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Sedentary behaviour and bone health in children, adolescents and young adults: a systematic review.

ABSTRACT: Sedentary behaviour (SB) is increasing in Western societies and some studies suggest a deleterious effect of SB on bone. The aim of this systematic review was to examine the association between SB and bone health in children, adolescents and young adults. Electronic databases (PubMed, MEDLINE, PsycINFO and Science Citation Index) were searched for relevant articles up to January 9, 2017. Studies were included when results on bone health (e.g. strength, mass and structure) and either subjectively (questionnaires) or objectively (accelerometry) measured SB were reported in healthy participants ?24 years. Two reviewers independently screened titles and abstracts for eligibility, rated methodological quality and extracted data. Seventeen observational studies were included. Several studies that used DXA or quantitative ultrasound suggested that objectively measured SB was negatively associated with lower extremity bone outcomes, such as femoral neck bone mineral density. The magnitude of this negative association was small and independent of moderate-to-vigorous physical activity. In contrast to the lower extremities, there was insufficient evidence for an association of lumbar spine bone outcomes with objectively measured SB. In high-quality studies that used DXA, no association was observed between objectively measured SB and total body bone outcomes. In studies using questionnaires, none of these relationships were observed. Well-designed longitudinal studies, objectively measuring SB, are needed to further unravel the effect of SB, physical activity and their interaction on bone health.

SUBMITTER: Koedijk JB

PROVIDER: S-EPMC5550522 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Sedentary behaviour and bone health in children, adolescents and young adults: a systematic review.

Koedijk J B JB van Rijswijk J J Oranje W A WA van den Bergh J P JP Bours S P SP Savelberg H H HH Schaper N C NC

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 20170526 9

Sedentary behaviour (SB) is increasing in Western societies and some studies suggest a deleterious effect of SB on bone. The aim of this systematic review was to examine the association between SB and bone health in children, adolescents and young adults. Electronic databases (PubMed, MEDLINE, PsycINFO and Science Citation Index) were searched for relevant articles up to January 9, 2017. Studies were included when results on bone health (e.g. strength, mass and structure) and either subjectively ...[more]

PMID: 28547135

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Project description:Accumulating evidence suggests that, independent of physical activity levels, sedentary behaviours are associated with increased risk of cardio-metabolic disease, all-cause mortality, and a variety of physiological and psychological problems. Therefore, the purpose of this systematic review is to determine the relationship between sedentary behaviour and health indicators in school-aged children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE and PsycINFO), personal libraries and government documents were searched for relevant studies examining time spent engaging in sedentary behaviours and six specific health indicators (body composition, fitness, metabolic syndrome and cardiovascular disease, self-esteem, pro-social behaviour and academic achievement). 232 studies including 983,840 participants met inclusion criteria and were included in the review. Television (TV) watching was the most common measure of sedentary behaviour and body composition was the most common outcome measure. Qualitative analysis of all studies revealed a dose-response relation between increased sedentary behaviour and unfavourable health outcomes. Watching TV for more than 2 hours per day was associated with unfavourable body composition, decreased fitness, lowered scores for self-esteem and pro-social behaviour and decreased academic achievement. Meta-analysis was completed for randomized controlled studies that aimed to reduce sedentary time and reported change in body mass index (BMI) as their primary outcome. In this regard, a meta-analysis revealed an overall significant effect of -0.81 (95% CI of -1.44 to -0.17, p = 0.01) indicating an overall decrease in mean BMI associated with the interventions. There is a large body of evidence from all study designs which suggests that decreasing any type of sedentary time is associated with lower health risk in youth aged 5-17 years. In particular, the evidence suggests that daily TV viewing in excess of 2 hours is associated with reduced physical and psychosocial health, and that lowering sedentary time leads to reductions in BMI.

Project description:IntroductionNon-ambulant children and young people with physical disabilities are at high risk of experiencing negative health outcomes associated with sedentary time. A previous scoping review summarising evidence relating to sedentary behaviours of children with physical disabilities identified the need for validated methods of measuring physical activity of children who use wheelchairs and evaluation of interventions to reduce sedentary time. The scoping review did not assess the quality of evidence relating to this topic, therefore its validity remains unclear. No reviews focussing on non-ambulant children and young people up to the age of 25 years have been undertaken.The objectives of this systematic search and review are to:Identify all peer-reviewed articles relating to sedentary behaviour of non-ambulant children and young people.Categorise the articles according to study design and four subquestions relating to (i) measurement, (ii) patterns, (iii) associated risks and (iv) interventions to reduce sedentary time or behaviour.Critically appraise quality of the articles using established critical appraisal tools.Summarise the evidence for each subquestion. Describe its cumulative strength and identify knowledge gaps.Methods and analysisThis protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The research questions, inclusion/exclusion criteria and search terms have been developed a priori using the 'Population, Concept and Context' framework. Online databases will be systematically searched to identify peer-reviewed articles published between 1996 and 2021. Two reviewers will screen, categorise and critically appraise the articles. Data extraction and analysis will be verified by the second reviewer.Results will be reported as a best evidence synthesis, with reference to the PRISMA checklist.Ethics and disseminationEthical approval is not required. The review will be submitted to an appropriate peer-reviewed journal.RegistrationThe review is registered on the Open Science Framework database. DOI: https://doi.org/10.17605/OSF.IO/SQXJB. Any protocol amendments will be recorded in the Open Science Framework database.

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Project description:BackgroundSelf-rated health (SRH) is an indicator that captures a person's perception of their overall health status. The relationship between physical activity (PA), sedentary behaviour (SB) and SRH has been investigated in systematic reviews among adult and elderly populations. No systematic review to date has synthesized the relationship between PA, SB and SRH among children and adolescents. The purpose of this systematic review and meta-analysis was to synthesize the associations between PA, SB and SRH in the general population of children and adolescents and to investigate the dose-response relationship between PA, SB and SRH.MethodsWe conducted a computer search for English language studies in the databases of MEDLINE, EMBASE and PSYCINFO that were published between 1946 and 2019. We searched PubMed, Google Scholar, and the references of the identified publications for additional studies. A meta-analysis was employed to synthesize the associations between PA, SB respectively and SRH. The dose-response association was tested using a random effects meta-regression model. The review was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.ResultsSixty-eight published articles were included in the final review, including 59 cross-sectional and nine longitudinal studies. We found evidence that PA was associated with better SRH, and SB was associated with lower SRH among children and adolescents. A dose-response relationship between PA and SRH was observed, where a higher level of PA was associated with better SRH than a lower level of PA. The relationship between PA, SB and SRH was observed in both boys and girls, and did not show a significant gender difference.ConclusionsThe findings in the systematic review suggest that health intervention programmes targeting promoting PA and reducing SB among children and adolescents may enhance their overall health status. Future research is needed to expand prospective cohort and intervention studies to address directionality and causality in the relationships between PA, SB and SRH among children and youth.Trial registrationPROSPERO - CRD42019142244 . Registered on October 18, 2019.

Dataset Information

Sedentary behaviour and bone health in children, adolescents and young adults: a systematic review.

Publications

Sedentary behaviour and bone health in children, adolescents and young adults: a systematic review.

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