Our results show beneficial theoretical associations between replacing as little as 10 min/day of sedentary time with an equal amount of time spent in moderate-to-vigorous physical activity and a wide array of cardiometabolic risk markers in healthy youth. |
Replacing sedentary time with an equal amount of light physical activity showed minor beneficial associations with cardiometabolic risk markers. |
Replacing sedentary time with active behaviours, particularly those of at least moderate intensity, appears to be an effective strategy to reduce cardiometabolic risk in young people. |
1 Introduction
2 Methods
2.1 Study Design
2.2 Participants
2.3 Assessment of Physical Activity and Sedentary Time
2.4 Assessment of Anthropometry and Cardiometabolic Risk Factor Outcomes
2.5 Statistical Analyses
3 Results
Studiesa | Children | Studies | Adolescents | Studies | Older adolescents | |
---|---|---|---|---|---|---|
N
| 2–13 | 4971 | 1–11 | 10,836 | 1, 3–5, 7–8 | 2393 |
N (%) girls | 2573 (51) | 5678 (52) | 956 (50) | |||
Age, years | ||||||
Mean | 8.1 (1.8) | 11.6 (1.0) | 16.2 (0.8) | |||
Range | 3.6–9.9 | 10.0–14.9 | 15–18.4 | |||
Weight, kg | 29.5 (8.9) | 43.8 (12.4) | 65.5 (17.4) | |||
Height, cm | 129.5 (12.7) | 149.6 (9.2) | 168.0 (9.1) | |||
IOTF category | ||||||
N (%) normal weight | 3913 (79) | 8092 (75) | 1324 (70) | |||
N (%) overweight | 759 (15) | 1991 (18) | 356 (19) | |||
N (%) obese | 295 (6) | 734 (7) | 216 (11) | |||
Metabolic risk factors | ||||||
Waist circumference, cm | 2–13 | 59.1 (8.2) | 1–11 | 68.6 (10.8) | 1, 3–5, 7–8 | 78.1 (14.4) |
Systolic blood pressure, mmHg | 2–8, 12 | 99.0 (8.9) | 1–8 | 105.5 (9.8) | 3–5, 7–8 | 110.6 (10.8) |
HDL cholesterol, mmol/L | 2–8, 11 | 1.53 (0.32) | 2–8, 11 | 1.43 (0.34) | 3–5, 7–8 | 1.35 (0.30) |
LDL cholesterol, mmol/L | 2–8, 11 | 2.57 (0.75) | 2–8, 11 | 2.41 (0.67) | 3–5, 7–8 | 2.39 (0.69) |
Insulin, mmol/L | 2–5, 11 | 34.8 (24.7) | 2–5, 7–8, 11 | 66.9 (54.4) | 3–5, 7–8 | 74.3 (64.6) |
Triglycerides, mmol/L | 2–8, 11 | 0.74 (0.37) | 2–8, 11 | 0.86 (0.45) | 3–5, 7–8 | 0.90 (0.50) |
Glucose, mmol/L | 2–5, 11 | 4.94 (0.52) | 2–5, 7–8, 11 | 5.16 (0.82) | 3–5, 7–8 | 5.14 (0.50) |
Physical activity | 2–13 | 1–11 | 1, 3–5, 7–8 | |||
Wear days | 4.0 (1.5) | 5.3 (1.7) | 4.0 (1.7) | |||
Wear time, min/day | 779 (68) | 790 (60) | 815 (77) | |||
Counts per minute | 661 (233) | 578 (210) | 433 (197) | |||
Sedentary time, min/day | 313 (95) | 372 (82) | 455 (102) | |||
LPA, min/day | 405 (72) | 361 (65) | 318 (83) | |||
MVPA, min/day | 56 (31) | 54 (29) | 39 (29) |
n
| Sedentary β (95% CI) | LPA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | 4971 | |||
Single | 0.124 (0.055 to 0.193)** | − 0.069 (− 0.150 to 0.012) | − 0.316 (− 0.571 to − 0.061)* | |
