Table 1 Study characteristics
Study | Sample (n and mean age or age range), study design, country | Obesity indicator | Movement behaviours (physical activity, sedentary behaviours and screen time and sleep) | Main findings |
|---|---|---|---|---|
Age group: toddlers | ||||
Lee et al. [30] | n = 151, 19.0 ± 1.9 months Cross-sectional Canada | BMI z-scores were calculated according to the WHO | PA was measured by accelerometer (ActiGraph wGT3X-BT). ST and sleep duration were reported by parents | The associations between meeting the specific and general combinations of the 24-h movement guidelines and BMI z-scores were null |
Santos et al. [31] | n = 202 (98 boys, 104 girls), 19.74 ± 4.07 months Cross-sectional Australia | BMI z-scores were calculated according to the WHO | PA was measured by accelerometer (ActiGraph wGT3X-BT). ST and sleep duration were reported by parents | BMI was not associated with accomplishing any of the 24-h movement guidelines |
Age group: preschool children | ||||
Berglind et al. [32] | n = 830, 4–5 years Cross-sectional and prospective (1-year follow-up) Sweden | BMI z-scores were calculated according to the IOTF | PA was measured by accelerometer (ActiGraph GT3X +). ST and sleep duration were reported by parents | There was no cross-sectional or prospective association of the 24-h movement guidelines with BMI or BMI z-score at ages 4 and 5 years |
Chaput et al. [13] | n = 803, 3.5 years Cross-sectional Canada | BMI z-scores were calculated according to the WHO | PA was measured by Actical accelerometers. ST and sleep duration were reported by parents | None of the combinations of recommendations was associated with adiposity |
Decraene et al. [33] | n = 2468, 4.75 ± 0.43 years Cross-sectional Seven countries* | BMI z-scores were calculated according to the WHO | PA was measured by pedometers and accelerometer (GT1M, GT3X). ST and sleep duration were reported by parents | There was no association between guideline compliance with all three movement behaviours and adiposity |
Feng et al. [34] | n = 173 (97 boys, 76 girls) Cross-sectional China (Hong Kong) | BMI z-scores were calculated according to the IOTF | PA was measured by accelerometer (activPAL). ST and sleep duration were reported by parents | No significant associations were found between meeting the guidelines and BMI |
Kim et al. [19] | n = 421 (216 boys, 199 girls), 3–5 years Cross-sectional Japan | BMI z-scores were calculated according to the WHO | PA was measured by accelerometer (Active Style Pro HJA-750C). ST and sleep duration were reported by parents | Children who did not meet all the guidelines had a higher odds of being overweight/obese than those who met all guidelines |
Leppänen et al. [35] | n = 778 (399 boys, 379 girls), 4.7 ± 0.9 years Cross-sectional Finland | BMI was calculated according to the IOTF. Trained researchers measured WC | PA was assessed 24 h/day over 7 days using ActiGraph wGT3X-BT accelerometer. ST and sleep duration were reported by parents | No significant associations were found between meeting 24-h movement guidelines and BMI or WC |
Meredith-Jones et al. [36] | n = 547 (279 boys, 268 girls), 1–5 years RCT New Zealand | BMI z-scores were calculated according to the WHO. DXA scan measured body composition at 5 years of age | PA was measured by accelerometer (Actical) Parents reported ST duration Reported by their parents | Adherence to meeting all three guidelines at earlier ages was not related to BMI z-score or body composition at age 5, either cross-sectionally or prospectively |
Age group: children and adolescents | ||||
Chemtob et al. [38] | n = 630 (344 boys, 286 girls), 8–10 years n = 564 (313 boys, 251 girls), 10–12 years n = 377 (201 boys, 176 girls), 15–17 years Prospective Canada | BMI z-scores were calculated according to the WHO, % of body fat, waist circumference and waist-to-height ratio | PA was measured by accelerometer (GT3X, ActiGraph). Participants reported ST duration Sleep was reported by their parents and self-reported by adolescents | Children 8–10 years: compared with children who meet three components, children who meet two, one and no components had significantly higher adiposity Children 10–12 years: The adjusted model shows no significant association between meet guidelines and body composition prospectively (2-year changes) Adolescents 15–17: The adjusted model shows no significant association between meet guidelines and body composition prospectively (7-year changes) |
Chen et al. [18] | n = 114,072 (56,103 boys, 57,969 girls), 13.75 ± 2.61 years Cross-sectional China | BMI z-scores were calculated according to the WHO | The HBSC survey questionnaire measured PA and ST. Measured by 1-item from the China Health and Nutrition Survey | Children and adolescents who met the 24-h movement guidelines were more likely to have lower risks of overweight and obesity |
