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Meta-Analysis
. 2016 Dec 20;11(12):e0168503.
doi: 10.1371/journal.pone.0168503. eCollection 2016.

Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents: Systematic Review and Meta-Analysis of Observational Evidence

Raphael Gonçalves de Oliveira  1   2 , Dartagnan Pinto Guedes  1
Affiliations
Meta-Analysis

Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents: Systematic Review and Meta-Analysis of Observational Evidence

Raphael Gonçalves de Oliveira et al. PLoS One. .

Abstract

Background: Metabolic syndrome (MetS) has been diagnosed in adolescents and among the associated factors are low levels of physical activity, sedentary behavior over long periods and low cardiorespiratory fitness. However, specifically in adolescents, studies present conflicting results. The aim of the present study was to conduct a systematic review and meta-analysis of observational studies, in order to map the association between physical activity, sedentary behavior, cardiorespiratory fitness and MetS in adolescents.

Methods: A search was performed in the databases PubMed, SPORTDiscus, LILACS and the Cochrane Library. For the meta-analysis, the odds ratio (OR) was calculated together with the respective confidence intervals (95% CI), in which the measures of effect were analyzed by dichotomous data (exposure variables) with MetS used as events.

Results: Eighteen studies were included in the meta-analysis. Primary analysis demonstrated that low levels of physical activity (OR = 1.35 [1.03 to 1.79]; p = 0.03) and low cardiorespiratory fitness (OR = 4.05 [2.09 to 7.87]; p < 0.01) were significantly associated with the development of MetS, while for sedentary behavior, represented by screen time > 2 hours/day, a significant association was not identified (OR = 1.20 [0.91 to 1.59]; p = 0.20). Subgroup analyses demonstrated that the association between low physical activity and MetS was dependent on the use of the accelerometry technique (OR = 2.93 [1.56 to 5.47]; p < 0.01). Screen time > 2 hours/day was significantly associated with MetS only on weekends (OR = 2.05 [1.13 to 3.73]; p = 0.02). With respect to cardiorespiratory fitness, a significant association with MetS was found independent of the maximal oxygen uptake (VO2max) measurement method.

Conclusions: Low levels of physical activity, low indices of cardiorespiratory fitness and sedentary behavior, represented by screen time > 2 hours/day on weekends, were significantly associated with the development of MetS in adolescence.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart presenting the summary of searches carried out in the literature.
Fig 2
Fig 2. Forest plot of the primary and subgroup analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high levels of physical activity versus low level of physical activity.
Fig 3
Fig 3. Forest plot of the primary and subgroup analysis comparing odds ratios for metabolic syndrome among adolescents with low screen time versus high screen time.
Fig 4
Fig 4. Forest plot of the primary and subgroup analysis comparing odds ratios for metabolic syndrome among adolescents with moderate/high cardiorespiratory fitness versus low cardiorespiratory fitness.
See this image and copyright information in PMC

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