Partition | 0.044 (− 0.002 to 0.091) | − 0.014 (−0.083 to 0.055) | − 0.243 (− 0.473 to − 0.014)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.058 (− 0.123 to 0.006) | − 0.287 (− 0.518 to − 0.056)* | |
Reduce LPA | 0.058 (−0.007 to 0.122) | Dropped | − 0.230 (− 0.417 to − 0.044)* | |
Reduce MVPA | 0.290 (0.057 to 0.523)* | 0.231 (0.042 to 0.421)* | Dropped | |
Adolescents | 10,836 | |||
Single | 0.127 (0.107 to 0.147)** | − 0.097 (− 0.131 to − 0.064)** | − 0.608 (− 0.731 to − 0.484)** | |
Partition | 0.035 (− 0.018 to 0.087) | − 0.012 (− 0.068 to − 0.044) | − 0.555 (− 0.716 to − 0.394)** | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.046 (− 0.073 to − 0.019)* | − 0.589 (−0.702 to − 0.477)** | |
Reduce LPA | 0.047 (0.021 to 0.074)** | Dropped | − 0.541 (− 0.659 to − 0.424)** | |
Reduce MVPA | 0.601 (0.491 to 0.712)** | 0.559 (0.444 to 0.674)** | Dropped | |
Older adolescents | 1896 | |||
Single | − 0.007 (− 0.049 to 0.035) | − 0.038 (− 0.106 to 0.031) | − 0.406 (− 0.874 to − 0.063)* | |
Partition | − 0.125 (− 0.255 to − 0.006) | − 0.153 (− 0.28 to −0.028)* | − 0.939 (− 1.436 to − 0.441)** | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.027 (− 0.131 to 0.078) | − 0.814 (− 1.334 to −0.294)* | |
Reduce LPA | 0.029 (− 0.076 to 0.134) | Dropped | − 0.784 (− 1.233 to − 0.336)* | |
Reduce MVPA | 0.834 (0.304–1.364)* | 0.813 (0.352–1.275)* | Dropped |
n
| Sedentary β (95% CI) | Light PA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | 3544 | |||
Single | − 0.008 (− 0.034 to 0.018) | − 0.006 (− 0.041 to 0.030) | − 0.091 (− 0.237 to 0.055) | |
Partition | − 0.054 (− 0.098 to − 0.010)** | − 0.027 (− 0.092 to 0.037) | − 0.151 (− 0.320 to 0.019) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.027 (− 0.005 to 0.058) | − 0.097 (− 0.250 to 0.055) | |
Reduce light PA | − 0.027 (− 0.059 to 0.005) | Dropped | − 0.124 (− 0.294 to 0.045) | |
Reduce MVPA | 0.096 (− 0.057 to 0.248) | 0.122 (− 0.047 to 0.292) | Dropped | |
Adolescents | 8100 | |||
Single | 0.032 (0.003 to 0.061)* | − 0.039 (− 0.060 to − 0.018)** | − 0.107 (− 0.179 to −0.035)* | |
Partition | 0.005 (− 0.033 to 0.044) | − 0.025 (− 0.050 to − 0.000)* | − 0.079 (− 0.122 to − 0.036)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.031 (− 0.051 to − 0.010)* | − 0.084 (− 0.143 to − 0.025)* | |
Reduce light PA | 0.030 (0.010–0.050)* | Dropped | − 0.056 (− 0.010 to − 0.012)* | |
Reduce MVPA | 0.083 (0.026 to 0.139)* | 0.052 (0.011 to 0.092)* | Dropped | |
Older adolescents | 1865 | |||
Single | 0.046 (− 0.009 to 0.102) | − 0.036 (− 0.101 to 0.029) | − 0.217 (− 0.507 to 0.072) | |
Partition | 0.058 (− 0.022 to 0.138) | 0.019 (− 0.055 to 0.094) | − 0.184 (− 0.408 to 0.041) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.039 (− 0.120 to 0.042) | − 0.240 (− 0.535 to 0.053) | |
