Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses
Open accessAbstract
The purpose of this study was to examine the relationships between movement behaviours (sleep duration, sedentary time, physical activity) and health indicators in a representative sample of children and youth using compositional analyses. Cross-sectional findings are based on 4169 children and youth (aged 6–17 years) from cycles 1 to 3 of the Canadian Health Measures Survey. Sedentary time (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived. Sleep duration was subjectively measured. Body mass index z scores, waist circumference, blood pressure, behavioural strengths and difficulties, and aerobic fitness were measured in the full sample. Triglycerides, high-density lipoprotein-cholesterol, C-reactive protein, and insulin were measured in a fasting subsample. The composition of movement behaviours was entered into linear regression models via an isometric log ratio transformation and was found to be associated with all health indicators (p < 0.01). Relative to other movement behaviours, time spent in SB or LPA was positively associated (p < 0.04) and time spent in MVPA or sleep was negatively associated (p < 0.02) with obesity risk markers. Similarly, LPA was positively associated (p < 0.005) and sleep was negatively associated (p < 0.03) with unfavourable behavioural strengths and difficulties scores and systolic blood pressure. Relative to other movement behaviours, time spent in SB was negatively associated (p < 0.001) and time spent in MVPA (p < 0.001) was positively associated with aerobic fitness. Likewise, MVPA was also negatively associated with several cardiometabolic risk markers (p < 0.008). Compositional data analyses provide novel insights into collective health implications of 24-h movement behaviours and can facilitate interesting avenues for future investigations.
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Participants achieving all 3 recommendations had preferable scores for social and emotional health compared with participants who did not meet the recommendations.
“3/3 studies found that participants achieving all 3 recommendations had preferable scores for the health outcomes compared with participants who did not meet the recommendations.”
Only 2 studies used compositional data analyses.
“However, in the current review, only 2 studies used compositional data analyses [34, 35].”
The composition of movement behaviours was associated with social and emotional health.
“2/10 studies used compositional data analyses and found that the composition of movement behaviours was associated with social and emotional health [34] and with HRQoL [35]”
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Tremblay, 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
“…fr om w w w .n rc re se ar ch pr es s. co m b y U N IV E R SI T Y O F N E W B R U N SW IC K o n 06 /2 1/ 16 Fo r pe rs on al u se o nl y. and public health messaging aimed at optimizing health in pediatric populations should consider an integrated movement behaviour approach (Carson et al. 2016b).”
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Self-citationTremblay, M. S., Chaput, J., Adamo, K. B., Aubert, S., Barnes, J. D., Choquette, L., Duggan, M., Faulkner, G., Goldfield, G. S., Gray, C. E., et al. (2017) · BMC Public Health · doi:10.1186/s12889-017-4859-6 · Cited by 638 · see citing works
“To address this reality, assess the legitimacy of the wholeday approach to health promotion in the early years, and help inform the new integrated guidelines, complementary compositional data analyses [47, 49] were conducted using data from the Canadian Health Measures Survey (CHMS) [50].”
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“The relationships between the composition of 24-h movement behaviors and adiposity indicators in a sample including both children and youth were examined in 1 study.(19) It was reported that the composition of movement behaviors was significantly associated with BMI z-scores and waist circumference.”
BackgroundSelf-citationCompositional data analysis for physical activity, sedentary time and sleep research
Dumuid, D., Stanford, T., Fernández, J. A. M., Pedišić, Ž., Maher, C. A., Lewis, L. K., Hron, K., Katzmarzyk, P. T., Chaput, J., Fogelholm, M., et al. (2017) · Statistical Methods in Medical Research · doi:10.1177/0962280217710835 · Cited by 548 · see citing works
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“Three papers used logistic regression analyses [18, 19, 39], 2 papers used compositional data analysis [34, 35], 2 papers used mixed linear models [20, 38], 2 other papers used standard linear regression [33, 37], and 1 paper used structural equation modelling [36].”
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“Youth Only two studies thus far have used the ISM with cardiometabolic biomarkers as outcome variables [28, 49].”
MethodDumuid, D., Pedišić, Ž., Stanford, T., Fernández, J. A. M., Hron, K., Maher, C. A., Lewis, L. K., & Olds, T. (2017) · Statistical Methods in Medical Research · doi:10.1177/0962280217737805 · Cited by 369 · see citing works
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Self-citationCompositional Data Analysis in Time-Use Epidemiology: What, Why, How
Dumuid, D., Pedišić, Ž., Palarea‐Albaladejo, J., Fernández, J. A. M., Hron, K., & Olds, T. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17072220 · Cited by 294 · see citing works
“Some studies report unfavorable associations between the pivot coordinate for SB and outcomes [3,50,55,58].”
