ScholarCrossref
12.
McArthur  BA , Racine  N , Browne  D , McDonald  S , Tough  S , Madigan  S .  Recreational screen time before and during COVID-19 in school-aged children.   Acta Paediatr. 2021;110(10):2805-2807. doi:10.1111/apa.15966PubMedGoogle ScholarCrossref
13.
Denstel  KD , Broyles  ST , Larouche  R ,  et al; ISCOLE Research Group.  Active school transport and weekday physical activity in 9-11-year-old children from 12 countries.   Int J Obes Suppl. 2015;5(2)(suppl 2):S100-S106. doi:10.1038/ijosup.2015.26PubMedGoogle ScholarCrossref
14.
Ridgers  ND , Salmon  J , Parrish  AM , Stanley  RM , Okely  AD .  Physical activity during school recess: a systematic review.   Am J Prev Med. 2012;43(3):320-328. doi:10.1016/j.amepre.2012.05.019PubMedGoogle ScholarCrossref
15.
Ward  JS , Duncan  JS , Jarden  A , Stewart  T .  The impact of children’s exposure to greenspace on physical activity, cognitive development, emotional wellbeing, and ability to appraise risk.   Health Place. 2016;40:44-50. doi:10.1016/j.healthplace.2016.04.015PubMedGoogle ScholarCrossref
16.
Anderson  RM , Heesterbeek  H , Klinkenberg  D , Hollingsworth  TD .  How will country-based mitigation measures influence the course of the COVID-19 epidemic?   Lancet. 2020;395(10228):931-934. doi:10.1016/S0140-6736(20)30567-5PubMedGoogle ScholarCrossref
17.
Golberstein  E , Wen  H , Miller  BF .  Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents.   JAMA Pediatr. 2020;174(9):819-820. doi:10.1001/jamapediatrics.2020.1456PubMedGoogle ScholarCrossref
18.
Racine  N , McArthur  BA , Cooke  JE , Eirich  R , Zhu  J , Madigan  S .  Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis.   JAMA Pediatr. 2021;175(11):1142-1150. doi:10.1001/jamapediatrics.2021.2482PubMedGoogle ScholarCrossref
19.
Benner  AD , Mistry  RS .  Child development during the COVID-19 pandemic through a Life Course Theory lens.   Child Dev Perspect. 2020;14(4):236-243. doi:10.1111/cdep.12387PubMedGoogle ScholarCrossref
20.
World Health Organization. Physical activity and COVID-19. Accessed February 8, 2022. https://www.euro.who.int/en/health-topics/disease-prevention/physical-activity/activities/physical-activity-and-covid-19
21.
Organisation for Economic Cooperation and Development. Health at a glance. Accessed February 8, 2022. https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2021_ae3016b9-en
22.
World Economic Forum. Children exercised less during lockdown: here’s how to get them moving again. Accessed February 8, 2022. https://www.weforum.org/agenda/2022/01/young-people-exercise-pandemic-health-covid-19/
23.
Hossain  MS , Deeba  IM , Hasan  M ,  et al.  International study of 24-h movement behaviors of early years (SUNRISE): a pilot study from Bangladesh.   Pilot Feasibility Stud. 2021;7(1):176. doi:10.1186/s40814-021-00912-1PubMedGoogle ScholarCrossref
24.
Medrano  M , Cadenas-Sanchez  C , Oses  M , Arenaza  L , Amasene  M , Labayen  I .  Changes in lifestyle behaviours during the COVID-19 confinement in Spanish children: a longitudinal analysis from the MUGI project.   Pediatr Obes. 2021;16(4):e12731. doi:10.1111/ijpo.12731PubMedGoogle ScholarCrossref
25.
Schmidt  SCE , Anedda  B , Burchartz  A ,  et al.  Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany: a natural experiment.   Sci Rep. 2020;10(1):21780. doi:10.1038/s41598-020-78438-4PubMedGoogle ScholarCrossref
26.
Delisle Nyström  C , Alexandrou  C , Henström  M ,  et al.  International study of movement behaviors in the early years (SUNRISE): results from SUNRISE Sweden’s pilot and COVID-19 study.   Int J Environ Res Public Health. 2020;17(22):8491. doi:10.3390/ijerph17228491PubMedGoogle ScholarCrossref
27.
World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age: 2019. Accessed February 8, 2022. https://apps.who.int/iris/handle/10665/311664
28.
World Health Organization. Guidelines on physical activity and sedentary behaviour: 2020. Accessed February 10, 2022. https://www.who.int/publications/i/item/9789240015128
29.
