Table 4 Summary of the findings from the studies assessing adiposity

Aggio et al. [44]

Children and youth (n = 353) from the Camden Active Spaces project, UK; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Body fat

Mekary et al. [12] / 60 min

Age, sex, ethnicity, height and school deprivation.

β (95% CI)

Body fat

SB ↔ LPA: − 0.774 (− 1.714, 0.167)

SB ↔ MVPA: 4.187 (1.142, 7.233)

LPA ↔ MVPA: − 4.961 (− 8.212, − 1.710)

Boyle et al. [19]

Adult breast cancer survivors (n = 256) from the ACCEL-Breast study, Australia; cross-sectional

SB (prolonged SB and non-prolonged SB), LPA, MVPA – waist-worn accelerometers; sleep – self report

Waist circumference, BMI

Mekary et al. [12] / 30 min

Age, socioeconomic status, comorbidity, and smoking status

β (95% CI)

Waist circumference

Sleep ↔ prolonged SB: 0.00 (− 0.85, 0.85)

Sleep ↔ non-prolonged SB: − 0.94 (− 1.80, − 0.08)

Sleep ↔ LPA: 0.20 (− 0.68, 1.09)

Sleep ↔ MVPA: − 2.50 (− 4.45, − 0.56)

Prolonged SB ↔ non-prolonged SB: − 0.94 (− 1.79, − 0.10)

Prolonged SB ↔ LPA: 0.20 (− 0.34, 0.74)

Prolonged SB ↔ MVPA: − 2.51 (− 4.38, − 0.64)

Non-prolonged SB ↔ LPA: 1.14 (0.18, 2.10)

Non-prolonged SB ↔ MVPA: − 1.56 (− 3.40, 0.27)

LPA ↔ MVPA: − 2.71 (− 4.72, − 0.69)

BMI

Sleep ↔ prolonged SB: 0.17 (− 0.20, 0.55)

Sleep ↔ non-prolonged SB: − 0.23 (− 0.62, 0.15)

Sleep ↔ LPA: 0.10 (− 0.30, 0.49)

Sleep ↔ MVPA: − 0.75 (− 1.61, 0.11)

Prolonged SB ↔ non-prolonged SB: − 0.41 (− 0.79, − 0.03)

Prolonged SB ↔ LPA: − 0.08 (− 0.32, 0.16)

Prolonged SB ↔ MVPA: − 0.93 (− 1.75, − 0.10)

Non-prolonged SB ↔ LPA: 0.33 (− 0.10, 0.77)

Non-prolonged SB ↔ MVPA: − 0.52 (− 1.34, 0.30)

LPA ↔ MVPA: − 0.85 (− 1.75, 0.05)

Buman et al. [48]

Adults (n = 2185 – full sample; n = 923 – fasting sub-sample) from the 2005–2006 US National Health and Nutrition Examination Survey, USA; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – self report

Waist circumference

Mekary et al. [12] / 30 min

Sex, race, marital status, education, work status, income, smoking, depressive symptoms, 24-h dietary recalls estimating intakes of total energy, saturated fat, caffeine, and alcohol, a general health rating, diagnosis of cancer, malignancy, CVD, or diabetes, and current use of diabetic, antihypertensive, lipidemic, or other CVD medication.

RR (95% CI)

Waist circumference

Sleep → MVPA: 0.976 (0.966, 0.985)

SB → MVPA: 0.973 (0.965, 0.981)

LPA → MVPA: 0.974 (0.966, 0.983)

Sleep → LPA: 1.001 (0.998, 1.005)

SB → LPA: 0.999 (0.996, 1.001)

SB → sleep: 0.997 (0.993, 1.001)

Carson et al. [49]

Children and youth aged 6–17 years (n = 4169 – full sample; n = 1242 – fasting sub-sample) from the Canadian Health Measures Survey, Canada; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – self report

BMI, waist circumference, blood pressure, behavioural strengths and difficulties, CRF – full sample. Triglycerides, HDL, C-reactive protein, and insulin – fasting subsample.

Chastin et al. [13] / 10 min

Age, sex, and highest household education.

Reallocating 10 min of MVPA to SB, LPA or sleep, resulted in a 5.1, 1.2, and 1.1% increase in BMI z score, respectively.

Reallocating 10 min of SB, LPA or sleep, to MVPA resulted in a less than 1% decrease in BMI z score.

Similar effects were noted across all health indicators.

Chastin et al. [13]

Adults (n = 1937) from the National Health and Nutrition Examination Survey 2005–2006 cycle, USA; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – self report

BMI

Chastin et al. [13] / 10 min

Age, sex, ethnicity/race, self-reported health, diagnosis of health conditions, educational level, social economic status, smoking status, alcohol consumption, calorie intake, caffeine and fat, medications for diabetes and/or high blood pressure.

Reallocating 10 min of MVPA to SB resulted in a 1.2% change in BMI.

Collings et al. [20]

Children (n = 410) from the Physical Activity and Nutrition in Children study, Finland; cross-sectional

Sleep, SB, LPA, MPA, VPA – heart rate and movement sensor

BMI, body composition (FMI, TFMI, FFMI),

Mekary et al. [12] / 10 min

Age, sex, monitor wear characteristics, income, sleep duration, energy intake, frequency of breakfast consumption, number of meals per day, snacking, birth weight, maternal and paternal BMI. When FMI, TFMI and FFMI were outcomes further adjustment for CRF was made. CRF was adjusted for FMI.

