A new paradigm employing 24-h movement guidelines that combines recommendations for movement behaviors across the whole day (physical activities of all intensities, sedentary behaviors, and sleep) is gaining momentum around the globe, and several jurisdictions are developing and releasing evidence-informed public health guidelines embracing this approach.1,2 The Sedentary Behavior Research Network (SBRN), the world’s largest network of researchers and health professionals focusing specifically on the health impact of sedentary behaviors, embraces this new paradigm and has worked to normalize the integration of sedentary behaviors into the movement-behavior paradigm.3
The newly released Canadian 24-Hour Movement Guidelines for Adults aged 18 to 64 years and Adults aged 65 years and older are consistent with this integrated movement-behavior paradigm; they represent the world’s first 24-h movement guidelines for adults and older adults and complete the “family” of 24-h guidelines in Canada.4 The new Canadian guidelines were developed following well-established, comprehensive, robust, and transparent processes that are thoroughly documented and publicly available.4 In these new guidelines, Canada becomes the first country to make specific time recommendations with regard to sedentary behavior and screen time for adults.4 The SBRN is regularly approached for such recommendations, but to date, authoritative guidelines have been lacking and, indeed, have been recently debated.5,6
The sedentary behavior portion of the new Canadian 24-Hour Movement Guidelines for Adults aged 18 to 64 years and Adults aged 65 years and older recommend “Limiting sedentary time to 8 h or less, which includes no more than 3 h of recreational screen time, and breaking up long periods of sitting as often as possible (strong recommendation, very low-quality evidence)”.4 By releasing these guidelines, Canada became the first country to identify specific targets for daily sedentary behavior and recreational screen time. The guidelines were informed by the United States Physical Activity Guidelines Advisory Committee Scientific Report,7,8 an overview of reviews by Saunders et al.9 and recent meta-analyses.10, 11, 12 Although it is acknowledged that these are strong recommendations based on low- to very-low-quality evidence, the recommendations are based on the best-available evidence, the informed opinion of panel experts, stakeholder input, and the observation that the benefits associated with adherence to the recommendations outweigh any possible negative consequences. Under such circumstances, recent recommendations encourage guideline developers to provide specific advice, even if the underlying evidence is of low quality or is insufficient.13
Before the new Canadian guidelines were finalized, a draft version was distributed through a stakeholder survey to gather input, feedback, and assessments from stakeholders, including SBRN members.4,14 The survey was designed to explore SBRN members’ perceptions and levels of agreement with the new sedentary-behavior recommendations outlined in the Canadian 24-Hour Movement Guidelines for Adults aged 18 to 64 years and Adults aged 65 years and older. The survey was live for 2 and a half weeks, and 877 stakeholders landed on the front page of the survey. Of these, 126 identified as SBRN members (aged 42.2 ± 18.5 years, mean ± SD), completed the survey, and were included in the analyses. Within the SBRN sample, the majority of participants were female (60.5%), had a university education (97.6%), and reported ethnicity as British Isles (37.3%), European (36.5%), or North American (19.0%). Respondents were from 8 different provinces across Canada (48.4%), as well as outside of Canada (51.6%), and represented several occupational sectors (respondents could select more than 1), including research (61.1%), public health (53.2%), education (31.0%), health care (23.8%), sport (19.0%), care for older adults (10.3%), recreation (7.9%), non-government organizations (4.0%), government (4.0%), and other (2.4%).
Based on SBRN members’ responses to the stakeholder survey (Fig. 1), there is strong, though not unanimous, support for the sedentary-behavior recommendations in the new guidelines. Of the participants, 82.3% indicated that they “somewhat agree” or “strongly agree” that the sedentary-behavior recommendations are clearly stated, and 80.2% reported they “somewhat agree” or “strongly agree” with how the sedentary behavior recommendations are stated. Conversely, a relatively small percentage of participants felt that the recommendations were not clearly stated (10.8%) or disagreed with how the recommendations were stated (15.8%). Additional comments from SBRN stakeholders were concerned primarily with quantifying “prolonged sitting” (n = 17), defining “sedentary” and providing practical examples (n = 11), and defining “recreational screen time” (n = 2). Only a few members (n = 4) suggested the recommendations were unrealistic and/or intimidating.
Senior Scientist and Director, Healthy Active Living and Obesity, CHEO Research Institute