Physical activity (PA), defined as any bodily movement that results in energy expenditure in skeletal muscles, such as walking, cycling, exercising, or doing household chores (1). Recreational Screen Time (RST), on the other hand, encompasses discretionary screen activities conducted while sedentary, such as watching television, playing video games, and using computers (2). Both PA and RST significantly influence the health and well-being of children and adolescents. Extensive research indicates that higher levels of PA, coupled with reduced RST, are effective in preventing and managing various health issues, including obesity and type 2 diabetes (3). Additionally, adequate PA and less RST enhances physical health, boosts cognitive abilities, improves academic performance, and reduces mental stress (3).

The World Health Organization (WHO) recommends that children and adolescents should engage in at least 60 min of Moderate-to-Vigorous Physical Activity (MVPA) daily to be considered active (3). Similarly, health guidelines from countries like Canada and China advocate for limiting RST to under 2 h per day for this demographic (2, 4). Despite these recommendations, adherence rates among children and adolescents are alarmingly low globally – only about 27 to 33% meet the WHO’s PA guidelines, and a mere 34 to 39% adhere to the RST guidelines of Canada and China (5, 6).

The same concerning phenomenon of low levels of PA and increased RST is also observed amongst Chinese children and adolescents, particularly in the context of rapid social transformation, economic growth, and widespread adoption of personal electronic devices in China (7, 8). Notably, in the Global Report Card on Physical Activity for Children and Youth, China ranks among the lowest in terms of PA and RST indicators (9). To support the Chinese government and organizations in formulating policies and initiatives to promote PA and reduce RST in children and adolescents, several nationally representative studies have examined the prevalence and current state of PA and RST among this demographic. For instance, Fan et al.’s (10) survey revealed that approximately 30% of Chinese children and adolescents met the WHO’s PA guidelines. Similarly, Zhu et al.’s (11) study found that 34.1% of Chinese children and adolescents adhered to the WHO’s PA guidelines, and 65.4% adhered to China’s RST guidelines, respectively. However, Liu et al.’s (12) survey indicated a significant decline, with only 14% of participants meeting the WHO’s PA guidelines and just 51% adhering to China’s RST guidelines. These studies also indicated variations in PA and RST based on sociodemographic factors such as gender and age. The sharp decrease in adherence between 2017 and 2020 might be partly attributed to the pandemic, but the lack of comprehensive data from 2017 to 2020 hinders a thorough understanding of the current state and hampers the development of effective policies.

To bridge this gap, our study, under the auspices of the Construction of a Big Data Platform for Children and Adolescents’ Sports and Fitness in China (CBDPCASF) project, assessed the current status of PA and RST among Chinese children and adolescents during 2017–2019. The objectives were twofold: (1) to augment existing data regarding PA and RST among this population during the specified period, and (2) to elucidate the distribution of PA and RST across various demographics, including gender, school levels, urban–rural areas, regions, and seasonal variations.

This study examined the PA and RST among Chinese children and adolescents, revealing that only 28.73% met the WHO’s PA guidelines, while 76.09% adhered to the RST guidelines of China and Canada. Notably, differences in PA and RST were observed across various demographics, including gender, area, region, and season, with these variances being more pronounced across some school levels.

Globally, previous research indicates that 27 to 33% of children and adolescents meet PA guidelines, but only 34 to 39% adhere to RST guidelines (6). The PA levels among Chinese children and adolescents align with the global average, however, their RST is significantly lower. In fact, the RST of Chinese children and adolescents appears to be indeed less than that of other countries. For instance, a 2017 national survey also reported that 65.4% of Chinese children and adolescents had less than 2 h of daily RST (11). This could be attributed to China’s status as a developing country with generally lower household incomes, leading to fewer children owning personal electronic devices. Additionally, the rigorous Chinese education system, particularly the emphasis on entrance exams for high schools and colleges, may compel students to dedicate more time to studies than screen-based recreation. Therefore, in China, greater efforts should be directed towards enhancing PA among children and adolescents.

Consistent with global trends, our study found that in China, males and younger children are more likely to meet PA guidelines, whereas females and older children are more likely to meet RST guidelines (5, 11, 24). The underlying reasons, explored in prior research, include physiological differences, interest disparities, varying levels of social support, shifts in academic pressure, environmental factors, and perceptions of PA (25–27). Despite these gender and age disparities, the harms of insufficient PA and excessive RST do not differ by gender or age, underscoring the need for targeted interventions focusing on the PA of females and older children, and the RST of males and younger students.