β (95% CI)

FMI

SB → LPA: − 1.2 (− 1.8, − 0.64)

SB → MPA: − 1.7 (− 2.7, − 0.78)

SB → VPA: − 11.8 (− 17.4, − 5.8)

LPA → MPA: − 0.51 (− 1.7, 0.73)

LPA → VPA: − 10.7 (− 16.2, − 4.8)

MPA → VPA: − 10.2 (− 16.4, − 3.5)

TFMI

SB → LPA: − 1.5 (− 2.1, − 0.82)

SB → MPA: − 2.0 (− 3.2, − 0.83)

SB → VPA: − 13.1 (− 20.1, − 5.5)

LPA → MPA: − 0.58 (− 2.0, 0.86)

LPA → VPA: − 11.8 (− 18.8, − 4.3)

MPA → VPA: − 11.3 (− 19.0, − 2.9)

FFMI

SB → LPA: − 0.0026 (− 0.013, 0.0079)

SB → MPA: 0.016 (− 0.0002, 0.031)

SB → VPA: − 0.042 (− 0.12, 0.033)

LPA → MPA: 0.018 (− 0.0042, 0.041)

LPA → VPA: -0.039 (− 0.11, 0.034)

MPA → VPA: − 0.057 (− 0.14, 0.024)

Collings et al. [21]

Children (n = 333) from the Born in Bradford birth cohort study, UK; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – self report or estimated from accelerometers

BMI, waist circumference, sum of skinfolds

Mekary et al. [12] / 20 min

Age, sex, ethnicity, index of multiple deprivation, monitor wear time, season of assessment and height.

β (95% CI)

BMI

SB → LPA: − 0.0096 (− 0.055, 0.036)

SB → MVPA: 0.052 (− 0.039, 0.14)

LPA → MVPA: 0.061 (− 0.054, 0.18)

Waist circumference

SB → LPA: − 0.034 (− 0.21, 0.15)

SB → MVPA: − 0.11 (− 0.46, 0.24)

LPA → MVPA: − 0.077 (− 0.53, 0.37)

Sum of skinfolds

SB → LPA: 0.048 (− 0.37, 0.47)

SB → MVPA: − 0.77 (− 1.46, − 0.084)

LPA → MVPA: − 0.82 (− 1.71, 0.062)

Dahl-Petersen et al. [22]

Adults (n = 1497) from the Inuit Health in Transition study (2005–2010), Greenland; cross-sectional

SB, LPA, MPA, VPA –combined accelerometer and heart rate monitor; sleep – not assessed

BMI, waist circumference, visceral fat and subcutaneous abdominal adipose tissue

Mekary et al. [12] / 60 min

Age, sex, smoking and fraction of weekend wear time (model 1) and BMI (model 2).

β (95% CI)

Model 1

BMI

SB → LPA: − 0.21 (− 0.37, − 0.04)

SB → MPA: − 0.47 (− 0.81, − 0.14)

LPA → MPA: − 0.27 (− 0.67, 0.14)

LPA → VPA: − 1.68 (− 2.89, − 0.46)

Waist circumference

SB → LPA: 0.57 (− 1.00, − 1.13)

SB → MPA: − 1.13 (− 2.01, − 0.26)

LPA → MPA: − 0.56 (− 1.63, 0.50)

LPA → VPA: − 6.05 (− 9.20, − 2.30)

Visceral fat

SB → LPA: − 0.04 (− 0.11, 0.04)

SB → MPA: − 0.23 (− 0.39, − 0.08)

LPA → MPA: − 20 (− 0.38, − 0.02)

LPA → VPA: − 0.66 (− 1.21, − 0.11)

Sub-cutaneous fat

SB → LPA: − 0.08 (− 0.12, − 0.03)

SB → MPA: − 0.05 (− 0,15, 0.04)

LPA → MPA: 0.02 (− 0.09, 0.14)

LPA → VPA: − 0.67 (− 1.01, − 0.34)

Model 2

Waist circumference

SB → LPA: − 0.007 (− 0.16, 0.14)

SB → MPA: − 0.01 (− 0.32, 0.30)

LPA → MPA: − 0.002(− 0.37, 0.37)

LPA → VPA: − 1.9(− 3.0, − 0.80)

Visceral fat

SB → LPA: 0.03 (− 0.02, 0.09)

SB → MPA: − 0.10 (− 0.21, 0.02)

LPA → MPA: − 0.13 (− 0.27, 0.007)

LPA → VPA: − 0.17 (− 0.58,0.25)

Sub-cutaneous fat

SB → LPA: − 0.03 (− 0.06, 0.005)

SB → MPA: 0.04 (− 0.02, 0.10)

LPA → MPA: 0.07 (− 0.01, 0.15)

LPA → VPA: − 0.33 (− 0.56, − 0.10)

Dalene et al. [23]

Samples of 6-year-olds (girls, n = 495–512; boys, n = 475–494) 9 (girls, n = 1198–1219; boys, n = 1225-1253) and 15-year-olds (girls, n = 778–850; boys, n = 766–824) from the Physical Activity among Norwegian Children Study, Norway; cross-sectional

SB, LPA, MPA, VPA – waist-worn accelerometers; sleep – not assessed

BMI, waist circumference

Mekary et al. [12] / 10 min

Age at baseline, sex, follow-up time, BMI and waist circumference at baseline.

