Cited by 589Physical Activity and HealthObesity, Physical Activity, DietSleep and related disorders

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index; none of the 23 sources its claims cite is checked for support yet.

Combinations of physical activity, sedentary behaviour and sleep: relationships with health indicators in school-aged children and youth

Open access

Abstract

The purpose of this systematic review was to determine how combinations of physical activity (PA), sedentary behaviour (SB), and sleep were associated with important health indicators in children and youth aged 5–17 years. Online databases (MEDLINE, EMBASE, SPORTdiscus, CINAHL, and PsycINFO) were searched for relevant studies examining the relationship between time spent engaging in different combinations of PA, SB, and sleep with the following health indicators: adiposity, cardiometabolic biomarkers, physical fitness, emotional regulation/psychological distress, behavioural conduct/pro-social behaviour, cognition, quality of life/well-being, injuries, bone density, motor skill development, and self-esteem. PA had to be objectively measured, while sleep and SB could be objectively or subjectively measured. The quality of research evidence and risk of bias for each health indicator and for each individual study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. A total of 13 cross-sectional studies and a single prospective cohort study reporting data from 36 560 individual participants met the inclusion criteria. Children and youth with a combination of high PA/high sleep/low SB had more desirable measures of adiposity and cardiometabolic health compared with those with a combination of low PA/low sleep/high SB. Health benefits were also observed for those with a combination of high PA/high sleep (cardiometabolic health and adiposity) or high PA/low SB (cardiometabolic health, adiposity and fitness), compared with low PA/low sleep or low PA/high SB. Of the 3 movement behaviours, PA (especially moderate- to vigorous-intensity PA) was most consistently associated with desirable health indicators. Given the lack of randomized trials, the overall quality of the available evidence was low.

Overview

Integrity signals

Registry

Crossref · 10.1139/apnm-2015-0626

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

26 Not checked yet · 22 Own method · 19 Own result · 9 No basis given · 8 Own interpretation

Verify all 23 references — free account

Show all 35 claims

  • It may state two separate claims as one. 30
  • Probably not a substantial claim. 32
  • The quote only partly states this claim. 1
49 of 49
  • The paper relies on this without support.

    The evidence on combinations of movement behaviours has yet to be systematically reviewed or synthesized.

    “Researchers have recently begun to compare the health impacts of specific combinations of these movement behaviours, but this evidence has yet to be systematically reviewed or synthesized.”
  • The paper relies on this without support.

    Meta-analysis was not possible because of high levels of heterogeneity across studies.

    “However, it was determined that a meta-analysis was not possible because of high levels of heterogeneity for the above characteristics across studies, and a narrative synthesis was performed for each health indicator instead.”
  • The paper relies on this without support.

    Subjective measures of PA typically focus exclusively on moderate-to-vigorous-intensity PA (MVPA).

    “whereas subjective measures of PA typically focus exclusively on moderate-to vigorous-intensity PA (MVPA).”
  • The paper relies on this without support.

    The minimum sample size thresholds of 300 for observational studies and 30 for intervention studies are appropriate.

    “Observational studies (e.g., cross-sectional, prospective or retrospective cohorts, and case-control studies) were required to have a minimum sample size of 300 participants; randomized controlled trials and other intervention studies were required to have at least 30 participants in the intervention group.”
  • The paper relies on this without support.

    Combinations of physical activity, sedentary behaviour, and sleep can be meaningfully classified into high/low categories to examine associations with health indicators.

    “the majority of studies compared only the best and worst combinations of behaviours (e.g., high PA/high sleep/low SB vs low PA/low sleep/high SB)”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 29 references

Research works printed but not linked: 1

  1. Guyatt G.H., 2011, Framing the question and deciding on important outcomes. J. Clin. Epidemiol., 64, 395

Cited by

Sorted by citations

Metadata

Authors
Saunders, T. J., Gray, C. E., Poitras, V. J., Chaput, J.-P., Janssen, I., Katzmarzyk, P. T., Olds, T., Connor Gorber, S., Kho, M. E., Sampson, M., Tremblay, M. S., & Carson, V.
Affiliations
  • University of Prince Edward Island (CA)
  • Children's Hospital of Eastern Ontario (CA)
  • Queen's University (CA)
  • Pennington Biomedical Research Center (US)
  • Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute of Health Research, University of South Australia, Adelaide 5001, Australia.
  • Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON, K1A 0K9, Canada.
  • McMaster University (CA)
  • University of Alberta (CA)
Venue
Applied Physiology, Nutrition, and Metabolism
Published
2016-06
Volume
41
Issue
6 (Suppl. 3)
Pages
S283-S293
ISSN
  • 1715-5312 (ISSN-L)
  • 1715-5320
OpenAlex
W2440319744
Cited by
589
References
29
Citations by year
2026: 37 · 2025: 55 · 2024: 77 · 2023: 81 · 2022: 72 · 2021: 85 · 2020: 68 · 2019: 34 · 2018: 40 · 2017: 29 · 2016: 10
FWCI
30.29
Type
journal article
Language
en
Open access
Locations
  • Applied Physiology, Nutrition, and Metabolism (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UniSA Research Outputs Repository (University of South Australia) (acceptedVersion, cc-by)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • IslandScholar (University of Prince Edward Island) (submittedVersion)
Funders
  • Public Health Agency of Canada
  • Public Health Agency
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
physical activity, sedentary behavior, sleep, children and young people, adiposity, cardiometabolic health, physical fitness, psychological distress, prosocial behavior, cognitive function, quality of life, injuries, bone mineral density, motor skill development, self-esteem, moderate-to-vigorous physical activity, health indicators
MeSH terms
Adolescent, Adolescent Behavior, Cardiovascular Diseases, Child, Child Behavior, Child, Preschool, Health Status, Humans, Physical Fitness, Quality of Life, Sleep, Exercise, Muscle, Skeletal, Metabolic Syndrome, Adiposity, Sedentary Behavior

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review