Physical Activity Guidelines: Global Trends and Korean Perspectives

Yoon-Jung Choi; Jeongran Ko; Junghoon Kim

doi:10.15758/ajk.2025.27.3.114

Asian J Kinesiol > Volume 27(3); 2025 > Article

Choi, Ko, and Kim: Physical Activity Guidelines: Global Trends and Korean Perspectives

Review

The Asian Journal of Kinesiology 2025;27(3):114-123.

Published online: July 31, 2025

DOI: https://doi.org/10.15758/ajk.2025.27.3.114

Physical Activity Guidelines: Global Trends and Korean Perspectives

Yoon-Jung Choi^*, Jeongran Ko^*, Junghoon Kim^**

Sports and Exercise Medicine Laboratory, Korea Maritime & Ocean University, Busan 49112, Republic of Korea

^* These two authors contributed equally to conduct of the studies.

^**Correspondence: Junghoon Kim, Ph.D., Sports and Exercise Medicine Laboratory, National Korea Maritime & Ocean University, Busan 49112, Republic of Korea;
Tel: +82-51-410-4792, Fax: +82-504-372-0664, E-mail: junghoonkim@kmou.ac.kr

Received July 21, 2025 Revised July 30, 2025 Accepted July 31, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Regular physical activity is universally recognized as a cornerstone of good health. Substantial evidence shows that an active lifestyle lowers the risk of major non-communicable diseases and improves mental well-being and overall quality of life. Despite these well-established benefits, physical inactivity remains a pervasive global problem; approximately one in three adults and four in five adolescents fail to meet recommended physical activity levels. Increasing attention focuses on 24-hour movement behaviors, an integrated concept that encompasses physical activity, sedentary behavior, and sleep across a full day. Rather than addressing these behaviors in isolation, recent guidelines advocate a whole-day approach, recognizing that activity, inactivity, and sleep collectively impact health. Evidence shows a clear dose–response relationship, as adhering to recommendations for all three behaviors yields greater health benefits than meeting only one or two. The 24-hour movement framework represents a global shift toward integrated health guidelines that emphasize physical activity, reduced sedentary time, and adequate sleep. In response to high inactivity and sedentary rates, Korea has aligned with this approach through its updated national guidelines. However, translating these recommendations into action requires cultural changes, supportive environments, and multilevel strategies. Future research should investigate how socioeconomic and cultural factors influence adherence to 24-hour movement guidelines in Korea and explore the effectiveness of integrated interventions targeting multiple behaviors simultaneously. Embracing and adapting the 24-hour approach is essential for advancing public health in Korea.

Keywords: 24-Hour Movement Guideline / Guidelines / Physical Activity / Sedentary Behavior / Sleep

Introduction

Regular physical activity is universally recognized as a cornerstone of good health. Substantial evidence shows that an active lifestyle lowers the risk of major non-communicable diseases (such as cardiovascular disease, diabetes, and certain cancers) and improves mental well-being and overall quality of life [1-5]. Despite these well-established benefits, physical inactivity remains a pervasive global problem; approximately one in three adults and four in five adolescents fail to meet recommended physical activity levels [2,3,6-8]. This inactivity is a major public health concern, contributing to the increasing prevalence of noncommunicable diseases and placing additional burden on healthcare systems. The persistent gap between the known benefits of physical activity and actual behavior highlights the urgent need for research to inform and support evidence-based public health policies aimed at increasing physical activity in the population. Strengthening the evidence base for effective interventions and guidelines is essential to inform global strategies for addressing physical inactivity and maximizing the health benefits of an active society.

Increasing attention focuses on 24-hour movement behaviors, an integrated concept that encompasses physical activity, sedentary behavior, and sleep across a full day [9,10]. Rather than addressing these behaviors in isolation, recent guidelines advocate a whole-day approach, recognizing that activity, inactivity, and sleep collectively impact health [11,12]. Evidence shows a clear dose–response relationship, as adhering to recommendations for all three behaviors yields greater health benefits than meeting only one or two [2,11,13,14]. In other words, adherence to all movement guidelines, including sufficient physical activity, limited sedentary time, and adequate sleep, is associated with more favorable health indicators than partial adherence [11]. Since 2016, this evidence has driven the development of integrated 24-hour movement guidelines by several organizations and countries.