β (95% CI)

Cross-sectional analyses

BMI

6-year-old girls

SB → LPA: 0.10 (0.04, 0.17)

SB → MPA: − 0.18 (− 0.35, − 0.01)

SB → VPA: − 0.21 (− 0.58, 0.16)

6-year-old boys

SB → LPA: 0.08 (0.02, 0.15)

SB → MPA: 0.03 (− 0.05, 0.12)

SB → VPA: − 0.32 (− 0.71, 0.06)

9-year-olds

SB → LPA: − 0.32 (− 0.71, 0.06)

SB → MPA: − 0.08 (− 0.15, − 0.02)

SB → VPA: − 0.83 (1.04, − 0.63)

15-year-olds

SB → LPA: 0.03 (− 0.02, 0.07)

SB → MPA: 0.06 (− 0.02, 0.15)

SB → VPA: − 0.56 (− 0.87, − 0.25)

Prospective analyses

SB → LPA: 0.05 (− 0.00, 0.11)

SB → MPA: − 0.05 (− 0.14, 0.04)

SB → VPA: 0.16 (− 0.17, 0.49)

Waist circumference

6-year-old girls

SB → LPA: 0.29 (0.13, 0.45)

SB → MPA: − 0.47 (− 0.85, − 0.10)

SB → VPA: − 0.15 (− 1.20, 0.90)

6-year-old boys

SB → LPA: 0.15 (− 0.02, 0.33)

SB → MPA: 0.06 (− 0.16, 0.29)

SB → VPA: − 0.79 (− 1.68, 0.10)

9-year-olds

SB → LPA: 0.17 (0.10, 0.25)

SB → MPA: − 0.32 (− 0.46, − 0.18)

SB → VPA: − 1.79 (− 2.36, − 1.23)

15-year-olds

SB → LPA: 0.17 (0.06, 0.28)

SB → MPA: 0.02 (− 0.20, 0.24)

SB → VPA: − 1.08 (− 1.94, − 0.21)

Prospective analyses

SB → LPA: 0.07 (− 0.08, 0.23)

SB → MPA: − 0.09 (− 0.37, 0.20)

SB → VPA: − 0.43 (− 1.29, 0.42)

Ekblom-Bak et al. [51]

Adults (n = 836) from the Swedish Cardio Pulmonary bioImage Study, Sweden; cross-sectional

SB, LPA, MPA, VPA – waist-worn accelerometers; sleep – not assessed

Waist circumference

Mekary et al. [12] / 1, 5, 10, 15, 20, 25, 30, 60, 90 and 120 min

Age, sex, education level, smoking habits, perceived psychological stress, energy intake and wear time.

OR (95% CI)

10-min reallocation

High waist circumference

SB → LPA: 0.97 (0.95, 0.98)

SB → MPA: 0.94 (0.88, 0.99)

SB → VPA: 0.62 (0.48, 0.79)

Ekblom-Bak et al. [52]

Adults (n = 654) from the Swedish Cardio Pulmonary bioImage Study, Sweden; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Waist circumference

Mekary et al. [12] / 1, 5,

10, 15, 20, 25, 30, 60, 90 and 120 min

Sex, age, education, smoking, perceived psychosocial stress.

RR (95% CI)

30 min reallocation

Waist circumference (women < 88 and men < 102)

SB → LPA: 0.982 (0.962, 1.003)

SB → MVPA: 0.931 (0.878, 0.987)

Waist circumference (women ≥88 and men ≥102)

SB → LPA: 0.981 (0.954, 1.009)

SB → MVPA: 0.880 (0.816, 0.950)

Fairclough et al. [25]

Children (n = 169) from the Active Schools Skelmersdale study, UK; cross-sectional

SB, LPA, MVPA – wrist-worn accelerometers; sleep – estimated from the ActiGraph raw accelerations

BMI, waist circumference

Dumuid et al. [14] / 15 min

IMD decile, age, sex, and BMI.

Reallocating 15 min from MVPA to sleep, SB or LPA predicted higher adiposity.

Reallocating time to MVPA from sleep, SB or LPA increased the magnitude of estimated detriments for adiposity. Furthermore, the detriments were larger in magnitude than the estimated benefits of time reallocation from MVPA to sleep, SB or LPA.

Falconer et al. [53]

Adults with type 2 diabetes (n = 519) from the Early Activity in Diabetes study, UK; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

BMI, waist circumference

Mekary et al. [12] / 30 min

Age, sex, ethnic group, IMD score, accelerometer wear time, relevant diabetes or lipid-lowering drugs.

β (95% CI)

BMI

SB bouts → SB nonbouts: − 0.60 (− 1.0, − 0.21)

SB bouts → LPA: − 0.26 (− 0.47, − 0.05)

SB bouts →MVPA: − 2.19 (− 2.89, − 1.49)

SB nonbouts →LPA: − 0.01 (− 0.38, 0.36)

SB nonbouts →MVPA: − 1.87 (− 2.59, − 1.14)

LPA → MVPA: − 2.00 (− 2.74, − 1.26)

Waist circumference

SB bouts → SB nonbouts: − 1.16 (− 2.08, − 0.25)

SB bouts →LPA: − 0.87 (− 1.35, − 0.39)

SB bouts →MVPA: − 4.56 (− 6.19, − 2.93)

SB nonbouts →LPA: − 0.44 (− 1.30, 0.41)

SB nonbouts →MVPA: − 3.97 (− 5.65, − 2.28)

LPA →MVPA: − 3.93 (− 5.65, − 2.21)

Gupta et al. [55]

Blue-Collar Workers (n = 692) from the PHysical ACTivity cohort, Denmark; cross-sectional

SB, standing time, MVPA – thigh-worn accelerometers; sleep – self report

BMI, waist circumference and body fat percentage

Mekary et al. [12] / 30 min

Age, sex, smoking status, alcohol intake, dietary patterns, and total measured time.

