Abstract
BACKGROUND: Adhering to 24-hour movement guidelines, encompassing physical activity, sedentary behavior, and sleep, is crucial for health. This study aimed to estimate the prevalence of (non)adherence to these guidelines in the Chinese population. METHOD: Four electronic databases (PubMed, Scopus, Web of Science, and CNKI) were searched for quantitative studies published in Chinese and English between June 2016 and October 2025. Studies were included if they reported overall (non)adherence to the 24-hour movement guidelines in Chinese participants. The prevalence data from multiple studies were pooled using a random-effects model. Subgroup analyses were conducted to determine differences in prevalence across populations, regions, survey years, female percentage, and assessment methods for physical activity and sleep. Additionally, meta-regression analyses were performed to identify the sources of heterogeneity. RESULTS: The meta-analysis included 68 studies, encompassing 832,027 participants. The overall pooled prevalence of meeting all three 24-hour movement guidelines was 7.6% (95% CI: 6.2%, 9.0%). Adults showed the highest adherence (17.9%, 95% CI: 11.4%, 25.4%), followed by preschoolers (13.3%, 95% CI: 11.3%, 15.4%), while children and adolescents (5.1%, 95% CI: 4.1%, 6.2%) and older adults (1.7%, 95% CI: 1.5%, 2.0%) demonstrated markedly lower adherence. Furthermore, 13.0% (95% CI: 11.0%, 14.9%) of the population met none of the guidelines, with older adults exhibiting the highest non-adherence (17.4%, 95% CI: 6.3%, 32.4%). CONCLUSION: This meta-analysis underscores the low adherence to 24-movement guidelines among Chinese populations. These findings highlight the urgent need for targeted interventions to improve 24-hour movement behaviors across all age groups. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25915-y.