Reilly  T , Peiser  B .  Seasonal variations in health-related human physical activity.   Sports Med. 2006;36(6):473-485. doi:10.2165/00007256-200636060-00002PubMedGoogle ScholarCrossref
30.
Shephard  RJ , Aoyagi  Y .  Seasonal variations in physical activity and implications for human health.   Eur J Appl Physiol. 2009;107(3):251-271. doi:10.1007/s00421-009-1127-1PubMedGoogle ScholarCrossref
31.
Ridgers  ND , Salmon  J , Timperio  A .  Too hot to move? objectively assessed seasonal changes in Australian children’s physical activity.   Int J Behav Nutr Phys Act. 2015;12:77. doi:10.1186/s12966-015-0245-xPubMedGoogle ScholarCrossref
32.
Cross  TJ , Isautier  JMJ , Stamatakis  E ,  et al.  Self-reported physical activity before a COVID-19 ‘lockdown’: is it just a matter of opinion?   BMJ Open Sport Exerc Med. 2021;7(2):e001088. doi:10.1136/bmjsem-2021-001088PubMedGoogle ScholarCrossref
33.
Freiberg  A , Schubert  M , Romero Starke  K , Hegewald  J , Seidler  A .  A rapid review on the influence of COVID-19 lockdown and quarantine measures on modifiable cardiovascular risk factors in the general population.   Int J Environ Res Public Health. 2021;18(16):8567. doi:10.3390/ijerph18168567PubMedGoogle ScholarCrossref
34.
Yomoda  K , Kurita  S .  Influence of social distancing during the COVID-19 pandemic on physical activity in children: a scoping review of the literature.   J Exerc Sci Fit. 2021;19(3):195-203. doi:10.1016/j.jesf.2021.04.002PubMedGoogle ScholarCrossref
35.
Khan  MA , Menon  P , Govender  R ,  et al.  Systematic review of the effects of pandemic confinements on body weight and their determinants.   Br J Nutr. 2022;127(2):298-317. doi:10.1017/S0007114521000921PubMedGoogle ScholarCrossref
36.
Polero  P , Rebollo-Seco  C , Adsuar  JC ,  et al.  Physical activity recommendations during COVID-19: narrative review.   Int J Environ Res Public Health. 2020;18(1):65. doi:10.3390/ijerph18010065PubMedGoogle ScholarCrossref
37.
Moher  D , Liberati  A , Tetzlaff  J , Altman  DG ; PRISMA Group.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.   PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097PubMedGoogle ScholarCrossref
38.
Xue  X , Qi  Q , Sotres-Alvarez  D ,  et al.  Modeling daily and weekly moderate and vigorous physical activity using zero-inflated mixture Poisson distribution.   Stat Med. 2020;39(30):4687-4703. doi:10.1002/sim.8748PubMedGoogle ScholarCrossref
39.
National Heart, Lung, and Blood Institute. Study quality assessment tools: quality assessment tool for observational cohort and cross-sectional studies. Accessed December 15, 2021. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
40.
Yang  M .  A Review of Random Effects Modelling in SAS. Centre for Multilevel Modelling; 2003.
41.
Cohen  J .  Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Lawrence Erlbaum; 1988.
42.
Hopkins  WG , Marshall  SW , Batterham  AM , Hanin  J .  Progressive statistics for studies in sports medicine and exercise science.   Med Sci Sports Exerc. 2009;41(1):3-13. doi:10.1249/MSS.0b013e31818cb278PubMedGoogle ScholarCrossref
43.
Cumming  G .  The new statistics: why and how.   Psychol Sci. 2014;25(1):7-29. doi:10.1177/0956797613504966PubMedGoogle ScholarCrossref
44.
Greier  K , Drenowatz  C , Bischofer  T ,  et al.  Physical activity and sitting time prior to and during COVID-19 lockdown in Austrian high-school students.   AIMS Public Health. 2021;8(3):531-540. doi:10.3934/publichealth.2021043PubMedGoogle ScholarCrossref
45.
Shneor  E , Doron  R , Levine  J ,  et al.  Objective behavioral measures in children before, during, and after the COVID-19 lockdown in Israel.   Int J Environ Res Public Health. 2021;18(16):8732. doi:10.3390/ijerph18168732PubMedGoogle ScholarCrossref
46.
Aguilar-Farias  N , Toledo-Vargas  M , Miranda-Marquez  S ,  et al.  Sociodemographic predictors of changes in physical activity, screen time, and sleep among toddlers and preschoolers in Chile during the COVID-19 pandemic.   Int J Environ Res Public Health. 2020;18(1):176. doi:10.3390/ijerph18010176PubMedGoogle ScholarCrossref
47.