β (95% CI)

Whole day

Waist circumference

Total SB →standing: − 0.50 (− 0.81, − 0.18)

Total SB →walking: 0.40 (− 0.53, 1.33)

Total SB →MVPA: − 4.21 (− 6.94, − 1.47)

Long SB bouts →standing: − 0.86 (− 1.22, − 0.5)

Long SB bouts →walking: 0.57 (− 0.35, 1.5)

Long SB bouts →MVPA: − 3.93 (− 6.62, − 1.23)

Long SB bouts →moderate SB bouts: − 0.36 (− 0.89, 0.16)

Long SB bouts →brief SB bouts: − 2.60 (− 3.55, − 1.65)

Body fat percentage

Total SB →standing: − 0.29 (− 0.45, − 0.13)

Total SB →walking: 0.19 (− 0.26, 0.65)

Total SB →MVPA: − 2.70 (− 4.03, − 1.37)

Long SB bouts →standing: − 0.46 (− 0.65, − 0.27)

Long SB bouts →walking: 0.27 (− 0.19, 0.72)

Long SB bouts →MVPA: − 2.38 (− 3.7, − 1.06)

Long SB bouts →moderate SB bouts: − 0.10 (− 0.38, 0.17)

Long SB bouts →brief SB bouts: −1.43 (− 1.92, − 0.94)

BMI

Total SB →standing: − 0.17 (− 0.28, − 0.06)

Total SB → walking:0.17 (− 0.15, 0.48)

Total SB →MVPA: − 1.37 (− 2.29, − 0.44)

Long SB bouts →standing: − 0.31 (− 0.44, − 0.17)

Long SB bouts →walking: 0.18(− 0.14, 0.5)

Long SB bouts →MVPA: − 1.28(− 2.2, − 0.35)

Long SB bouts →moderate SBbouts: − 0.16 (− 0.35, 0.03)

Long SB bouts →brief SB bouts: −0.82 (− 1.17, − 0.48)

Work time

Waist circumference

Total SB →standing:− 0.24(− 0.6, 0.11)

Total SB → walking:0.55 (− 0.38, 1.48)

Total SB →MVPA: − 3.43 (− 6.25, − 0.61)

Long SB bouts →standing: − 0.59 (− 1.16, − 0.03)

Long SB bouts →walking: 0.67(− 0.36, 1.7)

Long SB bouts →MVPA: − 3.42 (− 6.3, − 0.55)

Long SB bouts →moderate SB bouts:− 0.08 (− 0.81, 0.66)

Long SB bouts →brief SB bouts: −2.40 (− 3.43, − 1.36)

Body fat percentage

Total SB → standing:− 0.14 (− 0.32, 0.04)

Total SB → walking:0.27 (− 0.19, 0.74)

Total SB →MVPA: − 1.91 (− 3.29, − 0.52)

Long SB bouts →standing: − 0.17(− 0.48, 0.13)

Long SB bouts →walking: 0.47(− 0.06, 0.99)

Long SB bouts →MVPA: − 1.50 (− 2.9, − 0.11)

Long SB bouts →moderate SB bouts:0.20 (− 0.19, 0.6)

Long SB bouts →brief SB bouts: −1.22 (− 1.76, − 0.68)

BMI

Total SB →standing: − 0.08(− 0.2, 0.05)

Total SB → walking:0.25 (− 0.07, 0.57)

Total SB →MVPA: − 1.03 (− 1.97, − 0.09)

Long SB bouts →standing: − 0.17(− 0.38, 0.04)

Long SB bouts →walking: 0.28 (− 0.08, 0.64)

Long SB bouts →MVPA: − 0.96(− 1.92, 0.00)

Long SB bouts →moderate SB bouts:− 0.02 (− 0.29, 0.26)

Long SB bouts →brief SB bouts: −0.72 (− 1.1, − 0.35)

Non-work time

Waist circumference

Total SB → standing:− 0.82 (− 1.26, − 0.37)

Total SB → walking:− 0.02 (− 1.01, 0.97)

Total SB → MVPA: −4.00 (− 6.75, − 1.26)

Long SB bouts →standing: − 0.94 (− 1.39, − 0.49)

Long SB bouts →walking: 0.33(− 0.62, 1.28)

Long SB bouts →MVPA: − 3.77(− 6.51, − 1.03)

Long SB bouts →moderate SB bouts: − 0.42 (− 0.97, 0.14)

Long SB bouts → brief SB bouts: − 2.74 (− 3.77, − 1.72)

Body fat percentage

Total SB → standing: − 0.42 (− 0.65, − 0.19)

Total SB → walking: 0.00 (− 0.49, 0.49)

