Associations of different types of physical activity and sedentary behavior with self-rated health in children and adolescents: a systematic review of research from 2010 to 2024

Abstract

Background: Self-rated health (SRH) is one of the common measures to evaluate individuals' overall health. Many studies have explored the associations between different types of physical activity (PA), sedentary behavior (SB), and SRH in children and adolescents. These studies report inconsistent findings and sometimes highlight gender differences. This systematic review aims to synthesize findings to provide a comprehensive evaluation of these associations.

Methods: English-language articles published between January 2010 and September 2024 were systematically searched through Web of Science, PubMed, and EBSCOhost databases. Following PRISMA guidelines, we included 47 studies in this review that meet eligibility criteria. Study quality was assessed using the National Institutes of Health's study quality assessment tool for observational cohort and cross-sectional studies.

Results: The majority of study findings show that ≥ 60 min/day of moderate-to-vigorous PA (≥ 4 days/week), vigorous PA (≥ 3 days/week or ≥ 4 times/week), out-of-school PA (≥ 2 days/week), and sports participation are significantly positive associated with SRH. Additionally, evidence suggests that SB (e.g., watching TV and doing homework) generally shows no significant association with SRH. More study findings support that PA is positively associated with boys' SRH than that of girls.

Conclusions: Findings show significant positive associations between PA and SRH, particularly those of vigorous and moderate-to-vigorous intensity, while the association between SB and SRH requires further investigation beyond TV and video game/computer times. Evidence of gender differences in the associations suggests the potential need for targeted strategies to enhance SRH in girls.

Keywords: Adolescence; Child; Exercise; Movement behavior; Perceived health; Screen time.

Fig. 1

PRISMA flowchart for study selection

Fig. 2

Percentage of supporting findings on the association between PA and SRH (%, # of positive/negative/null findings noted on the right-hand side). Notes: PA, physical activity; LPA, light physical activity; MPA, moderate physical activity; VPA, vigorous physical activity; MVPA, moderate to vigorous physical activity; M, male; F, female; 0–33%: no association; 34–59%: inconclusive; 60–100%: positive association. “++”, “– –”, “??”, or “OO” was coded when four or more samples supported one same direction associations. Not all studies reported findings between genders, and two only reported girls’ results [22, 47]. Fourteen samples represented out-of-school VPA, school-based organized sports, sports outside of school, or organized leisure time sports activity were only counted once in the final calculation of total PA to avoid double-counting, as they overlap in categories such as VPA, out-of-school PA, for detailed information please see Supplementary Table 1

Fig. 3

Percentage of supporting findings on the association between SB and SRH (%, # of negative/positive/null findings noted on the right-hand side). Notes: SB, sedentary behavior; ST, screen time; M, male; F, female. 0–33%: no association; 34–59%: inconclusive; 60–100%: negative or positive association. “++”, “– –”, “??”, or “OO” was coded when four or more samples supported one same direction associations. Not all studies reported findings between genders, and two only reported girls’ results [22, 47]. For detailed information please see Supplementary Table 2