BackgroundHealth associations with meeting new 24-hour movement guidelines for Canadian children and youth
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Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors
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“search shows that combinations or patterns of behaviors can impact health in ways that cannot be explained by the effect of individual behaviors alone [62–65].”
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Canada’s Physical Literacy Consensus Statement: process and outcome
Tremblay, M. S., Costas-Bradstreet, C., Barnes, J. D., Bartlett, B., Dampier, D., Lalonde, C., Leidl, R., Longmuir, P. E., McKee, M., Patton, R., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5903-x · Cited by 201 · see citing works
“Current habitual movement behaviours of Canadian children and youth warrant concern given the important physical, psycho-social, and academic benefits that are accrued through healthy daily movement [1, 7, 20, 21].”
BackgroundSelf-citationInsufficient Sleep Duration Is Associated With Dietary Habits, Screen Time, and Obesity in Children
Tambalis, K. D., Panagiotakos, D. B., Psarra, G., & Sidossis, L. S. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7374 · Cited by 174 · see citing works
“32 Similarly, research in which 1,726 Portuguese females aged 10 to 18 years participated reported that poor sleep quality was associated with lower aerobic fitness.”
Fairclough, S. J., Dumuid, D., Taylor, S., Curry, W. B., McGrane, B., Stratton, G., Maher, C. A., & Olds, T. (2017) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-017-0521-z · Cited by 167 · see citing works
“8% in our sample) is a substantially larger relative change than taking time away from ST for example, which contributes a larger segment of the 24 h day (35% in our sample) [19, 20].”
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Self-citationChaput, J., Saunders, T. J., & Carson, V. (2017) · Obesity Reviews · doi:10.1111/obr.12508 · Cited by 139 · see citing works
“Similarly, having healthy sleep hygiene and reallocating sedentary time to physical activity have also been shown to provide important and valuable positive health benefits (5,23,29,62,65).”
BackgroundSelf-citationA short history of time use research; implications for public health
Bauman, A., Bittman, M., & Gershuny, J. (2019) · BMC Public Health · doi:10.1186/s12889-019-6760-y · Cited by 125 · see citing works
“This has generated new statistical techniques, ‘compositional data analysis’ (CoDA), which allow time use researchers to construct the day as a whole, rather than as separate activity domains, and model the effects on health outcomes of reallocating time from one domain to another [39].”
MethodSleep Duration and Obesity in Children and Adolescents
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“Recent research utilizing compositional analyses in Canadian school-aged children and youth [3] and”
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“All three reported that replacing sleep, SB, or LIPA with an equivalent duration of MVPA was associated with a decreased BMI [9, 12, 13].”
BackgroundMethodResultInfluentialIntroducing 24-Hour Movement Guidelines for the Early Years: A New Paradigm Gaining Momentum
Tremblay, M. S. (2019) · Journal of Physical Activity and Health · doi:10.1123/jpah.2019-0401 · Cited by 91 · see citing works
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Thivel, D., Tremblay, M. S., Katzmarzyk, P. T., Fogelholm, M., Hu, G., Maher, C. A., Maia, J. A. R., Olds, T., Sarmiento, O. L., Standage, M., et al. (2018) · Preventive Medicine · doi:10.1016/j.ypmed.2018.10.025 · Cited by 88 · see citing works
“Our findings support current public health approaches by showing that meeting a combination of 24-hour movement guidelines is more likely to provide dividends than meeting single recommendations(7-10).”
BackgroundSelf-citationRhodes, R. E., Spence, J. C., Berry, T. R., Faulkner, G., Latimer‐Cheung, A. E., O’Reilly, N., Tremblay, M. S., & Vanderloo, L. M. (2019) · BMC Public Health · doi:10.1186/s12889-019-7744-7 · Cited by 86 · see citing works
“Furthermore, these movement behaviors interact, demonstrating that the composition of behaviors across the whole day are associated with health outcomes [5, 6].”