Total SB → MVPA: − 2.18 (− 3.53, − 0.84)

Long SB bouts → standing: − 0.55 (− 0.78, − 0.32)

Long SB bouts → walking: 0.09 (− 0.38, 0.55)

Long SB bouts → MVPA: − 1.88 (− 3.22, − 0.55)

Long SB bouts → moderate SB bouts: − 0.18 (− 0.46, 0.1)

Long SB bouts → brief SB bouts: − 1.60 (− 2.11, − 1.09)

BMI

Total SB → standing: − 0.24 (− 0.4, − 0.08)

Total SB → walking: 0.08 (− 0.25, 0.41)

Total SB → MVPA: − 1.20 (− 2.12, − 0.28)

Long SB bouts → standing: − 0.32 (− 0.48, − 0.16)

Long SB bouts → walking: 0.13 (− 0.19, 0.45)

Long SB bouts → MVPA: − 1.10 (− 2.02, − 0.18)

Long SB bouts → moderate SB bouts: − 0.16 (− 0.36, 0.03)

Long SB bouts → brief SB bouts: − 0.87 (− 1.22, − 0.52)

Hamer et al. [56]

Adults (n = 445) from the Whitehall II epidemiological cohort, UK; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

BMI

Mekary et al. [12] / 10 min

Age, sex, smoking, employment grade, and current statin use.

β (95% CI)

BMI

SB ↔ LPA: − 0.002 (− 0.059, 0.056)

SB ↔ MVPA: − 0.39 (− 0.54, − 0.24)

LPA ↔ MVPA: − 0.39 (− 0.55, − 0.22)

Healy et al. [58]

A general population-based sample (n = 698) from the 2011/12 Australian Diabetes, Obesity, and Lifestyle Study, Australia; cross-sectional

SB, standing, stepping – thigh-worn accelerometers; sleep – self report

BMI, waist circumference

Mekary et al. [12] / 120 min

Age, sex, contraceptive pill use, blood pressure tablets, cholesterol tablets, diabetes medication, ethnicity, occupation and employment status, income, fibre intake, energy intake, energy-adjusted fibre intake, alcohol intake, sodium intake, potassium intake, fruit and vegetable serves.

RR (95% CI)

BMI

Sitting → standing: 0.99 (0.97, 1.02)

Sitting → stepping: 0.90 (0.86, 0.95)

Standing → stepping: 0.91 (0.86, 0.96)

β (95% CI)

Waist circumference

Sitting → standing: − 0.53 (− 3.08, 2.05)

Sitting → stepping: − 7.48 (− 10.80, − 4.17)

Standing → stepping: − 6.97 (− 11.05, − 2.89)

Healy et al. [57]

Individuals with diagnosed type 2 diabetes (n = 279) from the Living Well with Diabetes intervention, Australia; cross-sectional

SB (prolonged SB and non-prolonged SB), LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Waist circumference, BMI

Mekary et al. [12] / 30 min

Age, sex, BMI, waist circumference, log HbA1c, insulin use, oral hypoglycaemic use, use of glucagon-like-peptide-1 agents, diabetes duration, income, education, weight loss aids in last 6 months, smoking status, CVD-related condition, musculoskeletal condition, depression and/or anxiety, employment, place of birth, Caucasian, energy intake, diet quality score.

β (95% CI)

Waist circumference

Prolonged SB → non-prolonged SB: − 0.69 (− 1.46, 0.08)

Prolonged SB → LPA: − 0.77 (− 1.33, − 0.22)

Prolonged SB → MVPA: 0.64 (− 1.96, 3.24)

Non-prolonged SB → LPA: − 0.08 (− 0.93, 0.76)

Non-prolonged SB → MVPA: 1.33 (− 1.31, 3.96)

LPA → MVPA: 1.41 (− 1.37, 4.19)

BMI

Prolonged SB → non-prolonged SB: − 0.35 (− 0.70, − 0.01)

Prolonged SB → LPA: − 0.36 (− 0.61, − 0.11)

Prolonged SB → MVPA: 0.20 (− 0.93, 1.32)

Non-prolonged SB → LPA: − 0.01 (− 0.38, 0.37)

Non-prolonged SB → MVPA: 0.55 (− 0.58, 1.68)

LPA → MVPA: 0.56 (− 0.64, 1.76)

Huang et al. [59]

Children (n = 672) from the Understanding Children’s Activity and Nutrition cohort study, China; prospective cohort

SB (screen time, academic-related activities, other sedentary behaviours) and sleep – self report; LPA and MVPA – waist-worn accelerometers

BMI

Mekary et al. [12] / 30 min

Age, sex, snacking habit of the child, parental education, parental BMI, and marital status.

