Exercise in Children and Young People

The under-5s guidance recognises three developmental stages.

Infants under 1 year should be physically active several times a day in a variety of ways, including floor-based play such as crawling. For infants not yet mobile this includes at least 30 minutes of tummy time spread through the day while awake, built up gradually from a minute or two at a time, and babies should never be placed to sleep on their fronts. Toddlers aged 1 to 2 years should spend at least 180 minutes, or 3 hours, across the day in activities of any intensity, including active and outdoor play. Pre-schoolers aged 3 to 4 years should also reach at least 180 minutes a day, but of this at least 60 minutes should be moderate to vigorous activity. Across the early years the message is that more is better, and that long periods restrained in a buggy or car seat should be limited.

From 5 to 18 years, children and young people should average at least 60 minutes a day of moderate to vigorous activity across the week. The wording is deliberate: it is an average across the week rather than a strict daily minimum, which gives families flexibility. This can be made up of anything from physical education and active travel to play and sport. Alongside this, they should take part in a variety of types and intensities of activity across the week to develop movement skills, muscular fitness and bone strength, which means including vigorous activity and bone-loading activities such as running, jumping and skipping. As with adults, sedentary time should be minimised and long periods of sitting broken up with at least light activity.

The UK and WHO guidance for children are very similar, both recommending an average of 60 minutes a day of moderate to vigorous activity across the week, and the early-years figures are shared. The main difference is in how strengthening is expressed: WHO states explicitly that muscle and bone strengthening activities should be done on at least 3 days a week, whereas the UK folds this into the broader recommendation for a variety of activities that build muscular fitness and bone strength without naming a number of days. In practice both are asking for regular vigorous and bone-loading activity across the week.

The benefits of activity in this age group are wide: better cardiovascular fitness and healthy weight, stronger bones and muscles, improved mental health and wellbeing, and better learning and attainment. For an inactive child, any increase in activity or reduction in sitting is worthwhile. The practical emphasis is on enjoyment and variety, on high-quality physical education, and on creating opportunities to be active through play, sport and active travel, rather than on hitting a precise target. Separate UK guidelines for disabled children and young people, developed in 2022, recognise that the general evidence base was largely drawn from typically developing children. They recommend around 20 minutes of activity a day, built up gradually in manageable chunks, together with challenging but manageable strength and balance activities 3 times a week.

• •Under 1: active several times daily, including at least 30 minutes tummy time spread through the day; never sleep on the front.
• •1 to 2 years: at least 180 minutes any intensity; 3 to 4 years: at least 180 minutes including 60 minutes moderate to vigorous.
• •5 to 18 years: average at least 60 minutes a day of moderate to vigorous activity across the week.
• •Include variety and bone-loading activity; WHO specifies strengthening on at least 3 days a week.
• •Benefits include fitness, bone and muscle strength, mental health and better learning.
• •Separate UK guidelines cover disabled children and young people.