Combinations of Physical Activity, Sedentary Behavior, and Sleep Duration and Their Associations With Physical, Psychological, and Educational Outcomes in Children and Adolescents: A Systematic Review

Overview

Journal Am J Epidemiol

Publisher Oxford University Press

Specialty Public Health

Date 2022 Dec 14

PMID 36516992

Authors

Katrina Wilhite

Bridget Booker

Bo-Huei Huang

Devan Antczak

Lucy Corbett

Philip Parker

Michael Noetel

Chris Rissel

Chris Lonsdale

Borja Del Pozo Cruz

Taren Sanders

Affiliations

Soon will be listed here.

Abstract

We conducted a systematic review to evaluate combinations of physical activity, sedentary behavior, and sleep duration (defined as "movement behaviors") and their associations with physical, psychological, and educational outcomes in children and adolescents. MEDLINE, CINAHL, PsychInfo, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Included studies needed to 1) quantitatively analyze the association of 2 or more movement behaviors with an outcome, 2) analyze a population between 5 and 17 years of age, and 3) include at least an English abstract. We included 141 studies. Most studies included the combination of physical activity and sedentary behavior in their analyses. Sleep was studied less frequently. In combination, a high level of physical activity and a low level of sedentary behavior were associated with the best physical health, psychological health, and education-related outcomes. Sleep was often included in the combination that was associated with the most favorable outcomes. Sedentary behavior had a stronger influence in adolescents than in children and tended to be associated more negatively with outcomes when it was defined as screen time than when defined as overall time spent being sedentary. More initiatives and guidelines combining all 3 movement behaviors will provide benefit with regard to adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.

Citing Articles

Factor structure and psychometric properties of the Chinese version of the Intuitive Exercise Scale for young adults.

Shi D, Lv F, Tan J, Gao D Front Psychol. 2025; 16:1546015.

PMID: 40062199 PMC: 11887646. DOI: 10.3389/fpsyg.2025.1546015.

The moderating effects of physical activity on social anxiety and sleep disturbance: managing gaming disorder in young e-sports players.

Solmaz S, Inan M, Sahin M Front Public Health. 2025; 13:1544044.

PMID: 39980917 PMC: 11841710. DOI: 10.3389/fpubh.2025.1544044.

Associations between meeting 24h movement behavior guidelines and cognition, gray matter volume, and academic performance in children and adolescents: a systematic review.

Liu B, Shi P, Jin T, Feng X Arch Public Health. 2025; 83(1):10.

PMID: 39794834 PMC: 11720839. DOI: 10.1186/s13690-024-01493-0.

Physical activity in professional training of physiotherapists.

Fromel K, Dygryn J, Vorlicek M, Jakubec L, Groffik D, Smekal D Ann Med. 2025; 57(1):2446687.

PMID: 39744898 PMC: 11703062. DOI: 10.1080/07853890.2024.2446687.

Exploring urban-rural differences in 24-h movement behaviours among tunisian preschoolers: Insights from the SUNRISE study.

Ltifi M, Turki O, Ben-Bouzaiene G, Chong K, Okely A, Chelly M Sports Med Health Sci. 2024; 7(1):48-55.

PMID: 39649786 PMC: 11624334. DOI: 10.1016/j.smhs.2024.03.004.

References

Van Den Bulck J, Hofman A . The television-to-exercise ratio is a predictor of overweight in adolescents: results from a prospective cohort study with a two year follow up. Prev Med. 2009; 48(4):368-71. DOI: 10.1016/j.ypmed.2009.02.006. View

Aggio D, Smith L, Fisher A, Hamer M . Context-Specific Associations of Physical Activity and Sedentary Behavior With Cognition in Children. Am J Epidemiol. 2016; 183(12):1075-82. PMC: 4908213. DOI: 10.1093/aje/kww031. View

Donnelly J, Hillman C, Castelli D, Etnier J, Lee S, Tomporowski P . Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review. Med Sci Sports Exerc. 2016; 48(6):1197-222. PMC: 4874515. DOI: 10.1249/MSS.0000000000000901. View

Moura B, Rufino R, Faria R, Amorim P . Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescents. PLoS One. 2019; 14(11):e0225856. PMC: 6879145. DOI: 10.1371/journal.pone.0225856. View

