No or low self-reported moderate to vigorous physical activity among Chinese children and adolescents: a large-scale cross-sectional study

Evidence quantifying how many children and adolescents perform no—or extremely low levels of moderate-to-vigorous physical activity (MVPA) remains limited. Such estimates are essential for strengthening population-level PA surveillance and informing targeted interventions. This study, therefore, estimated the prevalence of no/low MVPA and examined sociodemographic disparities in these patterns among school-aged youth. We analyzed cross-sectional data from 60,659 participants (mean age = 13.1 years; 51.8% boys). MVPA was assessed with a single item: “How many days did you engage in MVPA for at least 60 minutes on weekdays over the past week? (0–7 days).” Reporting 0 days was coded as no/low MVPA (i.e., the extreme low end of engagement). We computed descriptive prevalence estimates and fitted multilevel binary logistic regression models to assess sociodemographic differences, reporting odds ratios (ORs) with 95% confidence intervals (CIs). 10.5% of study participants reported “no or low MVPA”. Girls (OR = 1.29, 95% CI = 1.22–1.36) were more likely than boys to report no or low MVPA. Primary school students (OR = 1.39, 95% CI = 1.22–1.59) and high school students (OR = 3.12, 95% CI = 2.56–3.80) were more likely to report no or low MVPA compared to those in junior middle school. Additionally, students not living with their parents (OR = 1.37, 95% CI = 1.24–1.51) are more likely to report no or low MVPA. Nationality and age were not associated with MVPA levels. Finally, a higher subjective family socioeconomic status (OR = 0.89, 95% CI = 0.88–0.91) was associated with a lower likelihood of reporting no or low MVPA. Around 11% of children and adolescents report no or low MVPA. Findings further indicate that girls, primary and high school students, children and adolescents living without parents, whereas those with lower subjective family socioeconomic status were more likely to report no or low MVPA, consistent with prior evidence that children from disadvantaged backgrounds tend to have fewer opportunities and resources for physical activity engagement.