Physical Activity, Sedentary Behavior, Sleep and Screen Time of Healthy Under-Fives Attending Selected Immunization Clinics and Anganwadis of South Kerala, India.

OBJECTIVE: To estimate the proportion of healthy under-fives whose physical activity, sedentary behavior, sleep and screen time adhered to WHO 2019 recommendations and to identify risk factors for non-adherence.

METHODS: A cross-sectional study was conducted among 480 healthy children (6 mo - 4 years) who attended 20 selected urban anganwadis or immunization clinics in South Kerala, India. Sociodemographic, anthropometric and outcome variables (duration of physical activity, sedentary behavior, sleep and screen time) were collected for all participants.

RESULTS: Physical activity, sedentary behavior, sleep and screen time recommendations were adhered by 63.3%, 22.7%, 82.2% and 22.7% under-five children, respectively. Risk factors for inadequate physical activity were female sex, nuclear family, maternal education below college level, unskilled maternal occupation/housewife, unskilled paternal occupation and low monthly income. Risk factors for non-adherence to recommended sedentary behavior duration included joint family, paternal education college level/above, unskilled maternal occupation/housewife, unskilled paternal occupation and low monthly income.

CONCLUSION: Under-fives should reduce sedentary behaviors and screen time and spend more time on physical activities.