This review provides a comprehensive overview of recent developments in 24-hour movement guidelines, focusing on the World Health Organization (WHO) global guidelines on physical activity and sedentary behavior, Canada’s pioneering 24-Hour Movement Guidelines (which integrate physical activity, sedentary behavior, and sleep), and the current status and challenges of physical activity participation in Korea. We examine major international recommendations, the integration of movement behaviors into guidelines, their health implications, and policy considerations.

Global Physical Activity Guidelines

WHO Guidelines on Physical Activity and Sedentary Behaviour

In 2020, the WHO updated its global recommendations on physical activity, expanding on the 2010 guidelines [15]. The revised guidelines provide age-specific targets for physical activity and, for the first time, include recommendations to limit sedentary behavior, though without a quantified limit [15]. The WHO emphasizes that “some physical activity is better than none,” and that more activity generally yields greater health benefits [15]. Regular aerobic activity and muscle-strengthening activities are recommended across all age groups [15]. While minimizing sedentary behavior throughout life is encouraged, the WHO did not specify exact time limits because of evidence uncertainties [15].

Key points from the 2020 WHO guidelines are:

• Adults (18–64 years): Adults should engage in 150–300 min of moderate-intensity aerobic activity per week, 75–150 min of vigorous-intensity activity, or an equivalent combination [15]. Muscle-strengthening activities involving major muscle groups are recommended at least 2 days per week [16]. Sedentary time should be minimized, as any increase in physical activity, even below the recommended thresholds, offers health benefits [15]. Notably, owing to insufficient evidence, the WHO did not set a specific quantitative limit for sedentary behavior beyond recommending that less is better [15].

• Older Adults (65 years or older): The adult guidelines above apply, with added emphasis on incorporating balance and coordination exercises at least 3 days per week for older adults with poor mobility to help prevent falls [16]. Additional strength training is advised at least 2 days per week, similar to that in younger adults [16]. Engaging in up to 300 min of moderate-intensity exercise per week is encouraged for additional health benefits [16].

• Children and Adolescents (5–17 years): This group should engage in at least 60 min of moderate-to-vigorous physical activity (MVPA) daily throughout the week [15]. Activities should include vigorous-intensity exercises and muscle- and bone-strengthening exercises (such as jumping, running, or sports) at least 3 days per week [15]. The WHO recommends limiting sedentary time, particularly recreational screen time, although no specific hourly limit is provided in global guidelines [15]. The primary message is that reduced sedentary behavior complements an active lifestyle and supports better health.

• Infants and Young Children (under 5 years): In 2019, the WHO issued separate guidelines integrating physical activity, sedentary behavior, and sleep for this age group. Infants (<1 year) should be physically active several times a day through interactive floor-based play, while toddlers or preschoolers (1–4 years) should accumulate at least 180 min of physical activity of any intensity, spread throughout the day [17]. Sedentary screen time is not recommended for infants and should be no more than 1 hour per day for children aged 2–4 years [17]. These guidelines also specify adequate sleep (e.g., 10–14 hours per day for children aged 1–4, including naps) [17]. This holistic approach for young children reinforces the importance of balancing active play, limited screen-based sedentary time, and sufficient sleep within a 24-hour period.

Canadian 24-Hour Movement Guidelines: An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Canada was the first country to introduce fully integrated 24-Hour Movement Guidelines that jointly address physical activity, sedentary behavior, and sleep. This paradigm began with the 2016 guidelines for children and youth and has since been extended to all age groups [18]. The Canadian guidelines emphasize that “the whole day matters,” promoting a balance of healthy movement behaviors characterized by increased physical activity, reducing sedentary time, and adequate sleep within a 24-hour cycle [10]. Table 1 summarizes the key recommendations from Canada’s 24-hour guidelines, alongside those from the WHO and other guidelines for comparison.

Canadian Adults (18–64 years): Canada released its first 24-hour guidelines for adults [10,18], integrating three core recommendations: Move More, Reduce Sedentary Time, and Sleep Well [10].

Specific recommendations for adults include:

• Physical Activity: Adults should achieve at least 150 min of moderate-to-vigorous aerobic activity per week [10] and perform muscle-strengthening activities at least 2 days per week [10]. Canada’s guidelines also encourage “several hours of light physical activity, including standing” daily, emphasizing the health benefits of lightintensity movements such as casual walking or standing breaks [10].