Reduce light PA | 0.039 (− 0.041 to 0.119) | Dropped | − 0.202 (− 0.467 to 0.062) | |
Reduce MVPA | 0.243 (− 0.048 to 0.535) | 0.206 (−0.055 to 0.467) | Dropped |
n
| Sedentary β (95% CI) | Light PA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | 3112 | |||
Single | 0.001 (− 0.002 to 0.004) | − 0.000 (− 0.003 to 0.003) | 0.006 (− 0.002 to 0.014) | |
Partition | 0.003 (0.000 to 0.005)* | − 0.001 (− 0.004 to 0.002) | 0.009 (− 0.001 to 0.014) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.004 (− 0.008 to 0.000) | 0.006 (− 0.001 to 0.013) | |
Reduce light PA | 0.004 (0.000 to 0.008) | Dropped | 0.010 (0.001 to 0.019)* | |
Reduce MVPA | − 0.006 (− 0.014 to 0.002) | − 0.010 (− 0.019 to − 0.002)* | Dropped | |
Adolescents | 2135 | |||
Single | − 0.001 (− 0.003 to − 0.000)* | 0.000 (− 0.001 to 0.002) | 0.007 (− 0.002 to 0.017) | |
Partition | − 0.002 (− 0.002 to − 0.001)** | − 0.002 (− 0.004 to −0.001)* | 0.005 (− 0.006 to 0.015) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.000(− 0.002 to 0.001) | 0.006 (− 0.005 to 0.018) | |
Reduce light PA | 0.000 (− 0.001 to 0.002) | Dropped | 0.006 (− 0.006 to 0.019) | |
Reduce MVPA | − 0.006 (− 0.018 to 0.005) | − 0.007 (− 0.019 to 0.006) | Dropped | |
Older adolescents | 1788 | |||
Single | − 0.000 (− 0.002 to 0.001) | 0.001 (0.000 to 0.002)* | 0.002 (− 0.002 to 0.006) | |
Partition | 0.001 (− 0.000 to 0.002) | 0.001 (− 0.001 to 0.003) | 0.002 (− 0.001 to 0.005) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.000 (− 0.003 to 0.003) | 0.000 (− 0.004 to 0.003) | |
Reduce light PA | − 0.001 (− 0.002 to 0.001) | Dropped | 0.001 (− 0.005 to 0.002) | |
Reduce MVPA | − 0.000 (− 0.003 to 0.004) | − 0.001 (− 0.002 to 0.004) | Dropped |
n
| Sedentary β (95% CI) | Light PA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | 2428 | |||
Single | − 0.002 (− 0.002 to 0.006) | 0.000 (− 0.002 to 0.004 | − 0.020 (− 0.030 to − 0.010)** | |
Partition | − 0.002 (− 0.007 to 0.003) | 0.002 (− 0.002 to 0.005) | − 0.024 (− 0.032 to − 0.016)** | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.003 (0.001–0.006)* | − 0.022 (− 0.032 to − 0.012)** | |
Reduce light PA | − 0.004 (− 0.006 to −0.001)* | Dropped | − 0.026 (− 0.035 to − 0.016)** | |
Reduce MVPA | 0.022 (0.012 to 0.032)** | 0.026 (0.016 to 0.035)** | Dropped | |
Adolescents | 1166 | |||
Single | − 0.003 (− 0.006 to 0.001) | 0.004 (− 0.001 to 0.010) | − 0.007 (− 0.021 to 0.007) | |
Partition | − 0.004 (− 0.009 to 0.001) | 0.003 (− 0.003 to 0.009) | − 0.016 (− 0.030 to − 0.001)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.003 (0.001 to 0.011)* | − 0.012 (− 0.023 to 0.001)* | |
