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. 2023 Apr 6;192(4):665-679.
doi: 10.1093/aje/kwac212.

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

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

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

Katrina Wilhite et al. Am J Epidemiol. .

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.

Keywords: adolescents; children; physical activity; sedentary behavior; sleep.

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Figures

Figure 1
Figure 1
Selection of studies for inclusion in a systematic review of the associations of combinations of movement behaviors (physical activity, sedentary behavior, and sleep duration) with physical, psychological, and educational outcomes in children and adolescents, 2002–2020 followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (24).
See this image and copyright information in PMC

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