Estimated Prevalence of Compliance With Muscle‐Strengthening Activity Recommendations in Children and Adolescents: A Meta‐Analysis

Aim To estimate the prevalence of meeting the World Health Organization (WHO) guidelines for muscle‐strengthening activities in children and adolescents, specifically engaging in these activities at least 3 days per week, and explore, whenever possible, this prevalence according to sociodemographic and healthy habits factors. Methods Four databases were systematically searched for studies published from inception to January 2025. Eligible studies included articles with samples of children and adolescents reporting the prevalence of meeting the muscle‐strengthening activities guidelines. Results Twenty‐nine studies comprising 1 273 544 children and adolescents (49.40% girls; mean age: 13.40 years) from 36 countries were included. Estimated prevalence of muscle‐strengthening activities was 38.51% (95% CI, 34.35% to 42.75%), based primarily on studies involving adolescent populations, with limited data available for children aged 6 to 12 years. According to the subgroup analyses, the predictors that favour compliance with the muscle‐strengthening activity guidelines are being a boy, having normal weight, meeting the aerobic physical activity recommendations and receiving high family support for engaging in physical activity. Conclusion Only 4 out of 10 children and adolescents meet the WHO muscle‐strengthening activity guidelines. Targeted efforts are needed, particularly for girls and those with lower support or physical activity levels, to improve participation and youth fitness.