Reduce light PA | − 0.006 (− 0.011 to − 0.001)* | Dropped | − 0.018 (− 0.029 to − 0.007)* | |
Reduce MVPA | 0.012 (0.001 to 0.024) | 0.018 (0.007–0.029) | Dropped | |
Older adolescents | 1222 | |||
Single | 0.003 (0.001 to 0.006)* | − 0.005 (− 0.010 to 0.000)* | − 0.023 (− 0.034 to − 0.012)** | |
Partition | − 0.000 (− 0.005 to 0.005) | − 0.001 (− 0.005 to 0.003) | 0.003 (− 0.018 to 0.025) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.001 (− 0.005 to 0.003) | 0.003 (− 0.022 to 0.029) | |
Reduce light PA | − 0.001 (− 0.003 to 0.005) | Dropped | 0.004 (− 0.019 to 0.027) | |
Reduce MVPA | − 0.005 (− 0.031 to 0.022) | − 0.006 (− 0.030 to 0.018) | Dropped |
n
| Sedentary β (95% CI) | Light PA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | 2415 | |||
Single | 0.002 (− 0.001 to 0.004) | − 0.003 (− 0.005 to 0.001) | − 0.008 (− 0.015 to − 0.000)* | |
Partition | − 0.001 (− 0.005 to 0.003) | − 0.002 (− 0.004 to 0.001) | − 0.007 (− 0.016 to − 0.003)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.001 (− 0.003 to 0.001) | − 0.006 (− 0.013 to 0.001) | |
Reduce light PA | 0.001 (− 0.001 to 0.003) | Dropped | − 0.005 (− 0.013 to 0.003) | |
Reduce MVPA | 0.006 (− 0.001 to 0.013) | 0.005 (− 0.003 to 0.013) | Dropped | |
Adolescents | 1160 | |||
Single | 0.001 (− 0.003 to 0.004) | − 0.001 (− 0.005 to 0.004) | − 0.017 (− 0.022 to − 0.011)* | |
Partition | − 0.003 (− 0.006 to 0.001) | 0.000 (− 0.003 to 0.002) | − 0.021 (− 0.030 to − 0.013)** | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.002 (− 0.003 to 0.008) | − 0.019 (− 0.026 to − 0.012)** | |
Reduce light PA | − 0.002 (− 0.008 to 0.003) | Dropped | − 0.021 (− 0.032 to − 0.010)** | |
Reduce MVPA | 0.019 (0.012 to 0.026)** | 0.021 (0.010 to 0.032)** | Dropped | |
Older adolescents | 1224 | |||
Single | 0.000 (− 0.003 to 0.003) | − 0.004 (− 0.008 to − 0.001)** | − 0.005 (− 0.019 to − 0.010)* | |
Partition | − 0.004 (− 0.011 to 0.004) | − 0.008 (− 0.014 to − 0.002)* | − 0.011 (− 0.020 to − 0.002)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.004 (− 0.007 to − 0.001)* | − 0.007 (− 0.014 to 0.001) | |
Reduce light PA | 0.004 (0.001 to 0.007)* | Dropped | − 0.003 (− 0.012 to 0.006) | |
Reduce MVPA | 0.006 (− 0.002 to 0.014) | 0.002 (− 0.008 to 0.011) | Dropped |
n
| Sedentary β (95% CI) | Light PA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | 2151 | |||
Single | − 0.127 (− 0.393 to 0.140) | 0.073 (− 0.092 to 0.238) | − 0.677 (− 1.301 to −0.052)* | |
Partition | − 0.151 (− 0.488 to 0.186) | 0.296 (0.081 to 0.510)* | − 1.000 (− 1.976 to − 0.023)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.446 (0.107 to 0.785)* | − 0.850 (− 1.614 to − 0.086)* | |
Reduce light PA | − 0.448 (− 0.785 to − 0.111)* | Dropped | − 1.295 (− 2.171 to − 0.419)* | |
