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Table 4 Summary of the findings from the studies assessing adiposity

From: Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies

Study Sample Measures of sleep, SB, LPA, MVPA Outcome measures Data analysis method / reallocated time Adjustments for confounding Results
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)
  1. SB sedentary behaviour, LPA light intensity physical activity, MVPA moderate-to-vigorous intensity physical activity, MPA moderate intensity physical activity, VPA vigorous intensity physical activity; BMI body mass index, HDL high-density lipoprotein, CVD cardiovascular disease, FFM fat-free mass, TFMI trunk fat mass index, FFMI fat-free mass index, FMI fat mass index, CRF cardiorespiratory fitness, IMD indices of multiple deprivation, CI confidence interval, RR relative risk, OR odds ratio