• Sedentary Behavior: Sedentary time should be limited to no more than 8 hours per day, with recreational screen time restricted to 3 hours or less [10]. Long periods of sitting should be interrupted as frequently as possible through standing or light activity [10]. These specific limits provide clear targets for adults to reduce sedentary behaviors, addressing the gap in WHO’s qualitative advice.

• Sleep: Adults are advised to get 7–9 hours of good-quality sleep each night, with consistent bed and wake times [10]. Including sleep duration and quality in the guidelines underscores its importance as part of a healthy day and its interdependence with activity levels and sedentary habits.

Canadian Older Adults (65 years or older):

• Physical Activity: Older adults should participate at least 150 min of moderate-to-vigorous aerobic activity per week and perform muscle-strengthening activities using major muscle groups at least 2 days per week [10,18]. It also emphasizes physical activities that challenge balance. Similar to the adult guidelines, Canada’s guidelines encourage “several hours of light physical activities, including standing” daily [10,18].

• Sedentary Behavior: Daily sedentary time should not exceed 8 hours, and recreational screen time restricted to 3 hours or less [10,18]. It is also recommended to frequently interrupt prolonged sitting by incorporating light physical activities or standing [10,18].

• Sleep: Older adults are recommended to get 7–8 hours of good-quality sleep per night, while maintaining consistent bed and wake times [10,18].

The Canadian adult guidelines emphasize the need to balance these behaviors. Specifically, sedentary time should be replaced with physical activity, but not at the expense of adequate sleep [9,10]. The guidelines stress that all movement counts— replacing sedentary time with any activity, and light activity with more intense activity (while maintaining adequate sleep), yields greater health benefits [9,10]. Even if all targets cannot be met immediately, progress toward any of them yields considerable health benefits [9,10]. This pragmatic approach promotes steady improvements toward an ideal combination of high physical activity, low sedentary time, and sufficient sleep. Emerging evidence supports these guidelines. For example, fewer than 1 in 10 Canadian adults currently meet all three recommendations; however, those who do demonstrate significantly better health biomarkers, including adiposity, fitness, and cardiometabolic profiles, than those meeting none or only one [19].

Canadian Children and Youth (5–17 years): Canada’s integrated guidelines for school-aged children (2016) [20] and early years (2017) have had a global influence [21]. For children and adolescents aged 5–17 years, the guidelines—often summarized as the “Sweat, Step, Sleep, Sit” paradigm—recommend the following: at least 60 min of MVPA daily, incorporating vigorous activity and muscle- and bone-strengthening exercises at least 3 days a week [8]; no more than 2 hours of recreational screen time per day [20]; and 9–11 hours of night sleep for children aged 5–13 years (or 8–10 hours for those aged 14–17) with consistent bedtimes [20]. Additionally, children should engage in several hours of light physical activity (active play) and avoid extended sedentary periods. These integrated targets are based on research indicating that Canadian youth who meet all three movement recommendations exhibit significantly better outcomes in body composition, physical fitness, and cognitive and mental health than those meeting only one or none [11].

Canadian Early Years (0–4 years): Canada’s 2017 guidelines recommend at least 3 hours of physical activity spread throughout the day for toddlers and preschoolers, including periods of energetic play. Screen time should be avoided for children under 2 years and limited to no more than 1 hour per day for those aged 2–4. Sleep recommendations vary by age, with toddlers, for example, requiring 11–14 hours per day [21]. These thresholds closely align with the WHO’s 2019 guidelines for children under 5, reflecting a shared emphasis on minimizing screen-based sedentary time and encouraging regular movement and sleep for healthy early development [9].

<Table 1> compares key elements from the WHO and Canadian guidelines for physical activity, sedentary behavior, and sleep. Many countries have either adopted these models or are progressing toward integrated 24-hour frameworks. For example, the Physical Activity Guidelines for Americans (2nd edition, 2018) recommend activity levels similar to those of the WHO—150 min per week for adults and 60 min per day for youth—and emphasize reducing sedentary time [22]. However, they do not specify quantitative limits for sedentary behavior or incorporate sleep (which is addressed in separate sleep health recommendations). Nonetheless, the trend is clearly toward holistic guidance. Canada’s approach has provided a feasible template that other nations and the WHO have begun to follow, particularly for the younger age group. By 2020, with the release of guidelines for adults, Canada had established a “full suite” of integrated 24-hour movement guidelines covering all age groups [18], an approach that may serve as a model for other regions.