Reduce MVPA | 0.847 (0.093 to 1.600)* | 1.291 (0.426 to 2.155)* | Dropped | |
Adolescents | 1049 | |||
Single | 0.136 (− 0.003 to 0.275) | 0.030 (− 0.162 to 0.221) | − 0.659 (− 1.607 to 0.290) | |
Partition | 0.226 (− 0.070 to 0.521) | 0.322 (− 0.062 to 0.707) | − 0.547 (− 1.558 to 0.464) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.094 (− 0.025 to 0.213) | − 0.770 (− 1.745 to 0.205) | |
Reduce light PA | − 0.101 (− 0.215 to 0.012) | Dropped | − 0.877 (− 1.897 to 0.144) | |
Reduce MVPA | 0.727 (− 0.293 to 1.474) | 0.817 (− 0.271 to 1.905) | Dropped | |
Older adolescents | 1222 | |||
Single | − 0.206 (− 0.51 to 0.107) | − 0.067 (− 0.313 to 0.179) | − 0.255 (− 1.474 to 0.964) | |
Partition | − 0.371 (− 0.684 to − 0.058)* | − 0.355 (− 0.540 to − 0.171)** | − 0.276 (− 1.822 to 1.269) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.017 (− 0.411 to 0.446) | − 0.092 (− 1.633 to 1.818) | |
Reduce light PA | − 0.020 (− 0.450 to 0.408) | Dropped | 0.068 (− 1.468 to 1.604) | |
Reduce MVPA | 0.123 (− 0.870 to 1.625) | 0.109 (− 1.674 to 1.456) | Dropped |
n
| Sedentary β (95% CI) | Light PA β (95% CI) | MVPA β (95% CI) | |
---|---|---|---|---|
Children | ||||
Single | 2165 | 0.001 (− 0.001 to 0.003) | − 0.003 (− 0.005 to − 0.000) | − 0.004 (− 0.013 to 0.005) |
Partition | 0.011 (− 0.008 to 0.030) | 0.001 (− 0.013 to 0.015) | 0.006 (− 0.010 to 0.021) | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | −0.010 (− 0.021 to − 0.000)* | − 0.006 (− 0.018 to 0.007) | |
Reduce light PA | 0.010 (0.000 to 0.021)* | Dropped | 0.005 (− 0.011 to 0.020) | |
Reduce MVPA | 0.005 (− 0.007 to 0.017) | − 0.005 (− 0.021 to 0.011) | Dropped | |
Adolescents | ||||
Single | 1060 | 0.000 (− 0.002 to 0.003) | − 0.006 (− 0.014 to 0.003) | − 0.018 (− 0.035 to − 0.002)* |
Partition | − 0.012 (− 0.023 to 0.000) | − 0.013 (− 0.030 to 0.003) | − 0.027 (− 0.050 to −0.004)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | − 0.002 (− 0.006 to 0.003) | − 0.016 (− 0.030 to − 0.002)* | |
Reduce light PA | 0.001 (− 0.003 to 0.006) | Dropped | − 0.013 (−0.024 to − 0.002)* | |
Reduce MVPA | 0.015 (0.001 to 0.030)* | 0.014 (0.000 to 0.027)* | Dropped | |
Older adolescents | ||||
Single | 1232 | − 0.002 (− 0.006 to 0.003) | 0.002 (− 0.001 to 0.006) | − 0.015 (− 0.028 to − 0.002)* |
Partition | − 0.003 (− 0.008 to 0.003) | − 0.002 (− 0.002 to 0.006) | − 0.017 (− 0.028 to − 0.006)* | |
Isotemporal substitution | ||||
Reduce sedentary | Dropped | 0.005 (0.001–0.008)* | − 0.015 (− 0.026 to − 0.003)* | |
Reduce light PA | − 0.005 (− 0.008 to − 0.001)* | Dropped | − 0.019 (− 0.028 to − 0.010)** | |
Reduce MVPA | 0.015 (0.003 to 0.026)* | 0.019 (0.009 to 0.029)** | Dropped |