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Table 6 List of key research gaps to be addressed to better inform future physical activity and sedentary behaviour guideline recommendations in children and adolescents aged 5–17 years

From: 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence

1. Research is needed to develop standardized and harmonized methods of processing device-based measures of physical activity and sedentary behaviour.
2. Randomized controlled trials and prospective cohort studies that use device-based measures are needed to elucidate the causal and independent dose-response associations between physical activity or sedentary behaviour and health outcomes.
3. Work is needed to better address whether the associations between physical activity or sedentary behaviour and health outcomes vary by type or domain of physical activity or sedentary behaviour.
4. More work needs to examine the interactive effects of physical activity and sedentary behaviour on health outcomes. It is possible that higher levels of physical activity may be needed among youth who spend large amounts of time in sedentary behaviours.
5. Studies that examine the effects of newer forms of sedentary behaviour (e.g., smartphones, tablets) on various health outcomes are needed as well as studies that try to determine the role of interruptions or breaks in sedentary behaviour (e.g., quantifying the optimal combination of frequency, intensity and duration of interruptions).
6. Future studies should include a broader range of outcomes when examining the association between physical activity or sedentary behaviour and health (e.g., mental health, cognition, academic achievement, quality of life, motor skill development, and musculoskeletal outcomes such as spine/neck problems associated with screen use).
7. Future studies will need to conduct subgroup analyses to determine whether the patterns of association between physical activity or sedentary behaviour and health outcomes vary by age, sex, race/ethnicity, socioeconomic status and/or weight status. This knowledge gap substantially limits the ability to determine whether guideline recommendations should be applied broadly to the population or adapted to specific subgroups.