Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update
Open accessAbstract
This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.
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Associations between physical activity and mental health outcomes are generally weak in terms of effect sizes.
“Associations between physical activity and mental health outcomes, however, are generally weak in terms of effect sizes.”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [56]
Sedentary behaviours (such as screen time) are associated with poorer mental health among children and adolescents.
“There is evidence that physical activity is associated with better mental health whereas sedentary behaviours (such as screen time) are associated with poorer mental health among children and adolescents.56 91–93”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [56]
Physical activity is associated with better mental health among children and adolescents.
“There is evidence that physical activity is associated with better mental health whereas sedentary behaviours (such as screen time) are associated with poorer mental health among children and adolescents.56 91–93”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [56]
Sedentary behavior in children is independently associated with poorer health outcomes.
“There are also concerns about coexisting sedentary behavior (SB) in children, which is independently associated with poorer health outcomes.5”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [5]
Higher levels of adolescent screen use are associated with increased adiposity.
“higher levels of adolescent screen use are associated with detrimental health outcomes, such as increased adiposity [2,3]”
From Using Wearable Cameras to Categorize the Type and Context of Screen-Based Behaviors Among Adolescents: Observational Study (2022) · cites this paper as [3]
Previous studies on the 24-h movement guidelines and health indicators have primarily focused on physical health outcomes.
“Previous studies looking at the 24-h movement guidelines and health indicators have primarily focused on examining the associations between the combinations of physical activity, sedentary time, and sleep duration with physical health outcomes [12–14].”
Physical activity, sedentary behaviour, and sleep are individually associated with better mental health among children and adolescents.
“Achieving high levels of physical activity, low levels of sedentary behaviour, and getting sufficient sleep have been individually associated with better mental health among children and adolescents [12–14].”
The searches used previously developed and validated searches for sleep, sedentary time, and physical activity.
“The searches looked for journal articles reporting on sleep, sedentary time and physical activity using previously developed and validated searches [12–14, 30].”
Isolated adherence to MVPA, screen time and sleep duration recommendations has been associated with lower adiposity indicators in children and adolescents.
“Isolated adherence to MVPA, screen time and sleep duration recommendations have been associated with lower adiposity indicators in children and adolescents [3, 5–10].”
From Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study (2016) · cites this paper as [9]
Behaviors of not meeting physical activity and high screen time are most frequently related to negative health outcomes.
“behaviors most frequently related to negative health outcomes [8, 9].”
From Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study (2016) · cites this paper as [9]
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World Health Organization 2020 guidelines on physical activity and sedentary behaviour
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“For these guidelines on children and adolescents, systematic reviews undertaken by Poitras et al , 8 Carson et al 9 and Okely et al 10 were used and updated.”
MethodSelf-citationSedentary Behavior Research Network (SBRN)—Terminology Consensus Project process and outcome
on behalf of SBRN Terminology Consensus Project Participants, Tremblay, M. S., Aubert, S., Barnes, J. D., Saunders, T. J., Carson, V., Latimer-Cheung, A. E., Chastin, S. F. M., Altenburg, T. M., & Chinapaw, M. J. M. (2017) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-017-0525-8 · Cited by 3,793 · see citing works
Self-citationTremblay, M. S., Carson, V., Chaput, J.-P., Connor Gorber, S., Dinh, T., Duggan, M., Faulkner, G., Gray, C. E., Gruber, R., Janson, K., et al. (2016) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2016-0151 · Cited by 2,024 · see citing works
“There is growing evidence that while not as efficacious as MVPA, light-intensity physical activity is associated with some health benefits, especially when it replaces sedentary behaviours (Buman et al. 2014; Carson et al. 2013b, 2016b; Poitras et al. 2016; Stone and Faulkner 2014), although this area remains relative…”
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Physical activity behaviours in adolescence: Current evidence and opportunities for intervention
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Teenagers, screens and social media: a narrative review of reviews and key studies
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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., et al. (2016) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2015-0626 · Cited by 589 · see citing works
“Articles identified as potentially relevant during the screening process of the other 3 systematic reviews (Carson et al. 2016; Chaput et al. 2016; Poitras et al. 2016) were also added to the database for de-duplication.”
BackgroundMethodInfluentialSelf-citationTremblay, M. S., Barnes, J. D., González, S. A., Katzmarzyk, P. T., Onywera, V. O., Reilly, J. J., Tomkinson, G. R., & _, _. (2016) · Journal of Physical Activity and Health · doi:10.1123/jpah.2016-0594 · Cited by 451 · see citing works
Self-citationSampasa-Kanyinga, H., Colman, I., Goldfield, G. S., Janssen, I., Wang, J., Podinic, I., Tremblay, M. S., Saunders, T. J., Sampson, M., & Chaput, J.-P. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00976-x · Cited by 430 · see citing works
Self-citationCarson, V., Tremblay, M. S., Chaput, J.-P., & Chastin, S. F. M. (2016) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2016-0026 · Cited by 414 · see citing works
“In contrast, primarily null associations have been observed between objectively measured total sedentary behaviour and cardio-metabolic health in children and youth (Carson et al. 2016).”
