Background:
The 24-hour movement behavior (24HMB) framework integrates physical activity, sedentary behavior, and sleep into a single health paradigm. University students are known to be vulnerable to inadequate movement patterns. However, no previous study has compared adherence to the 24HMB guidelines across the Visegrad Group (V4) countries (Czech Republic, Hungary, Poland, Slovakia).

Material and methods:
This cross-sectional study included 2,611 university students aged 18-29 years. Movement behaviors were assessed using the International Physical Activity Questionnaire – Long Form (IPAQ-LF) and self-reported sleep duration. Guidelines adherence was defined as meeting all three components: ≥150 minutes/week of moderate-to-vigorous physical activity (MVPA), ≤8 hours/day of sedentary time, and ≥7 hours of sleep. Descriptive statistics and Chi-square tests were applied to examine gender and country differences using IBM SPSS 29.0 software.

Results:
Overall, 44.24% of students met the physical activity guideline, 82.27% met the sedentary behavior guideline, and 85.43% met the sleep guideline. Only 26.92% adhered to all three 24HMB recommendations. Significant differences were observed across countries for physical activity (p<0.001) and sleep (p=0.025), but not for sedentary time or full adherence.

Conclusions:
Adherence to the integrated 24HMB guidelines is low among V4 university students, highlighting the need for coordinated, context-specific interventions.