Hrvatske 24-satne preporuke za tjelesnu aktivnost, sedentarno ponašanje i spavanje: prijedlog utemeljen na sustavnom pregledu literature ; Croatian 24-Hour Guidelines for Physical Activity, Sedentary Behaviour, and Sleep: A Proposal Based on a Systematic Review of Literature

Abstract

Moderan pristup oblikovanju javnozdravstvenih preporuka temelji se na objedinjavanju preporuka za tjelesnu aktivnost, sedentarno ponašanje i duljinu spavanja, odnosno na optimalnoj kombinaciji trajanja navedenih ponašanja tijekom 24 sata. Cilj ovog rada bio je napraviti sustavni pregled literature radi identificiranja i analize postojećih 24-satnih preporuka za tjelesnu aktivnost, sedentarno ponašanje i spavanje te izraditi prijedlog hrvatskih 24-satnih preporuka u skladu s postojećim nalazima. Sustavnim pregledom literature utvrđeno je da postoje 24-satne preporuke Svjetske zdravstvene organizacije (SZO) i nacionalne 24-satne preporuke za djecu i mlade (0 – 17 g.) u četiri države (Australiji, Južnoafričkoj Republici, Kanadi i Novom Zelandu), dok takve preporuke za odrasle i starije osobe nisu nađene. Sve postojeće 24-satne preporuke za djecu i mlade temelje se na Kanadskim nacionalnim preporukama i stoga su vrlo slične. Naime, kvantitativne su preporuke jednake, a razlike postoje samo u specifičnim primjerima ili opisima pojedinih aktivnosti. S obzirom na to da su prije spomenute preporuke oblikovane prema najboljim znanstvenim dokazima koji su trenutačno raspoloživi, one su upotrijebljene kao temelj za izradu prijedloga hrvatskih 24-satnih preporuka za djecu i mlade. Pritom su preporuke prilagođene specifičnostima hrvatskog konteksta. Budući da sustavnim pregledom literature nisu nađene objedinjene 24-satne preporuke za tjelesnu aktivnost, sedentarno ponašanje i spavanje odraslih i starijih osoba, proveden je iscrpan pregled literature. Na temelju preporuka SZO-a i najnovijih nacionalnih preporuka za svaku pojedinu sastavnicu, koje su utemeljene na najboljim znanstvenim dokazima što su trenutačno raspoloživi, napravljen je prijedlog hrvatskih 24-satnih preporuka. Predložene hrvatske 24-satne preporuke mogu se iskoristiti za individualno savjetovanje u ambulantama obiteljske medicine, klinikama ili rekreacijskim centrima, za oblikovanje poruka u javnozdravstvenim kampanjama te pri izradi nacionalnih, lokalnih i institucionalnih zdravstvenih politika. ; A modern approach to shaping public health guidelines is to integrate recommendations for physical activity, sedentary behaviour, and sleep and to recommend the optimal distribution of time spent in these behaviours in a 24-hour day. The aim of this paper was to conduct a systematic review of literature to identify and analyse the available 24-hour guidelines for physical activity, sedentary behaviour, and sleep, and to propose Croatian 24-hour guidelines in line with the existing findings. The systematic review of literature showed 24-hour guidelines from the World Health Organization (WHO) and national 24-hour guidelines for children and youth (0 – 17 years of age) in four countries (Australia, South Africa, Canada, and New Zealand). No such guidelines were found for adults and seniors. All the available 24-hour guidelines for children and youth are very similar, as they are based on the Canadian national guidelines. The quantitative recommendations are all the same, with differences found only in specific examples and descriptions of activities. Given that the foregoing guidelines were formulated in line with the best available scientific evidence, they were used to inform the development of the proposed Croatian 24-hour guidelines for children and youth. The proposed guidelines were tailored to the specific context in Croatia. Since no integrated 24-hour guidelines for physical activity, sedentary behaviour, and sleep for adults and seniors were found in the systematic review of literature, an additional thorough review of literature was conducted in order to identify the most relevant guidelines for each individual behaviour. The proposed Croatian 24-hour guidelines for adults and seniors were based on the WHO guidelines and the most recent and relevant national recommendations from other countries for each of the behaviours. The proposed Croatian 24-hour guidelines can be used: (1) to provide individual counselling in general practice clinics, medical clinics, and recreation centres; (2) to help formulate messages in public health campaigns; and (3) to develop national, local, and institutional health policies.