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Noordam, R., Bos, M. M., Wang, H., Winkler, T. W., Bentley, A. R., Kilpeläinen, T. O., de Vries, P. S., Sung, Y. J., Schwander, K., Cade, B. E., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-12958-0 · Cited by 80 · see citing works
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Multicontextual correlates of adolescent sugar-sweetened beverage intake
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“In addition, more hours of sleep was associated with lower SSB intake in individual models, and has previously been found to be associated with healthier diets and lower weight status.[38] The behavioral factors identified in this study warrant further investigation in longitudinal and intervention studies as a means…”
BackgroundA Systematic Review of Sleep, Hypertension, and Cardiovascular Risk in Children and Adolescents
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“While there is already some recognition of conceptualising sedentary time and physical activity (including all intensities such as LPA and MPA) together as part of a continuum in total volume research [72, 74], most studies have only investigated independent effects of patterns for a single intensity.”
BackgroundInfluentialHinkley, T., Timperio, A. F., Watson, A., Duckham, R. L., Okely, A. D., Cliff, D. P., Carver, A., & Hesketh, K. D. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00935-6 · Cited by 77 · see citing works
Patterns of health behaviour associated with active travel: a compositional data analysis
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“Studies in children indicate associations between timeuse composition and many outcomes including body composition, [23–25] cardiorespiratory fitness [23, 25], cardiometabolic profile, [25] quality of life [26] and academic performance [27].”
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Dumuid, D., Maher, C., Lewis, L. K., Stanford, T. E., Martín Fernández, J. A., Ratcliffe, J., Katzmarzyk, P. T., Barreira, T. V., Chaput, J.-P., Fogelholm, M., et al. (2018) · Quality of Life Research · doi:10.1007/s11136-018-1791-x · Cited by 68 · see citing works
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Self-citationRodríguez‐Gómez, I., Mañas, A., Losa‐Reyna, J., Rodríguez‐Mañas, L., CHASTIN, S. F. M., Alegre, L. M., García‐García, F. J., & Ara, I. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206013 · Cited by 66 · see citing works
Self-citationKim, H., Ma, J., Harada, K., Lee, S., & Gu, Y. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17249320 · Cited by 65 · see citing works
“As a result, since the time spent on one behavior affects other behaviors for the remainder of the day, and the composition and combination of movement behaviors are interdependent, the combination of movement behaviors within a 24-h period has an important health effect on preschool children [15,16].”
BackgroundGupta, N., Rasmussen, C. L., Holtermann, A., & Mathiassen, S. E. (2020) · Annals of Work Exposures and Health · doi:10.1093/annweh/wxaa056 · Cited by 64 · see citing works
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“For example, time spent being sedentary is positively associated with BMI z-score, and negatively associated with fitness in children and youth (aged 6–17 years) [74].”
BackgroundFitzpatrick, C., Almeida, M. L., Harvey, E., Garon‐Carrier, G., Berrigan, F., & Asbridge, M. (2022) · BMC Pediatrics · doi:10.1186/s12887-022-03280-8 · Cited by 74 · see citing works
“In addition to fostering neuropsychological risk, sedentary behaviors developed in early childhood, including media use habits, are likely to be maintained through middle childhood and increase the risk of obesity [11, 12].”
BackgroundDuncan, S., Stewart, T. I., Mackay, L. M., Neville, J., Narayanan, A., Walker, C. G., Berry, S., & Morton, S. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15071296 · Cited by 60 · see citing works
Biddle, G. J. H., Edwardson, C. L., Henson, J. J., Davies, M. J., Khunti, K. K., Rowlands, A. V., & Yates, T. E. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15102280 · Cited by 60 · see citing works
The Association of the Body Composition of Children with 24-Hour Activity Composition
Dumuid, D., Wake, M. A., Clifford, S. A., Burgner, D. P., Carlin, J. B., Mensah, F. K., Fraysse, F., Lycett, K., Baur, L. A., & Olds, T. (2019) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2018.12.030 · Cited by 60 · see citing works
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“, overall mental wellbeing (4) and health-related quality of life (68)).”