Studies by Cai et al. (28) and Song et al. (29) as well as Wagner et al. (30) demonstrate that urban children and adolescents have higher levels of PA and more RST compared to their rural counterparts, attributed to better access to PA facilities and electronic devices. Conversely, research by Euler et al. (31) and Sandercock et al. (32) shows that rural children and adolescents engage in higher levels of PA but less RST than those in urban areas. This difference is primarily due to rural children and adolescents having more space for PA, frequently needing to assist with family labor tasks, and having fewer electronic devices (31, 32). Distinct from both scenarios, our study indicates that compared to urban children and adolescents, those in rural areas exhibit both lower levels of PA and more RST. We believe that the higher levels of PA observed among urban children and adolescents in China, compared to their rural counterparts, corroborate the assumptions posited by Cai et al. (28) and Song et al. (29) Specifically, urban youths benefit from greater accessibility to PA facilities and have more opportunities for organized PA. However, the notably higher amounts of RST among rural children and adolescents compared to their urban counterparts may primarily be attributable to the phenomenon of parents from rural China working away from their hometowns (33), resulting in less supervision and potentially more time spent on electronic devices by these children. Therefore, prioritizing the enhancement of PA for rural children and adolescents through increased opportunities for PA, and managing their RST through heightened supervision, should be emphasized in China.

In China, the Qinling-Huaihe Line serves as a crucial geographical and economic boundary. Regions north of this line typically experience more arid and colder climates, poorer air quality, and lower levels of economic development compared to the south (15, 34). This study found that children and adolescents in the southern regions are less likely to meet PA guidelines but more likely to adhere to RST guidelines than those in the north. Guthold et al.’s (5) research indicates that children in economically affluent regions engage in more PA due to greater opportunities for such activities. Contrary to these findings, our study reveals that children in the economically advanced south demonstrate lower levels of PA. We hypothesize that this discrepancy may be attributable to the higher precipitation in southern China (15), which indirectly reduces the PA of children and adolescents (35). The relationship between RST, economic status, and regional disparities is more complex. Studies have produced varied findings, for instance, research by Demetriou et al. (36) suggests that in regions with higher levels of economic development, children and adolescents tend to have increased screen time (9). Conversely, Brodersen et al. (37) present findings that indicate more screen time among children and adolescents in regions with lower economic development. These differences could be related to the country where the study was conducted. In China, due to the pressures of entrance exams for high schools and colleges, affluent families typically enroll their children in various after-school tutoring classes (38). This leads to a reduction in their children’s RST, which may explain why the duration of RST among children and adolescents in southern China is less than in the northern regions. Therefore, in assessing the status of PA and RST among children and adolescents in different regions and formulating intervention measures, it is crucial to take into account the local economic, environmental, and social conditions.

Global studies indicate seasonal variations in PA and RST, with lower PA and higher RST observed in winter and autumn compared to spring, primarily due to more favorable springtime weather for PA (39–41). This study’s results confirm this, with children and adolescents surveyed in spring being more likely to meet both PA and RST guidelines compared to those surveyed in winter and autumn. This suggests that when weather conditions are less favorable, children’s and adolescents’ PA and RST should receive more attention, and conditions should be created to minimize the impact of climate on these behaviors, such as building more indoor activity spaces.

To our knowledge, this is the first study reporting on PA and RST among Chinese children and adolescents for the period 2017–2019, right before the pandemic. The study’s strengths include its nationally representative sample and consistent survey tools across different years. Most importantly, it provides an essential update on the status of PA and RST among Chinese children and adolescents during 2017–2019.

Despite these contributions, this study has several limitations. First, the self-reported nature of the survey tools might not accurately capture the actual PA and RST of children and adolescents, potentially leading to deviations in the calculation of prevalence rates. Although these inaccuracies do not significantly alter our understanding of the distribution of PA and RST, future studies could employ more objective measures, such as triaxial accelerometers, to enhance accuracy. Second, the PA questionnaire used in our study lacks detailed information regarding the duration and frequency of activities. As a result, our calculations of PA prevalence were based on criteria from Voss’s research, which limits their comparability with other studies. Future research should incorporate measures of intensity, frequency, and duration into PA assessment tools to improve reliability and comparability. Third, there were significant differences in the sample sizes across different seasons, although we used statistical methods such as adding weight variables to minimize the impact of these differences on the study results, caution is still needed when interpreting the season-related outcomes. Finally, as this study employs a cross-sectional design, it is unable to determine causality between school levels, urban–rural settings, regions, seasons, and PA or RST. Readers should bear this in mind when interpreting the results of this study.

From 2017 to 2019 in China, only 28.57% of children and adolescents adhered to the WHO’s PA guidelines, whereas 81.61% met the RST guidelines of China and Canada. Notably, females, older students, rural residents, and those in southern regions exhibited lower levels of PA compared to their male, younger, urban, and northern counterparts. Simultaneously, males, younger students, rural residents, and those in northern regions had longer periods of RST compared to females, older students, urban dwellers, and children and adolescents from southern regions. Furthermore, it was observed that, compared to the spring, children and adolescents engage in less PA and more RST during the autumn and winter. Consequently, targeted efforts are essential to enhance PA among females, older students, rural residents, and southerners, while simultaneously reducing RST among males, younger students, rural residents, and northerners. Additionally, it is crucial to develop PA facilities that are not affected by climatic conditions to increase PA and reduce RST among this demographic group.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving humans were approved by Human Experimentation Ethics Committee of East China Normal University. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants’ legal guardians/next of kin.

MG: Data curation, Formal analysis, Funding acquisition, Methodology, Writing – original draft, Writing – review & editing. YZ: Data curation, Writing – review & editing. XW: Conceptualization, Writing – review & editing.