Impact of early life exposure to active play and movement on health and wellbeing across the lifespan: A narrative review of RCTs from 2020-2025

INTRODUCTION/BACKGROUND: Competence in fundamental movement skills (FMS) is associated with higher physical activity levels across childhood and adolescence, influencing lifelong movement behaviours. Despite these benefits, most children globally fail to meet recommended physical activity levels from an early age and are increasingly affected by unhealthy body composition and chronic conditions such as obesity and type 2 diabetes (T2D). This article synthesises current evidence on early-life movement behaviours and interventions promoting physical activity during the first 2000 days, a critical developmental period shaping long-term health. MATERIALS AND METHODS: A comprehensive search of peer-reviewed randomized controlled trials (RCTs) published between 2020 and 2025 in Medline and Scopus identified studies examining physical activity, motor skill development, and related health outcomes in children aged 0-5 years. Findings were organized into five themes: (1) movement behaviours and early health; (2) historical development of guidelines; (3) global consensus and gaps; (4) early-years interventions; and (5) emerging implications. RESULTS: Eighteen studies met inclusion criteria. Evidence highlighted the importance of physical activity, adequate rest, and limited sedentary behaviour for early development. Most studies focused on preschoolers, with fewer addressing infants and toddlers. Interventions were largely from high-income contexts and varied in design and measurement tools. Integrating physical literacy showed promise. DISCUSSION: Early movement experiences shape body composition and chronic disease risk. Focusing on the first and next 1000 days may foster lifelong healthy habits. Future work should enhance equity, diversity, and measurement consistency in interventions.