Physical Activity and Sedentary Behavior in Korea: Current Status and Challenges

Despite global efforts to promote physical activity, South Korea faces significant challenges related to low activity levels and high sedentary behavior in its population. Recent data and national surveillance have revealed concerning trends. In 2020, only approximately 44.2% of Korean adults met the recommended levels of aerobic physical activity, meaning nearly half of the adult population is insufficiently active [13]. This level of inactivity is notably lower than the global average, where approximately 72% of adults achieve at least the minimum WHO-recommended activity levels [13]. Moreover, activity levels among Korean adults have been declining [23]. In 2014, 58.3% of adults met the aerobic exercise guidelines compared to 45.6% in 2020 [8]. This downward trend raises concern that Korea may be heading in the wrong direction in terms of public physical activity, despite growing awareness of its importance. Objective assessments using accelerometers show that the average daily sedentary time among Koreans was 8 hours (60.6% of the day), which is the highest compared with data reported from other countries (<Figure 1>) [7]. In contrast, the average time spent on MVPA was only 19 min per day (3.8% of the day). The proportion of the population meeting the recommended guidelines was 15.5% for physical activity, 48.5% for sedentary behavior, and 54.6% for sleep [13]. Notably, only 3.5% of the population met all three 24-hour movement behavior guidelines [13].

Physical inactivity is particularly prevalent among Korean youth. A 2020 national survey found that 94.1% of adolescents aged 11–17 years did not meet the WHO’s recommendation of at least 60 min of daily MVPA [8]. This corresponds to only 5.9% being sufficiently active, with 8.7% of boys and 2.9% of girls adhering to the guidelines [8]. This proportion of Korean adolescents meeting the guideline is significantly lower than the global average, where approximately 19% of adolescents globally met the 60-min recommendation based on 2016 data [8]. Physical activity declines with age, with older Korean adolescents—particularly high school students—being less active than middle school students [8]. Contributing factors include intense academic pressure, long study hours (reducing time for sports or exercise), and a screen-oriented leisure culture, which collectively limit opportunities for physical activity among Korean youth.

Beyond aerobic exercise, engagement in muscle-strengthening activities is low. In 2020, only 24.7% of Korean adults met the recommended minimum muscle-strengthening exercises of at least twice per week [3,8]. However, this rate has not improved over the past decade [8]. Consequently, only 16.9% of adults met both aerobic and muscle-strengthening guidelines, with 21.9% of men and only 11.8% of women [3,8]. Among adolescents, only 24% engaged in muscle-strengthening activities (e.g., push-ups and weight-lifting exercises) at least 3 days per week as recommended [8]. Notably, participation was significantly higher among boys (36.8%) than among girls (10.1%) [8]. This low participation in resistance exercise raises concern for musculoskeletal health and metabolic fitness and reflects suboptimal engagement in sports or physical education, particularly among female adolescents.

Koreans spend a considerable portion of their day engaged in sedentary behavior, such as sitting or reclining with minimal energy expenditure. In 2020, a study reported an average sedentary time of 8.6 hours per day among Korean adults [8]. Young adults (aged 19–29 years) were the most sedentary at 9.7 hours per day, while even the least sedentary group (those in their 60s) sat nearly 8 hours per day [8]. Daily sedentary time has steadily increased since 2014 [8] and is likely exacerbated by shifts toward office work, screen-based leisure activities, and COVID-19 restrictions (e.g., remote work and online schooling). Sedentary behavior is even more pronounced among Korean adolescents, who averaged over 10 hours of sitting per day in 2020 [8]. Girls had slightly higher sedentary time (10.7 hours per day) than boys (9.9 hours per day) [8], and the trend for both sexes has been increasing in recent years. Such prolonged sedentary behavior, likely attributed to screen use for studying, gaming, and smartphone engagement, poses independent health risks. Long sitting periods were associated with poor cardiometabolic health and higher all-cause mortality, even after adjusting for physical activity [8]. Therefore, the extremely high sedentary time among Korean youth, far exceeding the 8-hour threshold recommended by Canada’s adult guidelines, is a serious public health concern.

The health implications of these patterns in Korea are significant. Physical inactivity and sedentary lifestyles contribute to increased rates of obesity, type 2 diabetes, cardiovascular disease, certain cancers, and mental health conditions such as depression [2,13,24,25]. In Korea, the government has emphasized that insufficient physical activity is linked to a higher risk of chronic diseases and premature mortality. From an economic perspective, approximately 76 trillion KRW (nearly $58 billion) in healthcare costs and 20 trillion KRW in productivity losses were attributable to physical inactivity and related deaths in a given year. These striking figures underscore that sedentary behavior and physical inactivity are not only medical concerns but also substantial societal and economic burdens.