β (95% CI)

Screen time ↔ academic-related activities: − 0.00 (− 0.06, 0.06)

Screen time ↔ other SBs: − 0.12 (− 0.20, − 0.04)

Screen time ↔ sleep: − 0.03 (− 0.13, 0.06)

Screen time ↔ LPA: − 0.05 (− 0.12, 0.02)

Screen time ↔ MVPA: − 0.42 (− 0.59, − 0.24)

Academic-related activities ↔ other SBs: − 0.13 (− 0.21, − 0.04)

Academic-related activities ↔ sleep: − 0.04 (− 0.14, 0.06)

Academic-related activities ↔ LPA: − 0.05 (− 0.12, 0.02)

Academic-related activities ↔ MVPA: − 0.42 (− 0.60, − 0.24)

Other SBs ↔ academic-related activities: 0.13 (0.04, 0.21)

Other SBs ↔ sleep: 0.09 (− 0.03, 0.20)

Other SBs ↔ LPA: 0.07 (− 0.02, 0.16)

Other SBs ↔ MVPA: − 0.30 (− 0.49, − 0.10)

Sleep ↔ academic-related activities: 0.04 (− 0.06, 0.14)

Sleep ↔ other SBs: − 0.09 (− 0.20, 0.03)

Sleep ↔ LPA: − 0.01 (− 0.12, 0.10)

Sleep ↔ MVPA: − 0.38 (− 0.59, − 0.18)

LPA ↔ academic-related activities: 0.05 (− 0.02, 0.12)

LPA ↔ other SBs: − 0.07 (− 0.16. 0.02)

LPA ↔ sleep: 0.01 (− 0.10 to 0.12)

LPA ↔ MVPA: − 0.37 (− 0.57, − 0.16)

MVPA ↔ academic-related activities: 0.42 (0.24, 0.60)

MVPA ↔ other SBs: 0.30 (0.10, 0.49)

MVPA ↔ sleep: 0.38 (0.18, 0.59)

MVPA ↔ LPA: 0.37 (0.16, 0.57)

Leppänen et al. [63]

Four year old children (n = 307) from the MINISTOP trial, Sweden; cross-sectional

Sleep, SB, LPA, MPA, VPA – wrist-worn accelerometers

FFMI

Mekary et al. [12] / 5 min

Maternal BMI and educational attainment, paternal BMI and educational attainment, child’s age and sex at the measurement and awake wearing time of the ActiGraph. Waist circumference was adjusted for height.

β (95% CI)

FFMI

SB ↔ LPA: − 0.01 (− 0.04, 0.02)

SB ↔ MPA: 0.01 (− 0.02, 0.04)

SB ↔ VPA: 0.17 (0.04, 0.30)

LPA ↔ MPA: 0.02 (− 0.03, 0.08)

LPA ↔ VPA: 0.18 (0.05, 0.30)

MPA ↔ VPA: 0.16 (0.01, 0.31)

Leppänen et al. [27]

Four year old children (n = 138) from the MINISTOP trial, Sweden; prospective cohort

Sleep, SB, LPA, MPA, VPA – wrist-worn accelerometers

BMI, FMI, FFMI, body fat percentage, waist circumference

Mekary et al. [12] / 5 min

Child’s age, sex at measurement, awake wearing time, models with SB or MPA as exposures were adjusted for VPA, while models with VPA or MVPA were adjusted for SB.

Reallocating 5 min from SB to LPA or MPA to VPA at baseline was associated with an increase in FFMI and BMI.

Loprinzi et al. [65]

Children (n = 1036) and adolescents (n = 1608) from the 2003–2006 National Health and Nutrition Examination Survey, USA; prospective cohort

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

BMI, waist circumference, triceps and subscapularis skinfold, sex specific android body fat percent, gynoid body fat percent, total body fat percent

Mekary et al. [12] / 60 min

Age, sex, race-ethnicity, energy intake, poverty-to-income ratio, cotinine, and accelerometer wear time.

β (95% CI)

BMI

SB ↔ LPA: − 0.18 (− 0.53, 0.16)

SB ↔ MVPA: − 1.20 (− 1.60, − 0.79)

LPA ↔ MVPA: − 1.01 (− 1.57, − 0.45)

BMI Percentile

SB ↔ LPA: 0.17 (− 2.60, 2.95)

SB ↔ MVPA: − 7.33 (− 11.88, − 2.78)

LPA ↔ MVPA: − 7.50 (− 12.53, − 2.47)

Waist circumference

SB ↔ LPA: − 0.55 (− 1.50, 0.38)

SB ↔ MVPA: − 3.81 (− 5.09, − 2.54)

LPA ↔ MVPA: − 3.25 (− 4.91, − 1.59)

Triceps skinfold

SB ↔ LPA: − 0.13 (− 0.70, 0.43)

SB ↔ MVPA: − 2.54 (− 3.30, − 1.78)

LPA ↔ MVPA: − 2.40 (− 3.31, − 1.49)

Subscapularis skinfold

SB ↔ LPA: − 0.36 (− 0.80, 0.08)

SB ↔ MVPA: − 1.66 (− 2.37, − 0.95)

LPA ↔ MVPA: − 1.30 (− 1.97, − 0.63)

Android body fat percent

SB ↔ LPA: − 0.28 (− 1.59, 1.02)

SB ↔ MVPA: − 6.62 (− 8.80, − 4.45)

LPA ↔ MVPA: − 6.34 (− 9.40, − 3.27)

Gynoid body fat percent

SB ↔ LPA: − 0.07 (− 0.87, 0.71)

SB ↔ MVPA: − 4.40 (− 5.74, − 3.07

LPA ↔ MVPA: − 4.32 (− 6.11, − 2.54)

Total body fat percent (standard error)

SB ↔ LPA: − 0.27 (0.58)

SB ↔ MVPA: − 4.62 (0.77)

LPA ↔ MVPA: − 4.34 (0.89)

Mekary et al. [12]

Adult women (n = 4558) from the Nurses’ Health Study II, USA; prospective cohort

TV watching, easy walking, average walking, brisk walking, running, other activities, total activity – self report; sleep – not assessed

Weight change

Mekary et al. [12] / 30 min

Baseline age, weight, height, alcohol intake, sugar-sweetened beverage intake, energy-adjusted trans-fat intake, energy-adjusted fibre intake, oral contraceptive use, parity and antidepressant use.

