Table 1 Characteristics of included studies
Authors and Study design | Year | Location | Age range (years) | N and statistical analysis | PA measure | SED measure | Sleep measure | Mental health outcome | Main Findings |
|---|---|---|---|---|---|---|---|---|---|
Carson et al. [33] Cross-sectional | 2017 | Canada | 6–17 | 4157 (1239 fasting subsample) Linear regression | Accelerometer (Actical, Respironics) MVPA | Questionnaire (Parents/guardians for those aged 6 to 11 years and self-reported by participants aged 12 to 17 years). Screen time | Questionnaire (Parents/guardians for those aged 6 to 11 years and self-reported by participants aged 12 to 17 years). Estimated sleep duration in a 24-h period. | Social and emotional health (Behavioral strengths and difficulties scores) | There was a dose–response pattern between the number of recommendations achieved and social and emotional health. Compared to meeting all three recommendations, meeting none, one, and two recommendations were associated with a higher behavioral strengths and difficulties score in a gradient pattern. Unstandardized beta coefficients and their 95% confidence intervals in parenthesis for meeting 3 > 2 > 1 > 0 recommendations were: 0 (reference group), 0.12 (0.01, 0.24), 0.23 (0.10, 0.37), and 0.34 (0.18, 0.50). |
Carson et al. [34] Cross-sectional | 2016 | Canada | 6–17 | 4169 Compositional data analysis | Accelerometer (Actical, Respironics) LPA and MVPA | Accelerometer (Actical, Respironics) Sedentary time | Questionnaire (Parents/guardians for those aged 6 to 11 years and self-reported by participants aged 12 to 17 years). Estimated sleep duration in a 24-h period. | Social and emotional health (Behavioral strengths and difficulties scores) | The composition of movement behaviours was found to be associated with all health indicators. LPA was positively associated with unfavourable behavioural strengths and difficulties scores, whereas sleep was negatively associated with unfavourable behavioural strengths and difficulties scores. |
Dumuid et al. [35] Cross-sectional | 2018 | Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, United Kingdom, and United States | 9–11 | 5855 Compositional data analysis | Accelerometer (Actigraph GT3X+) LPA and MVPA | Accelerometry (Actigraph GT3X+) Sedentary time | Accelerometry (Actigraph GT3X+) Nocturnal sleep duration | Health-related quality of life (KIDSCREEN-10) | The relationship between children’s health-related quality of life and their movement behaviors is moderated by their country’s human development index. In the very high human development index strata alone, health related quality of life was significantly related to the movement behavior composition, with moderate-to-vigorous physical activity (relative to remaining behaviors) being positively associated with health-related quality of life. |
Guerrero et al. [36] Cross-sectional | 2019 | United States | 9–10 | 4524 Structural equation modelling | Questionnaire MVPA | Questionnaire Daily average recreational screen time | Questionnaire (Reported by parents using the Parent Sleep Disturbance Scale for Children) Sleep duration on most night | Impulsivity (UPPS-P Impulsive Behavior Scale34, Behavioral Inhibition System (BIS)/ Behavioral Activation System (BAS) Scale, and cash choice delay discounting task) | Adherence to individual movement behavior recommendations as well as combinations of adherence to movement behavior recommendations were associated with each dimension of impulsivity |
Janssen et al. [37] Cross-sectional | 2017 | Canada | 10–17 | 17,000 Linear regression | Questionnaire MVPA | Questionnaire Average daily screen time | Questionnaire Average nightly sleep duration | Emotional problems, Life satisfaction (Cantril ladder), Prosocial behaviour | Achieving any given recommendation had preferable scores for the health outcomes compared with participants who did not meet the recommendations. There was a dose–response pattern between the number of recommendations achieved and the health outcomes. The adjusted mean and standard errors in parenthesis for meeting 3 > 2 > 1 > 0 recommendations were: 0.72 (0.04), 0.48 (0.03), 0.30 (0.04) and 0.08 (0.07) for emotional problems, −0.82 (0.05), − 0.62 (0.05), − 0.43 (0.05) and − 0.29 (0.09) for life satisfaction, and − 0.37 (0.05), − 0.20 (0.05), − 0.02 (0.06) and 0.11 (0.09) for emotional problems. When the number of recommendations achieved was the same, there were no differences in the health outcomes. |
Knell et al. [18] Cross-sectional | 2019 | United States | 13–20 | 59,397 Logistic regression | Questionnaire MVPA | Questionnaire Average daily screen time | Questionnaire Average nightly sleep duration | Depressive symptoms (2-week sadness), cigarette smoking, alcohol consumption, and cannabis use over the past 30 days | Meeting all 3 recommendations was associated with lower odds of depressive symptoms among males and females, alcohol consumption among females, and cannabis use among males compared to meeting none of the recommendations. Meeting the 3 guidelines was associated with greater odds of smoking cigarette among males compared with meeting none of the recommendations. |
Pearson et al. [19] Cross-sectional | 2019 | United Kingdom | 14 | 3899 Logistic regression | Accelerometer (GENEActiv) MVPA | Questionnaire Screen time on typical weekday | Questionnaire Average nightly sleep duration | Depressive symptoms (Mood and Feelings questionnaire (MFQ)) | Meeting all 3 recommendations was associated with lower odds of depressive symptoms among both males and females compared with meeting none of the recommendations. |
Sampasa-Kanyinga et al. [38] Cross-sectional | 2017 | Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, United Kingdom, and United States | 9–11 | 6106 Linear mixed models | Accelerometer (Actigraph GT3X+) LPA (not included in statistical analyses) and MVPA | Accelerometry (Actigraph GT3X+) Sedentary time | Accelerometry (Actigraph GT3X+) Nocturnal sleep duration | Health-related quality of life (KIDSCREEN-10) | Children meeting the screen time recommendation, the screen time and sleep recommendation, and all three recommendations had significantly better HRQoL than children not meeting any of these guidelines. |
Walsh et al. [20] Cross-sectional | 2018 | United States | 9–10 | 4524 Linear mixed effects models | Questionnaire MVPA | Questionnaire Daily average recreational screen time | Questionnaire (Reported by parents using the Parent Sleep Disturbance Scale for Children) Sleep duration on most night | Global cognition (Youth NIH Toolbox) | There was a positive gradient between global cognition and each additional recommendation met. Meeting the screen + sleep or screen-only recommendations were the strongest predictors of superior cognition compared to not meeting any recommendations. |
Zhu et al. [39] Cross-sectional | 2019 | United States | 6–17 | 20,708 Logistic regression | Questionnaire All intensities | Questionnaire Daily average recreational screen time | Questionnaire Average weeknight sleep duration | Anxiety and depression (parent- reports) | Meeting all three 24-h movement guidelines was associated with lower odds for anxiety and depression among adolescents compared with meeting none of the recommendations. |