BackgroundLee, E., Spence, J. C., Tremblay, M. S., & Carson, V. (2018) · Mental health and physical activity · doi:10.1016/j.mhpa.2018.02.001 · Cited by 53 · see citing works
Self-citationFairclough, S., Dumuid, D., Mackintosh, K., Stone, G., Dagger, R., Stratton, G., Davies, I., & Boddy, L. (2018) · Preventive medicine reports · doi:10.1016/j.pmedr.2018.07.011 · Cited by 43 · see citing works
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Shen, H., Yan, J. H., Hong, J., Clark, C. C. T., Yang, X.-N., Liu, Y., & Chen, S. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17093066 · Cited by 50 · see citing works
Khan, A., Lee, E., & Tremblay, M. S. (2020) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2020.10.017 · Cited by 50 · see citing works
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“…from compositional analyses, which recently have been shown to be superior to traditional linear regression techniques as 24-h behavioural data (sleep, sedentary time and physical activity) are intrinsically co-dependent, finite and subject to collinearity (Carson et al. 2016; Chastin et al. 2015).”
BackgroundShi, Y., Huang, Y., Sit, C. H. P., & Wong, S. H. (2020) · Journal of Physical Activity and Health · doi:10.1123/jpah.2019-0230 · Cited by 47 · see citing works
Associations Between Executive Functions and Physical Fitness in Preschool Children
Veraksa, А., Tvardovskaya, A. A., Gavrilova, M., Анатольевна, Я. В., & Musálek, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.674746 · Cited by 48 · see citing works
“Physical activity was defined as follows in the study of Welk et al. (2000, p. 65): “Physical activity refers to any bodily movement produced by skeletal muscles that results in energy expenditure” (Caspersen et al., 1985).”
MethodDi, J., Leroux, A., Urbanek, J. K., Varadhan, R., Spira, A. P., Schrack, J. A., & Zipunnikov, V. (2017) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/182337 · Cited by 48 · see citing works
Matricciani, L., Dumuid, D., Paquet, C., Fraysse, F., Wang, Y., Baur, L. A., Juonala, M., Ranganathan, S., Lycett, K., Kerr, J. A., et al. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2020.12.001 · Cited by 46 · see citing works
Lee, E., Khan, A., Uddin, R., Lim, E., & George, L. (2020) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2020.11.001 · Cited by 46 · see citing works
“Utilizing compositional analysis, time use epidemiologists have recently found that ST should be replaced with PA for health benefits among young people.(39,40) Therefore, discouraging ST while encouraging PA throughout the week, particularly during weekend days, could potentially reverse the replacement patterns betw…”
MethodSwindell, N., Rees, P., Fogelholm, M., Drummen, M., Macdonald, I., Martinez, J., Navas-Carretero, S., Handjieva-Darlenska, T., Boyadjieva, N., Bogdanov, G., et al. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00936-5 · Cited by 39 · see citing works
Liangruenrom, N., Dumuid, D., Craike, M. J., Biddle, S., & Pedišić, Ž. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-01011-9 · Cited by 44 · see citing works
Chong, K. H., Parrish, A., Cliff, D. P., Dumuid, D., & Okely, A. D. (2021) · European Journal of Sport Science · doi:10.1080/17461391.2021.1903562 · Cited by 43 · see citing works
Chong, K. H., Parrish, A., Cliff, D. P., Dumuid, D., & Okely, A. D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115995 · Cited by 43 · see citing works
“This finding is consistent with existing literature that shows favourable associations between sleep duration and emotional and behavioural problems in the school-aged population [8,15].”
BackgroundMethodResultInfluentialTowards precision 24-hour movement behavior recommendations—The next new paradigm?
Tremblay, M. S., Duncan, M. J., Kuzik, N., Silva, D. A. S., & Carson, V. (2024) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2024.05.003 · Cited by 43 · see citing works
“(cid:1) 12,15 (cid:1) 18,22,25,31 (cid:1) 33 This knowledge was not deliberately ignored by guideline developers in the past, but the amount of such information has been limited (though rapidly expanding), and the possibility of practitioners synthesizing evidence on an individualized basis has…”
BackgroundInfluentialSelf-citationA systematic review of the association between sleep health and stress biomarkers in children
Ordway, M. R., Condon, E. M., Ibrahim, B. B., Abel, E. A., Funaro, M. C., Batten, J., Sadler, L. S., & Redeker, N. S. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101494 · Cited by 43 · see citing works
Predicting parental support and parental perceptions of child and youth movement behaviors
Rhodes, R., Stearns, J., Berry, T., Faulkner, G., Latimer-Cheung, A., O'Reilly, N., Tremblay, M., Vanderloo, L. M., & Spence, J. (2019) · Psychology of Sport And Exercise · doi:10.1016/j.psychsport.2018.11.016 · Cited by 39 · see citing works
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“Previous CoDA studies have reported beneficial associations of more MVPA and less sedentary time (relative to one or more other activities) with fitness and adiposity [13, 14, 17], and more sleep and less LPA (relative to other activities) with adiposity [11, 14].”