Del Pozo-Cruz B, Perales F, Parker P, Lonsdale C, Noetel M, Hesketh K . Joint physical-activity/screen-time trajectories during early childhood: socio-demographic predictors and consequences on health-related quality-of-life and socio-emotional outcomes. Int J Behav Nutr Phys Act. 2019; 16(1):55. PMC: 6615223. DOI: 10.1186/s12966-019-0816-3. View

Tahir M, Willett W, Forman M . The Association of Television Viewing in Childhood With Overweight and Obesity Throughout the Life Course. Am J Epidemiol. 2018; 188(2):282-293. PMC: 6357794. DOI: 10.1093/aje/kwy236. View

Laurson K, Lee J, Gentile D, Walsh D, Eisenmann J . Concurrent Associations between Physical Activity, Screen Time, and Sleep Duration with Childhood Obesity. ISRN Obes. 2014; 2014:204540. PMC: 3964685. DOI: 10.1155/2014/204540. View

Tremblay M . Introducing 24-Hour Movement Guidelines for the Early Years: A New Paradigm Gaining Momentum. J Phys Act Health. 2019; 17(1):92-95. DOI: 10.1123/jpah.2019-0401. View

Ogawa S, Kitagawa Y, Fukushima M, Yonehara H, Nishida A, Togo F . Interactive effect of sleep duration and physical activity on anxiety/depression in adolescents. Psychiatry Res. 2019; 273:456-460. DOI: 10.1016/j.psychres.2018.12.085. View

10.

Sun Y, Yin X, Li Y, Bi C, Li M, Yang X . Isotemporal substitution of sedentary behavior for physical activity on cardiorespiratory fitness in children and adolescents. Medicine (Baltimore). 2020; 99(30):e21367. PMC: 7386960. DOI: 10.1097/MD.0000000000021367. View

11.

Djalalinia S, Qorbani M, Rezaei N, Sheidaei A, Mahdavi-Gorabi A, Kasaeian A . Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study. J Pediatr Endocrinol Metab. 2017; 30(7):731-738. DOI: 10.1515/jpem-2016-0486. View

12.

Chaput J, Leduc G, Boyer C, Belanger P, LeBlanc A, Borghese M . Objectively measured physical activity, sedentary time and sleep duration: independent and combined associations with adiposity in canadian children. Nutr Diabetes. 2014; 4:e117. PMC: 4079924. DOI: 10.1038/nutd.2014.14. View

13.

Dumuid D, Wake M, Clifford S, Burgner D, Carlin J, Mensah F . The Association of the Body Composition of Children with 24-Hour Activity Composition. J Pediatr. 2019; 208:43-49.e9. DOI: 10.1016/j.jpeds.2018.12.030. View

14.

Cao R, Gao T, Hu Y, Qin Z, Ren H, Liang L . Clustering of lifestyle factors and the relationship with depressive symptoms among adolescents in Northeastern China. J Affect Disord. 2020; 274:704-710. DOI: 10.1016/j.jad.2020.05.064. View

15.

Agostinis-Sobrinho C, Gomez-Martinez S, Nova E, Hernandez A, Labayen I, Kafatos A . Lifestyle patterns and endocrine, metabolic, and immunological biomarkers in European adolescents: The HELENA study. Pediatr Diabetes. 2018; 20(1):23-31. DOI: 10.1111/pedi.12802. View

16.

Cao H, Qian Q, Weng T, Yuan C, Sun Y, Wang H . Screen time, physical activity and mental health among urban adolescents in China. Prev Med. 2011; 53(4-5):316-20. DOI: 10.1016/j.ypmed.2011.09.002. View

17.

Santos D, Marques A, Minderico C, Ekelund U, Sardinha L . A cross-sectional and prospective analyse of reallocating sedentary time to physical activity on children's cardiorespiratory fitness. J Sports Sci. 2017; 36(15):1720-1726. DOI: 10.1080/02640414.2017.1411176. View

18.

Cristi-Montero C, Chillon P, Labayen I, Casajus J, Gonzalez-Gross M, Vanhelst J . Cardiometabolic risk through an integrative classification combining physical activity and sedentary behavior in European adolescents: HELENA study. J Sport Health Sci. 2019; 8(1):55-62. PMC: 6349585. DOI: 10.1016/j.jshs.2018.03.004. View

19.

Kantomaa M, Stamatakis E, Kankaanpaa A, Kajantie E, Taanila A, Tammelin T . Associations of Physical Activity and Sedentary Behavior With Adolescent Academic Achievement. J Res Adolesc. 2016; 26(3):432-442. PMC: 4995724. DOI: 10.1111/jora.12203. View

20.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View