Recognizing these challenges, Korean health authorities have taken proactive steps. In 2023, the Ministry of Health and Welfare released the revised Physical Activity Guidelines for Koreans—the first major revision since 2013 [26]. This updated national guideline aligns closely with WHO’s global recommendations and, for the first time, explicitly emphasizes reducing sedentary behavior. It reiterates that adults should accumulate 150–300 min of moderate-intensity (or 75–150 min of vigorous-intensity) activity weekly, engage in muscle-strengthening exercises on at least 2 days per week [26], and incorporate balance exercises in older adults [26]. Additionally, the guidelines reinforce the recommendation of at least 60 min of physical activity per day for adolescents aged 6–17 years [26]. A consistent message for all age groups is to “sit less and move more,” advising the replacement of excessive screen time (TV, computer, and smartphone) with physical activity whenever possible [27]. By translating the WHO guidelines into the local context (including a Korean-language version of the WHO 2020 guidelines [28], the government aims to raise public awareness. However, effective implementation remains a challenge, as widespread dissemination and adoption at the community level are essential to drive meaningful behavioral changes.

Emerging Research Trends and Policy Implications

The transition toward 24-hour movement guidelines marks a shift in research focus, moving from isolated behaviors to the integrated impact of physical activity, sedentary time, and sleep on health [29-31]. A key development is the use of compositional analysis, which considers how time reallocation among daily behaviors affects outcomes. Evidence shows that replacing sedentary time with light activity or ensuring sufficient sleep within recommended levels improves health[27]. These findings support interventions that simultaneously address multiple behaviors and emphasize the importance of health campaigns that encourages substituting inactivity with more active alternatives.

Sedentary behavior is now recognized as an independent risk factor for adverse health outcomes[5,32,33]. Prolonged sitting increases health risks even among individuals who meet the recommended physical activity levels [34-38]. Consequently, the recommendations increasingly promote breaking up sedentary time and limiting screen use. Research suggests that high levels of physical activity can partially mitigate the effects of prolonged sitting; however, reducing sedentary time remains essential— particularly for guiding workplace and school-based policies, such as movement breaks and standing alternatives.

The inclusion of sleep in the movement guidelines reflects its close connection with activity [39-41]. Poor sleep is associated with cardiovascular disease, obesity, mental health disorders, and cognitive impairment [39-41]. In contrast, regular physical activity improves sleep quality, and vice versa [42]. Adolescent sleep deprivation is a major concern in Korea, making sufficient sleep a critical target for promoting youth health.

Surveillance systems have been adapted to assess adherence to 24-hour guidelines; however, compliance remains low— typically less than 10% in many countries, including Korea. Wearables enhance measurement accuracy and support targeted interventions. Some studies have also focused on specific populations, leading to tailored recommendations for older adults, individuals with chronic conditions, and youth [41,43-45]. In Korea, strategies to increase physical activity include integrating culturally familiar activities, leveraging schools for youth interventions, and exploring technology-based solutions, such as fitness apps and exergaming. Policy directions include promoting a multi-sectoral approach (across health, education, and urban planning), raising public awareness, addressing access and equity, and creating supportive environments. Monitoring and evaluation using national targets and consistent data collection are essential to guide and improve implementation. As inactivity poses a high economic burden, investment in the promotion of physical activity can be justified as a cost-effective public health strategy.

Current research and policy momentum are toward treating physical activity, sedentary behavior, and sleep as interdependent aspects of the health puzzle. The 24-hour movement guidelines, led by the WHO and Canada, encapsulate this holistic view. For South Korea, adopting this perspective is both timely and necessary. Although the country has achieved remarkable success in other health metrics over the past decades, the rising prevalence of sedentary lifestyles and insufficient physical activity poses a growing threat to public health. The challenge now lies in effectively translating the guidelines into practice and fostering a culture and environment that supports active, less sedentary, and well-rested lifestyles as societal norms.

Conclusion

The 24-hour movement framework represents a global shift toward integrated health guidelines that emphasize physical activity, reduced sedentary time, and adequate sleep. In response to high inactivity and sedentary rates, Korea has aligned with this approach through its updated national guidelines. However, translating these recommendations into action requires cultural changes, supportive environments, and multilevel strategies. Future research should investigate how socioeconomic and cultural factors influence adherence to 24-hour movement guidelines in Korea and explore the effectiveness of integrated interventions targeting multiple behaviors simultaneously. Embracing and adapting the 24-hour approach is essential for advancing public health in Korea.

