First study to measure physical activity in Canadian infants and toddlers

TORONTO—New research from The Hospital for Sick Children (SickKids) is the first of its kind to objectively measure physical activity in children under age three. The study measured physical activity and sedentary time in children aged four months to five years old. Most children ages 18 months to four years met Canadian physical activity guidelines, whereas children under 18 months and over five years did not. The study is published in the Nov. 17 online edition of Applied Physiology, Nutrition, and Metabolism.

The current Canadian Society for Exercise Physiology guidelines recommend 180 minutes of physical activity throughout the day for children four and under, and at least 60 minutes of moderate to vigorous activity each day for children five to 11.

“While our study shows that the five year olds struggled to meet the guidelines, it may have more to do with the changes in physical activity guidelines when children transition from the younger to the older age groups, rather than a decrease in physical activity,” says Dr. Cornelia Borkhoff, first author of the study and Senior Research Associate in the Division of Paediatric Medicine at SickKids.

The research, led by Dr. Catherine Birken, paediatrician at SickKids and co-lead of TARGet Kids! (The Applied Research Group for Kids!), had primary care physicians equip 90 children with a wearable technology called an accelerometer which measures their daily physical activity and sedentary time.

The children were divided into three age-groups: under 18 months, 18 months to four years, and five years and older. Researchers found the youngest and oldest age groups were struggling to meet current Canadian standards.

The middle group (18 months to four years) fared well, with 76 per cent achieving the daily requirement of 180 minutes of physical activity. However, only 23 per cent of participants younger than 18 months met the same guideline.

Even fewer children five years and over were meeting their age-specific requirements, with only 13 per cent getting the recommended 60 minutes of moderate to vigorous physical activity per day. This group had a higher average total number of minutes of daily physical activity compared with children ages 18 months to four years, but in a day 58 per cent of their time was spent sedentary, 33 per cent of their time was spent doing light physical activity, and only nine per cent of their day was spent doing moderate to vigorous activity.

Despite the very low activity levels, researchers say the change in guidelines themselves could be part of the explanation.

Borkhoff says the findings also suggest that more research is needed about how to measure activity in infants not yet crawling or walking independently “We may need to reconsider basing recommendations on the number of minutes of activity for this age group,” says Borkhoff.

In the meantime, she has some advice for parents, “Physical activity can be a family affair. Other research has shown that when parents themselves are active, children are too.”

Parents can also increase their child’s exercise by encouraging more unstructured play.


TARGet Kids! is a collaborative research project between SickKids and St. Michael’s Hospital that aims to understand the links between healthy eating and active living behaviours in early childhood and adult health.

About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit

For more information, please contact:
Caitlin McNamee-Lamb
The Hospital for Sick Children
416-813-7654, ext. 201436