BackgroundInfluentialSelf-citationDiPietro, L., Al-Ansari, S. S., Biddle, S. J. H., Borodulin, K., Bull, F. C., Buman, M. P., Cardon, G., Carty, C., Chaput, J.-P., Chastin, S., et al. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-01042-2 · Cited by 387 · see citing works
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for the ISCOLE Research Group, Roman-Viñas, B., Chaput, J.-P., Katzmarzyk, P. T., Fogelholm, M., Lambert, E. V., Maher, C., Maia, J., Olds, T., Onywera, V., et al. (2016) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0449-8 · Cited by 368 · see citing works
“In addition to not meeting the minimum amount of recommended physical activity, the majority of the sample engaged in recreational screen time for more than 2 hours per day, behaviors most frequently related to negative health outcomes [8, 9].”
BackgroundSelf-citationHealth associations with meeting new 24-hour movement guidelines for Canadian children and youth
Carson, V., Chaput, J.-P., Janssen, I., & Tremblay, M. S. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2016.12.005 · Cited by 285 · see citing works
Self-citationScreen Time and Problem Behaviors in Children: Exploring the Mediating Role of Sleep Duration
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Self-citationBarnett, T. A., Kelly, A. S., Young, D. R., Perry, C. K., Pratt, C. A., Edwards, N. M., Rao, G., Vos, M. B., & On behalf of the American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; and Stroke Council (2018) · Circulation · doi:10.1161/cir.0000000000000591 · Cited by 249 · see citing works
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Kuzik, N., Poitras, V. J., Tremblay, M. S., Lee, E.-Y., Hunter, S., & Carson, V. (2017) · BMC Public Health · doi:10.1186/s12889-017-4851-1 · Cited by 246 · see citing works
Self-citationPhysical activity and health in Chinese children and adolescents: expert consensus statement (2020)
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“behaviors, (4) the theoretical underpinnings of interventions and (5) the reporting and methodological quality of interventions.”
BackgroundMethodCross-cohort change in adolescent outcomes for children with mental health problems
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Adherence to the 24-Hour Movement Guidelines among 10- to 17-year-old Canadians
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Adherence to 24-hour movement guidelines and academic performance in adolescents
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Self-citationScreen time and depression risk: A meta-analysis of cohort studies
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Academic performance and lifestyle behaviors in Australian school children: a cluster analysis
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Screen time, physical activity and self-esteem in children: The Ulm birth cohort study
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Self-citationScreen-based behaviors in Australian adolescents: Longitudinal trends from a 4-year follow-up study
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Different Types of Screen Behavior and Depression in Children and Adolescents
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“Systematic reviews and meta-analyses have shown that higher levels of adolescent screen use are associated with detrimental health outcomes, such as increased adiposity [2,3] and depression [4,5], as well as low academic achievement [6].”
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Shuteye Time Compared With Bedtime: Misclassification of Sleep in Adolescent Females
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- Authors
- Carson, V., Hunter, S., Kuzik, N., Gray, C. E., Poitras, V. J., Chaput, J.-P., Saunders, T. J., Katzmarzyk, P. T., Okely, A. D., Connor Gorber, S., Kho, M. E., Sampson, M., Lee, H., & Tremblay, M. S.
- Affiliations
- University of Alberta (CA)
- Children's Hospital of Eastern Ontario (CA)
- University of Prince Edward Island (CA)
- Pennington Biomedical Research Center (US)
- University of Wollongong (AU)
- Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada.
- McMaster University (CA)
- ORCID
- Venue
- Applied Physiology, Nutrition, and Metabolism
- Publisher
- Canadian Science Publishing
- Published
- 2016-06
- Volume
- 41
- Issue
- 6 (Suppl. 3)
- Pages
- S240-S265
- ISSN
- 1715-5312 (ISSN-L)
- 1715-5320
- OpenAlex
- W2425091006
- Semantic Scholar
- cd07dfe985fca3fb79a3d4d82adce84ef05e96b1
- Cited by
- 1,380
- References
- 514
- Citations by year
- 2026: 93 · 2025: 110 · 2024: 125 · 2023: 155 · 2022: 206 · 2021: 211 · 2020: 183 · 2019: 114 · 2018: 99 · 2017: 62 · 2016: 15 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 11.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Applied Physiology, Nutrition, and Metabolism (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- IslandScholar (University of Prince Edward Island) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Education › Child Development and Digital Technology
- Keywords
- sedentary behavior, screen time, television viewing, video game use, children and young people, body composition, cardiometabolic risk, cardiovascular risk factors, prosocial behavior, academic performance, physical fitness, self-esteem, computer use, homework
- MeSH terms
- Adolescent, Adolescent Behavior, Body Composition, Cardiovascular Diseases, Child, Child Behavior, Child, Preschool, Health Status, Humans, Physical Fitness, Risk Factors, Television, Exercise, Randomized Controlled Trials as Topic, Metabolic Syndrome, Sedentary Behavior, Non-Randomized Controlled Trials as Topic
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