Jáuregui  A , Argumedo  G , Medina  C , Bonvecchio-Arenas  A , Romero-Martínez  M , Okely  AD .  Factors associated with changes in movement behaviors in toddlers and preschoolers during the COVID-19 pandemic: a national cross-sectional study in Mexico.   Prev Med Rep. 2021;24:101552. doi:10.1016/j.pmedr.2021.101552PubMedGoogle ScholarCrossref
48.
López-Gil  JF , Tremblay  MS , Brazo-Sayavera  J .  Changes in healthy behaviors and meeting 24-h movement guidelines in Spanish and Brazilian preschoolers, children and adolescents during the COVID-19 lockdown.   Children (Basel). 2021;8(2):83. doi:10.3390/children8020083PubMedGoogle ScholarCrossref
49.
Nathan  A , George  P , Ng  M ,  et al.  Impact of covid-19 restrictions on western Australian children’s physical activity and screen time.   Int J Environ Res Public Health. 2021;18(5):2583. doi:10.3390/ijerph18052583PubMedGoogle ScholarCrossref
50.
Okely  AD , Kariippanon  KE , Guan  H ,  et al.  Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries.   BMC Public Health. 2021;21(1):940. doi:10.1186/s12889-021-10852-3PubMedGoogle ScholarCrossref
51.
Bronikowska  M , Krzysztoszek  J , Łopatka  M , Ludwiczak  M , Pluta  B .  Comparison of physical activity levels in youths before and during a pandemic lockdown.   Int J Environ Res Public Health. 2021;18(10):5139. doi:10.3390/ijerph18105139PubMedGoogle ScholarCrossref
52.
Carrillo-Diaz  M , Ortega-Martínez  AR , Romero-Maroto  M , González-Olmo  MJ .  Lockdown impact on lifestyle and its association with oral parafunctional habits and bruxism in a Spanish adolescent population.   Int J Paediatr Dent. 2022;32(2):185-193. doi:10.1111/ipd.12843PubMedGoogle ScholarCrossref
53.
Puccinelli  PJ , da Costa  TS , Seffrin  A ,  et al.  Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey.   BMC Public Health. 2021;21(1):425. doi:10.1186/s12889-021-10470-zPubMedGoogle ScholarCrossref
54.
Ostermeier  E , Tucker  P , Clark  A , Seabrook  JA , Gilliland  J .  Parents’ report of Canadian elementary school children’s physical activity and screen time during the covid-19 pandemic: a longitudinal study.   Int J Environ Res Public Health. 2021;18(23):12352. doi:10.3390/ijerph182312352PubMedGoogle ScholarCrossref
55.
Jia  P , Zhang  L , Yu  W ,  et al.  Impact of COVID-19 lockdown on activity patterns and weight status among youths in China: the COVID-19 Impact on Lifestyle Change Survey (COINLICS).   Int J Obes (Lond). 2021;45(3):695-699. doi:10.1038/s41366-020-00710-4PubMedGoogle ScholarCrossref
56.
Hyunshik  K , Jiameng  M , Sunkyoung  L , Ying  G .  Change in Japanese children’s 24-hour movement guidelines and mental health during the COVID-19 pandemic.   Sci Rep. 2021;11(1):22972. doi:10.1038/s41598-021-01803-4PubMedGoogle ScholarCrossref
57.
Alonso-Martínez  AM , Ramírez-Vélez  R , García-Alonso  Y , Izquierdo  M , García-Hermoso  A .  Physical activity, sedentary behavior, sleep and self-regulation in Spanish preschoolers during the COVID-19 lockdown.   Int J Environ Res Public Health. 2021;18(2):693. doi:10.3390/ijerph18020693PubMedGoogle ScholarCrossref
58.
Moore  SA , Faulkner  G , Rhodes  RE ,  et al.  Few Canadian children and youth were meeting the 24-hour movement behaviour guidelines 6-months into the COVID-19 pandemic: follow-up from a national study.   Appl Physiol Nutr Metab. 2021;46(10):1225-1240. doi:10.1139/apnm-2021-0354PubMedGoogle ScholarCrossref
59.
López-Bueno  R , Calatayud  J , Ezzatvar  Y ,  et al.  Association between current physical activity and current perceived anxiety and mood in the initial phase of COVID-19 confinement.   Front Psychiatry. 2020;11:729. doi:10.3389/fpsyt.2020.00729PubMedGoogle ScholarCrossref
60.