β (95% CI)

TV watching ↔ slow walking: − 1.02 (− 1.55, − 0.48)

TV watching ↔ brisk walking: − 2.16 (− 2.64, − 1.68)

TV watching ↔ running: − 3.73 (− 4.89, _2.57)

TV watching ↔ other activities: − 1.73 (− 2.13, − 1.33)

TV watching ↔ total activity: 0.47 (0.36, 0.59)

Slow walking ↔ brisk walking: − 1.14 (− 1.75, − 0.53)

Slow walking ↔ running: − 2.71 (− 3.97, − 1.45)

Slow walking ↔ other activities: − 0.72 (− 1.39, − 0.04)

Slow walking ↔ total activity: − 0.54 (− 1.07, − 0.02)

Brisk walking ↔ running: − 1.57 (− 2.82, − 0.33)

Brisk walking ↔ other activities: 0.43 (− 0.22, 1.07)

Brisk walking ↔ total activity: − 1.69 (− 2.15, − 1.22)

Running ↔ other activities: 2.00 (0.77, 3.22)

Running ↔ total activity: − 3.26 (− 4.41, − 2.10)

Other activities ↔ total activity: − 1.26 (− 1.65, − 0.87)

Mekary et al. [68]

Adult men (n = 10,500) from the Health Professionals Follow-Up Study, USA; prospective cohort

TV watching, MVPA (aerobic activity), weight training, other activities; sleep – self report

Waist circumference

Mekary et al. [12] / 20 min

Baseline age and waist circumference total average alcohol intake, sugar-sweetened beverage intake, percent energy of trans-fat, energy-adjusted fibres, energy-adjusted glycemic load, smoking, antidepressant Intake, percent energy of protein intake, sleep duration, slow walking in addition to TV watching, MVPA, weight training, and other activities.

β (95% CI)

TV watching ↔ MVPA (aerobic activity): −0.42 (− 0.50, − 0.34)

TV watching ↔ weight training: − 0.76 (− 1.02, − 0.50)

TV watching ↔ other activities: − 0.24 (− 0.37, − 0.11)

TV watching ↔ total discretionary time: 0.08 (0.05, 0.12)

MVPA (aerobic activity) ↔ weight training: − 0.34 (− 0.62, − 0.07)

MVPA (aerobic activity) ↔ other activities: 0.17 (0.03, 0.31)

MVPA (aerobic activity) ↔ total discretionary time: − 0.33 (− 0.39, − 0.26)

Weight training ↔ other activities: 0.52 (0.23, 0.80)

Weight training ↔ total discretionary time: − 0.67 (− 0.93, − 0.41)

Other activities ↔ total discretionary time: − 0.15 (− 0.28, − 0.03)

Moore et al. [28]

Youth (n = 11,588) from the International Children’s Accelerometry Database, Brazil, Europe, and USA; cross-sectional

SB, LPA, MPA, VPA – waist-worn accelerometers; sleep – not assessed

Waist circumference

Mekary et al. [12] / not presented

Accelerometer cut points.

Reallocating LPA with VPA was associated with a 0.67 to 7.30 cm smaller waist circumference at the 50th to 90th percentiles

Nilsson et al. [29]

Older woman (n = 113) recruited from an newspaper ad, Sweden; cross-sectional

SB (accumulated, continuous), LPA, MVPA – waist-worn accelerometers; sleep – not assessed

Waist circumference

Mekary et al. [12] / 10 min

Medical history, self-rated health status, total energy intake, fat intake, and alcohol consumption.

β (95% CI)

Waist circumference

MVPA → LPA: 2.19 (1.45, 2.93)

MVPA → accumulated SB: 1.78 (1.04, 2.57)

MVPA → continuous SB: 2.08 (1.35, 2.8)

Rosique-Esteban et al. [32]

Adults (n = 5776) from the PREDIMED-PLUS trial, Spain; cross-sectional

Sleep, SB, LPA, MVPA – self report

Prevalence of obesity, abdominal obesity

Mekary et al. [12] / 60 min

Age, sex, education, marital and employment status, smoking habits, personal and family history of illness, medical conditions, medication use, and adherence to an energy-restricted Mediterranean diet.

RR (95% CI)

Obesity

MVPA → sleep: 0.95 (0.93, 0.97)

MVPA → TV-viewing: 0.92 (0.90, 0.94)

MVPA → LPA: 0.96 (0.93, 0.99)

LPA → sleep: 0.98 (0.95, 1.01)

LPA → TV-viewing: 0.95 (0.92, 0.98)

Sleep → TV-viewing: 0.97 (0.96, 0.98)

Abdominal obesity

MVPA → sleep: 0.97 (0.96, 0.98)

MVPA → TV-viewing: 0.97 (0.96, 0.98)

MVPA → LPA: 0.97 (0.96, 0.98)

LPA → sleep: 1.01 (0.99, 1.03)

LPA → TV-viewing: 0.99 (0.98, 1.00)

Sleep → TV-viewing: 0.99 (0.98, 1.00)

Sardinha et al. [70]

Children (n = 386) from the Lisbon Metropolitan area, Portugal; cross-sectional

SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed

BMI, waist circumference, TFMI, total body fat mass

Mekary et al. [12] / 15, 30 min

Age, sex, accelerometer wear time and in the prospective analysis results were further adjusted for baseline body composition.