Notes

Acknowledgments

This work was supported by Korea Maritime & Ocean University, the National Research Foundation of Korea (NRF) grant (NRF-2022S1A5B5A17047010) and Korea Institute of Marine Science & Technology Promotion (KIMST) funded by the Ministry of Oceans and Fisheries (RS-2025-02317535).

Conflicts of Interest

The authors declare no conflicts of interest.

Figure 1.

Proportion of physical activity and sedentary time for Korean.

Note: (A) Proportion of physical activity parameter measured by accelerometer [7]; (B) Comparison of sedentary time by country (data from Bauman et al. 2011 [46] and Unpublished data by authors)

Table 1.

Key Recommendations in Selected 24-Hour Movement Guidelines (Physical Activity, Sedentary Behavior, and Sleep).

Guideline (Year)	Population	Physical Activity Recommendation	Sedentary Behavior Recommendation	Sleep Recommendation
WHO Global Guidelines (2020) [4]	Early Childhood (0–4 yr)	Infants: physically active several times/day (interactive floor play). Toddlers/ Preschoolers: ≥180 min physical activity of any intensity spread throughout the day (include energetic play).	No screen time for infants <2 yr; ≤1 h/day sedentary screen time for ages 2–4 yr; avoid keeping children restrained (strollers, high chairs) >1 h at a time.	14–17 h/day sleep (0–3 mo); 12–16 h (4–11 mo); 11–14 h (1–2 yr); 10–13 h (3–4 yr), including naps.
WHO Global Guidelines (2020) [16]	Youth (5–17 yr)	≥60 min/day moderate-to-vigorous physical activity; including vigorous intensity and muscle- or bone-strengthening ≥3 days/week.	Limit sedentary behaviors (especially recreational screen time), but no specific hourly limit given in the WHO guidelines.	–
WHO Global Guidelines (2020) [15].	Adults (18–64 yr)	150–300 min/week moderate or 75– 150 min/week vigorous aerobic activity (or equivalent combination); muscle-strengthening ≥2 days/week.	Limit sedentary time— stay as physically active as possible; no specific quantitative limit given (sedentary time should be minimized).	–
Canada 24-Hour (2017) [21]	Early Childhood (0–4 yr)	Infants: active several times daily. Toddlers: ≥180 min/day of physical activity (any intensity); Preschoolers: ≥180 min/day with ≥60 min energetic play.	No screen time for those aged <2 yr; ≤1 h/day for ages 2–4; ensure plenty of interactive, non-screen sedentary time (e.g., reading and storytelling) instead.	11–14 h/ day sleep (infants aged 4–11 mo); 10–13 h (toddlers aged 1–2 yr); 10–13 h (preschoolers aged 3–4 yr) with consistent routines.
Canada 24-Hour (2016) [20]	Youth (5–17 yr)	≥60 min/day MVPA; vigorous aerobic and strengthening activities on ≥3 days/week (as part of the 60 min).	≤2 h/day recreational screen time; limit extended sitting periods.	9–11 h/night sleep (ages 5–13) or 8–10 h (ages 14–17); consistent bed and wake times.
Canada 24-Hour (2020) [10]	Adults (18–64 yr)	≥150 min/week moderate-to-vigorous aerobic activity; muscle-strengthening ≥2 days/week; plus “several hours” of light activities (including standing) daily.	Sedentary time ≤8 h/day, including ≤3 h of recreational screen time; break up long sitting periods frequently.	7–9 h of good-quality sleep per night, with consistent bed and wake times.

Reference: WHO 2019 and 2020 global guidelines [15]; Canadian 24-Hour Movement Guidelines (2016–2020) [10].

Note: The U.S. (2018) physical activity guidelines for adults and youth are similar to the WHO’s recommendations for exercise (150 min/week for adults; 60 min/day for youth) and advise reducing sedentary time but do not include explicit sleep or screen-time limits in a 24-hour framework.

References

1. Ding D, Mutrie N, Bauman A, Pratt M, Hallal PR, Powell KE. Physical activity guidelines 2020: comprehensive and inclusive recommendations to activate populations. The Lancet. 2020; 396(10265): 1780–1782.