Burkart  S , Parker  H , Weaver  RG ,  et al.  Impact of the COVID-19 pandemic on elementary schoolers’ physical activity, sleep, screen time and diet: a quasi-experimental interrupted time series study.   Pediatr Obes. 2022;17(1):e12846. doi:10.1111/ijpo.12846PubMedGoogle ScholarCrossref
61.
Ng  JYY , He  Q , Chong  KH , Okely  AD , Chan  CHS , Ha  AS .  The impact of COVID-19 on preschool-aged children’s movement behaviors in Hong Kong: a longitudinal analysis of accelerometer-measured data.   Int J Environ Res Public Health. 2021;18(22):11907. doi:10.3390/ijerph182211907PubMedGoogle ScholarCrossref
62.
Gelman  A .  Scaling regression inputs by dividing by two standard deviations.   Stat Med. 2008;27(15):2865-2873. doi:10.1002/sim.3107PubMedGoogle ScholarCrossref
63.
Korczak  DJ , Madigan  S , Vaillancourt  T .  Data divide—disentangling the role of the COVID-19 pandemic on child mental health and well-being  Published online April 25, 2022.  JAMA Pediatr. 2022. doi:10.1001/jamapediatrics.2022.0791PubMedGoogle ScholarCrossref
64.
Wood  W , Rünger  D .  Psychology of habit.   Annu Rev Psychol. 2016;67:289-314. doi:10.1146/annurev-psych-122414-033417PubMedGoogle ScholarCrossref
65.
Verplanken  B , Roy  D , Whitmarsh  L . Cracks in the wall: habit discontinuities as vehicles for behaviour change. In: Verplanken  B , ed.  The Psychology of Habit. Springer; 2018:189-205. doi:10.1007/978-3-319-97529-0_11
66.
van Sluijs  EM , McMinn  AM , Griffin  SJ .  Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials.   BMJ. 2007;335(7622):703. doi:10.1136/bmj.39320.843947.BEPubMedGoogle ScholarCrossref
67.
Maltagliati  S , Rebar  A , Fessler  L ,  et al.  Evolution of physical activity habits after a context change: the case of COVID-19 lockdown.   Br J Health Psychol. 2021;26(4):1135-1154. doi:10.1111/bjhp.12524PubMedGoogle ScholarCrossref
68.
Hall  G , Laddu  DR , Phillips  SA , Lavie  CJ , Arena  R .  A tale of two pandemics: how will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another?   Prog Cardiovasc Dis. 2021;64:108-110. doi:10.1016/j.pcad.2020.04.005PubMedGoogle ScholarCrossref
69.
Weaver  RG , Armstrong  B , Hunt  E ,  et al.  The impact of summer vacation on children’s obesogenic behaviors and body mass index: a natural experiment.   Int J Behav Nutr Phys Act. 2020;17(1):153. doi:10.1186/s12966-020-01052-0PubMedGoogle ScholarCrossref
70.
Hunt  ET , von Klinggraeff  L , Jones  A ,  et al.  Differences in the proportion of children meeting behavior guidelines between summer and school by socioeconomic status and race.   Obes Sci Pract. 2021;7(6):719-726. doi:10.1002/osp4.532PubMedGoogle ScholarCrossref
71.
Zosel  K , Monroe  C , Hunt  E , Laflamme  C , Brazendale  K , Weaver  RG .  Examining adolescents’ obesogenic behaviors on structured days: a systematic review and meta-analysis.   Int J Obes (Lond). 2022;46(3):466-475. doi:10.1038/s41366-021-01040-9PubMedGoogle ScholarCrossref
72.
Alexander  K , Pitcock  S , Boulay  M .  The Summer Slide: What We Know and Can Do About Summer Learning Loss. Teachers College Press; 2016.
73.
World Health Organization. To grow up healthy, children need to sit less and play more. Accessed April 24, 2022. https://www.who.int/news/item/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more
74.
Abid  R , Ammar  A , Maaloul  R , Souissi  N , Hammouda  O .  Effect of COVID-19-related home confinement on sleep quality, screen time and physical activity in Tunisian boys and girls: a survey.   Int J Environ Res Public Health. 2021;18(6):3065. doi:10.3390/ijerph18063065PubMedGoogle ScholarCrossref
75.
UNICEF. Averting a lost COVID generation: a six-point plan to respond, recover and reimagine a post-pandemic world for every child. Accessed February 21, 2022. https://www.unicef.org/media/86881/file/Averting-a-lost-covid-generation-world-childrens-day-data-and-advocacy-brief-2020.pdf
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