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Meta-Analysis
. 2025 May;26(5):e13884.
doi: 10.1111/obr.13884. Epub 2025 Jan 20.

Association between 24-hour movement behaviors and adiposity in children and adolescents: A compositional data meta-analysis

Matthew Bourke  1   2 , Zoe Harrison  1 , Kathryn Fortnum  1 , George Thomas  1   3 , Martin O'Flaherty  1 , Samantha K Mulcahy  1 , Sjaan R Gomersall  1   4 , Tahlia Alsop  1   4 , Stewart G Trost  5 , Jennifer J Koplin  6 , Brianne A Bruijns  2   7 , Sophie M Phillips  2 , Leigh M Vanderloo  2   7 , Patricia Tucker  2 , Kylie D Hesketh  8 , Matthew Y W Kwan  9   10 , John Cairney  1
Affiliations
Meta-Analysis

Association between 24-hour movement behaviors and adiposity in children and adolescents: A compositional data meta-analysis

Matthew Bourke et al. Obes Rev. 2025 May.

Abstract

Purpose: To quantitatively synthesize published evidence on the association between 24-hour movement behavior composition with adiposity in children and adolescents aged 3-18 years.

Methods: Systematic literature searches were conducted in five electronic databases to identify papers published between January 2015 and January 2024. A machine learning-assisted systematic review was conducted to identify studies applying compositional data analysis to examine the association between 24-hour movement behaviors and adiposity in children and youth. Random effect meta-analyses were estimated to examine the relative association between each component of the 24-hour movement behavior composition and body mass index z-score (zBMI), waist circumference, fat mass percentage, and fat mass index (FMI).

Results: A total of 16 studies reporting on 15,230 children and youth were included in the review. Most studies reported on zBMI (k = 14), followed by waist circumference (k = 5), body fat percentage (k = 3), and FMI (k = 2). Spending more time sleeping and engaged in moderate-to-vigorous intensity physical activity (MVPA) relative to other behaviors was associated with lower adiposity, while spending more time sedentary and engaged in light-intensity physical activity was associated with higher adiposity.

Conclusion: These results provide support for most recommendations of the 24-hour movement behavior guidelines, including getting an adequate amount of sleep, limiting sedentary time, and engaging in MVPA, to improve adiposity outcomes.

Keywords: adiposity; physical activity; sedentary; sleep.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Change in zBMI associated relative changes in each part of the 24‐hour movement behavior compositions. Note that the plot for MVPA is presented on a different scale to improve readability.
FIGURE 3
FIGURE 3
Bubble plot of the results from the meta‐regression of the association between time spent in MVPA relative to other 24‐hour movement behaviors on BMI z‐score regressed on average participant age.
FIGURE 4
FIGURE 4
Change in waist circumference associated with relative changes in each part of the 24‐hour movement behavior composition. Note that the plots are presented on a different scale to improve readability.
FIGURE 5
FIGURE 5
Change in body fat percentage associated with relative changes in each part of the 24‐hour movement behavior composition. Note that the plots are presented on a different scale to improve readability.
FIGURE 6
FIGURE 6
Change in fat mass index associated with relative changes in each part of the 24‐hour movement behavior composition. Note that the plots are presented on a different scale to improve readability.
See this image and copyright information in PMC

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