2. Choi Y, Kang SJ, Kim J. Association between meeting the 24-hour movement guidelines and cardiometabolic syndrome in Korean adults. Sci Rep. 2025; 15(1): 6879.

3. Bennie JA, Ding D, Khan A, Stamatakis E, Biddle SJ, Kim J. Run, lift, or both? Associations between concurrent aerobic-muscle strengthening exercise with adverse cardiometabolic biomarkers among Korean adults. Eur J Prev Cardiol. 2020; 27(7): 738–748.

4. Kim J, Tanabe K, Yokoyama N, Zempo H, Kuno S. Objectively measured light-intensity lifestyle activity and sedentary time are independently associated with metabolic syndrome: a cross-sectional study of Japanese adults. International Journal of Behavioral Nutrition and Physical Activity. 2013; 10(1): 1–7.

5. Kim J, Im JS, Choi YH. Objectively measured sedentary behavior and moderate-to-vigorous physical activity on the health-related quality of life in US adults: The National Health and Nutrition Examination Survey 2003-2006. Qual Life Res. 2017; 26(5): 1315–1326.

6. Ferrari G, Cristi-Montero C, Drenowatz C, et al. Meeting 24-h movement guidelines and markers of adiposity in adults from eight Latin America countries: the ELANS study. Scientific Reports. 2022; 12(1): 11382.

7. Shin SW, Kim H, Kang YH, Kim J. Accelerometer-derived physical activity and sedentary behavior patterns among Korean adults. Phys Act Nutr. 2023; 27(2): 025–033.

8. Seo YB, Oh YH, Yang YJ. Current Status of Physical Activity in South Korea. Korean J Fam Med. 2022; 43(4): 209–219.

9. The Canadian Society for Exercise Physiology. 24-Hour Movement Guidelines. 2021; https://csepguidelines.ca/).

10. The Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. 2020; https://csepguidelines.ca/guidelines/adults-18-64).

11. Okely AD, Ghersi D, Loughran SP, et al. A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep. Int J Behav Nutr Phys Act. 2022; 19(1): 2.

12. Chastin S, McGregor D, Palarea-Albaladejo J, et al. Joint association between accelerometry-measured daily combination of time spent in physical activity, sedentary behaviour and sleep and all-cause mortality: a pooled analysis of six prospective cohorts using compositional analysis. Br J Sports Med. 2021; 55(22): 1277–1285.

13. Shin SW, Choi Y, Kang YH, Kim J. Associations of meeting 24-h movement guidelines and metabolic syndrome in Korean adults during the COVID-19 pandemic. Public Health. 2024; 227:187–193.

14. Chastin SF, Palarea-Albaladejo J, Dontje ML, Skelton DA. Combined Effects of Time Spent in Physical Activity, Sedentary Behaviors and Sleep on Obesity and Cardio-Metabolic Health Markers: A Novel Compositional Data Analysis Approach. PLoS One. 2015; 10(10): e0139984.

15. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020; 54(24): 1451–1462.

16. World Health Organization. Physical activity. 2025; https://www.who.int/initiatives/behealthy/physical-activity).

17. World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. 2019; https://www.who.int/publications/i/item/9789241550536).

18. Ross R, Chaput JP, Giangregorio LM, et al. Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2020; 45(10 (Suppl. 2)): S57–s102.

19. Rollo S, Lang JJ, Roberts KC, et al. Health associations with meeting the Canadian 24-hour movement guidelines for adults: Results from the Canadian Health Measures Survey. Health Rep. 2022; 33(1): 16–26.

20. Tremblay MS, Carson V, Chaput JP, et al. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. Appl Physiol Nutr Metab. 2016; 41(6 Suppl 3): S311–327.

21. Tremblay MS, Chaput JP, Adamo KB, et al. Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. BMC Public Health. 2017; 17(Suppl 5): 874.

22. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. Jama. 2018; 320(19): 2020–2028.

23. Kim J. Longitudinal trend of prevalence of meeting physical activity guidelines among Korean adults. Exercise Medicine. 2017; 1.

24. Shin SW, Kim J. Association of Physical Activity Patterns with the Metabolic Syndrome in Korean Adults: A Nationwide Cross-Sectional Study. Rev Cardiovasc Med. 2024; 25(4): 115.

25. Kim J, Choi YH. Physical activity, dietary vitamin C, and metabolic syndrome in the Korean adults: the Korea National Health and Nutrition Examination Survey 2008 to 2012. Public Health. 2016; 135:30–37.

