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. 2024 Apr 18;24(1):1080.
doi: 10.1186/s12889-024-18364-6.

Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review

Gabrielli T de Mello  1 , Giseli Minatto  2 , Rafael M Costa  2 , Rebecca M Leech  3 , Yingting Cao  4 , Rebecca E Lee  5 , Kelly S Silva  2
Affiliations

Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review

Gabrielli T de Mello et al. BMC Public Health. .

Abstract

Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.

Keywords: Adolescent health; Child Health; Clustering; Diet; Exercise; Food and Nutrition; Sleep.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study inclusion for the review. PA: physical activity; SB: sedentary behavior. Note: * Polash idiom; Explained how to use cluster analysis – did not present results
Fig. 2
Fig. 2
Assessment of the risk of bias of studies. PA: physical activity. SB: sedentary behavior. Low: low risk of bias. Moderate: moderate risk of bias. High: high risk of bias
Fig. 3
Fig. 3
Cluster types (n = 66) according to sample stratum and respective studies references. PA: physical activity. SB: sedentary behavior. UPF: ultra-processed foods. FV: fruit and vegetables. Specific Diet” involve consumption of foods that do not frame on FV and UPF (e.g., milk and meat consumption). # The cluster is also characterized by high discrepancy and quality of sleep
See this image and copyright information in PMC

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