BackgroundSelf-citationChild mortality levels and trends: A new compositional approach
Ezbakhe, F., & Foguet, A. P. (2020) · Demographic Research · doi:10.4054/demres.2020.43.43 · Cited by 40 · see citing works
“…to model trends in other SDG-related indicators, such as safe water and sanitation (Pérez-Foguet, Giné-Garriga, and Ortego 2017; Ezbakhe and Pérez-Foguet 2019), clean energy (Marcillo-Delgado, Ortego, and Pérez-Foguet 2019), and healthrelated outcomes (Carson et al. 2016; Fairclough et al. 2017).”
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Self-citationHossian, M., Mielke, G. I., Nisar, M., Tremblay, M. S., & Khan, A. (2025) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-025-01809-5 · Cited by 39 · see citing works
Self-citationThe integration of pediatric sleep health into public health in Canada
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“The use of innovative analytical methods, namely compositional data analyses, have opened new opportunities to quantitatively assess timedependent behavior compositions in relation to health outcomes of interest [23-25].”
Self-citationRosen, P., Dohrn, I., & Hagströmer, M. (2019) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13561 · Cited by 39 · see citing works
Zink, J., Booker, R., Wolff‐Hughes, D. L., Allen, N. B., Carnethon, M. R., Alexandria, S. J., & Berrigan, D. A. (2024) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-024-01587-6 · Cited by 42 · see citing works
“Different data handling procedures were needed to conduct CoDA, which is also designed for data that make up portions of a finite whole (i.e., the 24-h day) [47–50].”
MethodCompliance of Adolescent Girls to Repeated Deployments of Wrist-Worn Accelerometers
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Robust Compositional Analysis of Physical Activity and Sedentary Behaviour Data
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“Although health benefits for attaining adequate levels ofMVPA and sleep, together with reducing sedentary behaviors (like screen time) are wellestablished and evidence-based (27), negative trends in all three movement behaviors have been observed in children throughout”
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- Authors
- Carson, V., Tremblay, M. S., Chaput, J.-P., & Chastin, S. F. M.
- Affiliations
- University of Alberta (CA)
- Children's Hospital of Eastern Ontario (CA)
- Glasgow Caledonian University (GB)
- Venue
- Applied Physiology, Nutrition, and Metabolism
- Publisher
- Canadian Science Publishing
- Published
- 2016-06
- Volume
- 41
- Issue
- 6 (Suppl. 3)
- Pages
- S294-S302
- ISSN
- 1715-5312 (ISSN-L)
- 1715-5320
- OpenAlex
- W2423833455
- Semantic Scholar
- 824aa8e7306286fb30dde13958b2c0379a5c9d60
- Cited by
- 414
- References
- 40
- Citations by year
- 2026: 7 · 2025: 41 · 2024: 37 · 2023: 43 · 2022: 63 · 2021: 50 · 2020: 63 · 2019: 36 · 2018: 45 · 2017: 19 · 2016: 9
- FWCI
- 29.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Applied Physiology, Nutrition, and Metabolism (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ResearchOnline (Glasgow Caledonian University) (acceptedVersion, cc-by)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion)
- Funders
- Public Health Agency of Canada
- Public Health Agency
- Canadian Institutes of Health Research
- Social Sciences and Humanities Research Council of Canada
- Topics
- Health Sciences › Medicine › Physiology › 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
- sleep duration, sedentary behavior, physical activity, 24-hour movement behaviours, children and young people, cardiometabolic risk, systolic blood pressure, cardiorespiratory fitness, light physical activity, moderate-to-vigorous physical activity, compositional data analysis, isometric log-ratio
- MeSH terms
- Adolescent, Adolescent Behavior, Blood Pressure, C-Reactive Protein, Canada, Cardiovascular Diseases, Child, Child Behavior, Cross-Sectional Studies, Female, Health Status, Humans, Insulin, Cholesterol, HDL, Cholesterol, LDL, Male, Obesity, Risk Factors, Sleep, Triglycerides, Biomarkers, Exercise, Body Mass Index, Metabolic Syndrome, Waist Circumference, Young Adult, Sedentary Behavior, Accelerometry
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