26. Ministry of Health and Welfare. Physical Activity Guidelines for Koreans (Revised Edition). 2023; https://www.mohw.go.kr/board.es?mid=a10411010300&bid=0019&act=view&list_no=1479208).

27. Ma J, Kim H, Kim J. Isotemporal Substitution Analysis of Accelerometer-Derived Sedentary Behavior and Physical Activity on Cardiometabolic Health in Korean Adults: A Population-Based Cross-Sectional Study. Int J Environ Res Public Health. 2021; 18(21): 11102.

28. Lee EY, Jayawardena R, Park S, Jeon JY, Kim YS, Tremblay MS. Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea. Clin Exp Pediatr. 2025; 68(1): 16–29.

29. Janssen I, Clarke AE, Carson V, et al. A systematic review of compositional data analysis studies examining associations between sleep, sedentary behaviour, and physical activity with health outcomes in adults. Appl Physiol Nutr Metab. 2020; 45(10 S2): S248–S257.

30. Kastelic K, Pedišić Ž, Lipovac D, Kastelic N, Chen ST, Šarabon N. Associations of meeting 24-h movement guidelines with stress and self-rated health among adults: is meeting more guidelines associated with greater benefits? BMC Public Health. 2021; 21(1): 929.

31. Katzmarzyk PT, Staiano AE. Relationship Between Meeting 24-Hour Movement Guidelines and Cardiometabolic Risk Factors in Children. J Phys Act Health. 2017; 14(10): 779–784.

32. Kim J, Im J-S, Choi Y-H. Objectively measured sedentary behavior and moderate-to-vigorous physical activity on the health-related quality of life in US adults: The National Health and Nutrition Examination Survey 2003- 2006. Quality of Life Research. 2017; 26:1315–1326.

33. Tremblay MS, Aubert S, Barnes JD, et al. Sedentary behavior research network (SBRN)-terminology consensus project process and outcome. International journal of behavioral nutrition and physical activity. 2017; 14(1): 1–17.

34. Seguin R, Buchner DM, Liu J, et al. Sedentary behavior and mortality in older women: the Women’s Health Initiative. American journal of preventive medicine. 2014; 46(2): 122–135.

35. Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary Behavior, Exercise, and Cardiovascular Health. Circ Res. 2019; 124(5): 799–815.

36. Ford ES, Caspersen CJ. Sedentary behaviour and cardiovascular disease: a review of prospective studies. Int J Epidemiol. 2012; 41(5): 1338–1353.

37. Wilmot EG, Edwardson CL, Achana FA, et al. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012; 55(11): 2895–2905.

38. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Medicine & science in sports & exercise. 2009; 41(5): 998–1005.

39. Huang BH, Duncan MJ, Cistulli PA, Nassar N, Hamer M, Stamatakis E. Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk. Br J Sports Med. 2022; 56(13): 718–724.

40. Liang K, de Lucena Martins CM, Chen ST, et al. Sleep as a Priority: 24-Hour Movement Guidelines and Mental Health of Chinese College Students during the COVID-19 Pandemic. Healthcare (Basel). 2021; 9(9).

41. Prinz P. Sleep, appetite, and obesity—what is the link? PLoS Medicine. 2004; 1(3): e61.

42. Alnawwar MA, Alraddadi MI, Algethmi RA, Salem GA, Salem MA, Alharbi AA. The Effect of Physical Activity on Sleep Quality and Sleep Disorder: A Systematic Review. Cureus. 2023; 15(8): e43595.

43. Riquelme R, Rezende LFM, Marques A, Drenowatz C, Ferrari G. Association between 24-h movement guidelines and cardiometabolic health in Chilean adults. Sci Rep. 2022; 12(1): 5805.

44. Sampasa-Kanyinga H, Chaput JP, Goldfield GS, et al. 24-hour movement guidelines and suicidality among adolescents. J Affect Disord. 2020; 274:372–380.

45. Vanderloo LM, Maguire JL, Keown-Stoneman CD, et al. Associations between meeting the 24-Hour Movement Guidelines and cardiometabolic risk in young children. Pediatr Exerc Sci. 2021; 33(3): 112–119.

46. Bauman A, Ainsworth BE, Sallis JF, et al. The descriptive epidemiology of sitting. A 20-country comparison using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med. 2011; 41(2): 228–235.