β (95% CI)

30 min reallocation

Cross-sectional analysis

BMI

SB → LPA: 0.03 (− 0.09, 0.12)

SB → MVPA: − 0.21 (− 0.39, − 0.03)

Waist circumference

SB → LPA: 0.21 (− 0.81, 1.23)

SB → MVPA: − 1.32 (− 3.06, 0.42)

TFMI

SB → LPA: − 0.09 (− 0.36, 0.15)

SB → MVPA: − 0.81 (− 12.60, − 0.36)

Total body fat mass

SB → LPA: − 0.27 (− 0.78, 0.27)

SB → MVPA: -1.62 (− 2.52, − 0.69)

Prospective analyses

BMI

SB → LPA: 0.03 (− 0.06, 0.09)

SB → MVPA: − 0.06 (− 0.18, 0.06)

Waist circumference

SB → LPA: − 0.21 (− 0.87, 0.45)

SB → MVPA: − 1.11 (− 2.16, − 0.06)

TFMI

SB → LPA: 0.03 (− 0.09, 0.15)

SB → MVPA: − 0.21 (− 0.39, 0.00)

Total body fat mass

SB → LPA: 0.09 (− 0.15, 0.33)

SB → MVPA: − 0.48 (− 0.87, − 0.06)

15 min reallocation

Cross-sectional analysis

BMI

SB → LPA: 0.02 (− 0.05, 0.06)

SB → MVPA: − 0.11 (− 0.20, − 0.02)

Waist circumference

SB → LPA: 0.11 (− 0.41, 0.62)

SB → MVPA: − 0.66 (− 1.53, 0.21)

TFMI

SB → LPA: − 0.05 (− 0.18, 0.08)

SB → MVPA: − 0.41 (− 6.30, − 0.18)

Total body fat mass

SB → LPA: − 0.14 (− 0.39, 0.14)

SB → MVPA: − 0.81 (− 1.26, − 0.35)

Prospective analyses

BMI

SB → LPA: 0.02 (− 0.03, 0.05)

SB → MVPA: − 0.03 (− 0.09, 0.03)

Waist circumference

SB → LPA: − 0.11 (− 0.44, 0.23)

SB → MVPA: − 0.56 (− 1.08, − 0.03)

TFMI

SB → LPA: 0.02 (− 0.05, 0.08)

SB → MVPA: − 0.11 (− 0.20, 0.00)

Total body fat mass

SB → LPA: 0.05 (− 0.08, 0.17)

SB → MVPA: − 0.24 (− 0.44, − 0.03)

Van der Berg et al. [35]

Adults (n = 2213) from The Maastricht Study, Netherlands; cross-sectional

SB, standing, stepping – thigh-worn accelerometers; sleep – not assessed

Waist circumference, BMI

Mekary et al. [12] / 30 min

Age, sex, level of education, smoking status, alcohol consumption, energy intake, mobility limitation, and prevalent cardiovascular disease

OR (95% CI)

Waist circumference

SB → standing: − 0.405 (− 0.60, − 0.21)

SB → stepping: − 1.422 (− 1.78, − 1.06)

Standing → stepping: − 1.017 (− 1.47, − 0.56)

BMI

SB → standing: − 0.038 (− 0.11, 0.03)

SB → stepping: − 0.480 (− 0.62, − 0.35)

Standing → stepping: − 0.443 (− 0.61, − 0.27)

Varela-Mato et al. [37]

Adult male heavy goods vehicle drivers (n = 87), from a transport company from the East Midlands, UK; cross-sectional

SB, standing and stepping (LPA, MVPA) – thigh-worn accelerometers; sleep – estimated from the accelerometers and matched with the participants’ daily log

Waist circumference, BMI

Mekary et al. [12] / 30 min

Age, ethnicity, education levels, shift pattern, smoking, alcohol intake, fruit and vegetable consumption and BMI.

β (95% CI)

Workdays

Waist Circumference

SB → standing: − 0.1 (− 1.4, 1.2)

SB → LPA: − 0.6 (− 3.9, 2.7)

SB → MVPA: − 6.5 (− 11.0, − 1.9)

SB → sleep: 0.1 (− 0.3, 0.5)

BMI

SB → standing: 0.07 (− 0.4, 0.6)

SB → LPA: − 0.7 (− 1.9, 0.5)

SB → MVPA: − 1.5 (− 3.2, 0.2)

SB → sleep: − 0.0 (− 0.2, 0.1)

Non-workdays

Waist Circumference

SB → standing: − 0.4 (− 1.2, 2.1)

SB → LPA: 0.4 (− 1.3, 2.1)

SB → MVPA: − 0.8 (− 4.8, 3.2)

SB → sleep: − 0.4 (− 1.1, 0.5)

BMI

SB → standing: 0.1 (− 0.5, 0.2)

SB → LPA: − 0.2 (− 0.8, 0.4)

SB → MVPA: 0.2 (− 1.2, 1.7)

SB → sleep: − 0.3 (− 0.5,–0.05)