Haegele et al. [45] | n = 3582 (2367 boys, 1215 girls), 10–17 years Cross-sectional USA | BMI z-scores were calculated according to the WHO | PA, ST and sleep were self-reported | There was no relationship between accomplishing all 24-h movement guidelines and body composition |
Hinkley et al. [37] | n = 471 (250 boys, 221 girls), 4.6 at baseline Prospective Australia | BMI z-scores were calculated according to the WHO, waist circumference | PA was measured by accelerometer (GT1M, ActiGraph). ST and sleep duration were reported by parents | No association was found between compliance with 24-h movement guidelines at baseline and BMI z-score 3 years later, but there was a significant inverse association between compliance and BMI z-score 6 years later |
Hui et al. [48] | n = 12,590 (6563 boys, 6027 girls) Cross-sectional Six countries** | Body fat percentage was assessed using bioelectrical impedance analysis | PA was measured by IPAQ-SF. The Adolescents Sedentary Activity Questionnaire assessed ST. Sleep was self-reported | There was no relationship between accomplishing all 24-h movement guidelines and %BF |
Jakubec et al. [42] | n = 679, 8–18 years Cross-sectional Czech Republic | BMI z-score, FM% and VAT were used as the adiposity indicators | PA was measured by accelerometer (ActiGraph GT3X +). ST was measured by a question from the HBSC study. Heuristic algorithm of the wake-up and fall-asleep times from the daily log was used to identify the sleep time | There was no association between 24-h movement guidelines and adiposity indicators |
Katzmarzk and Staiano [46] | n = 357, 5–18 years Cross-sectional USA | BMI percentiles were computed according to CDC Growth Charts. WC, %BF, VAT and SAT were measured in a clinical setting | PA, ST and sleep were self-reported | Meeting more components of the 24-h guidelines was associated with lower levels of obesity and several cardiometabolic risk factors |
Laurson et al. [21] | n = 674, 7–12 years Cross-sectional USA | BMI z-score and percentile were calculated according to CDC Growth Charts | PA was assessed by pedometer (Digiwalker SW-2000). ST and sleep were self-reported | Meeting the 24-h guidelines seems to have a protective effect against obesity |
Roman-Viñas et al. [20] | n = 6128, 10.4 ± 0.6 Cross-sectional Twelve countries*** | BMI z-scores were calculated according to the WHO | PA was objectively assessed using 24-h, waist-worn accelerometry. ST and sleep were self-reported | Meeting the 24-h movement guidelines was associated with lower OR for obesity |
Shi et al. [39] | n = 1039, 11–18 years Cross-sectional China (Hong Kong) | BMI z-scores were calculated according to the WHO | PA was measured by accelerometer (activPAL). Sleep was measured by accelerometer (activPAL) | Overall, there were no differences in obesity levels between children and adolescents who comply and who do not comply with all recommendations |
Suárez et al. [44] | n = 367, 7–11 years Cross-sectional Spain | BMI z-scores were calculated according to the IOTF. WC and waist-to-height ratio were calculated | PA and ST were self-reported Sleep was reported by their parents | Overall, there were no differences in obesity levels between children and adolescents who complied and who do not comply with the recommendations |
Tanaka et al. [43] | n = 902, 9.4 ± 1.7, 6–12 years Cross-sectional Japan | BMI z-scores were calculated according to the WHO | PA was measured by accelerometer (Active stylePro HJA-350IT). ST and sleep were self-reported by children and their parents | Overall, there were no differences in obesity levels between children and adolescents who complied and who do not comply with the recommendations |
Yang et al. [40] | n = 34,887 (18,074 boys, 16,816 girls), 11.4 ± 3.2 years Cross-sectional China | BMI z-scores were calculated according to the IOTF | PA, ST and sleep were reported by the adolescents and their parents together | Compared to those who met all three 24-h guidelines, those who met the sleep guideline were significantly associated with a higher risk of underweight and those who only met the MVPA or screen time guidelines were significantly associated with a higher risk of overweight or obesity |
Zhou et al. [41] | n = 978 (520 boys, 458 girls), 9.1 ± 1.4 years Cross-sectional China | Chinese sex-specific and age-specific BMI cutoff points | PA, ST and sleep were self-reported, using items derived from the HBSC survey | Children who met more 24-h guidelines showed a lower risk of being overweight and obese and lower levels of %BF |
Zhu et al. [47] | n = 30,478 (14,954 boys, 15,524 girls), 10–17 years Cross-sectional USA | BMI was calculated based on parent-reported height and weight | PA, ST and sleep were self-reported | Meeting physical activity guidelines was associated with the lowest odds of being overweight and obese |