Children's adherence to health behavior recommendations associated with reducing risk of non-communicable disease

The aim of this study is to report the proportions of Australian children age 5-16 years meeting six health behavior recommendations associated with reducing risk of non-communicable disease. Data comes from a representative cross-sectional population survey conducted in 2015. Parents completed a health behavior questionnaire for children age < 10 years and adolescents age > 10 years self-reported. Adherence rates were calculated separately for children and adolescents on meeting recommendations for fruit (2-serves/day), vegetables (5-serves/day), physical activity (≥ 60 min/day), screen-time (< 2 h/day), oral health (brush-teeth twice daily) and sleep (children 9-11 h/night; adolescents: 8-10 h/night). Participants were 3884 children and 3671 adolescents. Adherence to recommendations was low, with children adhering to an average of 2.5 and adolescents to 2.3 of six recommendations. Overall, recommendation adherence rates were 7% for vegetables, 18% for screen-time, 20% for physical activity, 56% for sleep, 67% for dental (teeth brushing) 79% for fruit; 3.3% reported zero adherence with recommendations and < 0.5% adhered to all six recommendations. There was evidence of social disparity in adherence rates; children and adolescents from low socioeconomic neighborhoods met fewer recommendations and were less likely to meet screen-time and dental recommendations, compared with high socioeconomic peers. Children and adolescents from rural areas met more recommendations, compared with urban peers. Children's and adolescents' adherence to health behavior recommendations is sub-optimal, exposing them to risk of developing non-communicable diseases during adulthood. Better communication and health promotion strategies are required to improve parents' and children's awareness of and adherence to health behavior recommendations.