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Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Self-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. METHODS:We 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. RESULTS:Sixty-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. CONCLUSIONS:The 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 REGISTRATION:PROSPERO - CRD42019142244 . Registered on October 18, 2019.

SUBMITTER: Zhang T

PROVIDER: S-EPMC7650260 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis.

Zhang Tong T Lu Guohua G Wu Xiu Yun XY

BMC public health 20200903 1

<h4>Background</h4>Self-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 be ...[more]

PMID: 32883275

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Project description:BACKGROUND:The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. METHODS:Calcaneus SI was first measured by quantitative ultrasound among children aged 2-9?years old in 2007/08. It was measured again after 2?years in the IDEFICS study and after 6?years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. RESULTS:The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (??=?-?0.35, p?=?0.008). However, baseline weekly duration of watching TV (??=?-?0.63, p?=?0.021) and change after 2?years (??=?-?0.63, p?=?0.022) as well as the change in weekly duration of playing computer/games after 6?years (??=?-?0.75, p?=?0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2?years (??=?1.28, p?=?0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6?years in all groups. CONCLUSIONS:Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.

Project description:Self-rated health (SRH) is an independent determinant for all-cause mortality. We aimed to examine the independent and combined associations of components of physical fitness with SRH at baseline (cross-sectional) and two years later (longitudinal) in children and adolescents. Spanish youth (N = 1378) aged 8 to 17.9 years participated at baseline. The dropout rate at 2-year follow-up was 19.5% (n = 270). Participants were categorized as either children (8 to 11.9 years age) or adolescents (12 to 17.9 years age). The ALPHA health- related fitness test battery for youth was used to assess physical fitness, and SRH was measured by a single-item question. Cumulative link, ANOVA and ANCOVA models were fitted to analyze the data. Cardiorespiratory fitness, relative upper body isometric muscular strength, muscular strength score, and global physical fitness were positively associated with SRH in children (OR, 1.048; 95% CI, 1.020-1.076; OR, 18.921; 95% CI, 3.47-104.355; OR, 1.213; 95% CI, 1.117-1.319, and OR, 1.170; 95% CI, 1.081-1.266, respectively; all p < 0.001) and adolescents (OR, 1.057; 95% CI, 1.037-1.076; OR, 5.707; 95% CI, 1.122-29.205; OR, 1.169; 95% CI, 1.070-1.278, and OR, 1.154 95% CI, 1.100-1.210, respectively; all p < 0.001); and motor fitness was positively associated with SRH only in adolescents at baseline (OR, 1.192; 95% CI, 1.066-1.309; p < 0.01). Cardiorespiratory fitness and global physical fitness were positively associated with SRH in children two years later (OR, 1.056; 95% CI, 1.023-1.091; p < 0.001; and OR, 1.082; 95% CI, 1.031-1.136; p < 0.01; respectively). Only cardiorespiratory fitness was independently associated with SRH in children and adolescents at baseline (OR, 1.059; 95% CI, 1.029-1.090; and OR, 1.073; 95% CI, 1.050-1.097, respectively; both p < 0.001) and two years later (OR, 1.075; 95% CI, 1.040-1.112; p < 0.001; and OR, 1.043; 95% CI, 1.014-1.074; p < 0.01, respectively). A high level of cardiorespiratory fitness at baseline or maintaining high levels of cardiorespiratory fitness from the baseline to 2-year follow-up were associated with a higher level of SRH at 2-year follow-up in children (p < 0.01) and adolescents (p < 0.05). These findings emphasize the importance of cardiorespiratory fitness as strong predictor of present and future SRH in youth. Intervention programs to enhance cardiorespiratory fitness level of the youth population are urgently needed for present and future youth's health.

Project description:BackgroundThe number of commercial apps to improve health behaviours in children is growing rapidly. While this provides opportunities for promoting health, the content and quality of apps targeting children and adolescents is largely unexplored. This review systematically evaluated the content and quality of apps to improve diet, physical activity and sedentary behaviour in children and adolescents, and examined relationships of app quality ratings with number of app features and behaviour change techniques (BCTs) used.MethodsSystematic literature searches were conducted in iTunes and Google Play stores between May-November 2016. Apps were included if they targeted children or adolescents, focused on improving diet, physical activity and/or sedentary behaviour, had a user rating of at least 4+ based on at least 20 ratings, and were available in English. App inclusion, downloading and user-testing for quality assessment and content analysis were conducted independently by two reviewers. Spearman correlations were used to examine relationships between app quality, and number of technical app features and BCTs included.ResultsTwenty-five apps were included targeting diet (n = 12), physical activity (n = 18) and sedentary behaviour (n = 7). On a 5-point Mobile App Rating Scale (MARS), overall app quality was moderate (total MARS score: 3.6). Functionality was the highest scoring domain (mean: 4.1, SD: 0.6), followed by aesthetics (mean: 3.8, SD: 0.8), and lower scoring for engagement (mean: 3.6, SD: 0.7) and information quality (mean: 2.8, SD: 0.8). On average, 6 BCTs were identified per app (range: 1-14); the most frequently used BCTs were providing 'instructions' (n = 19), 'general encouragement' (n = 18), 'contingent rewards' (n = 17), and 'feedback on performance' (n = 13). App quality ratings correlated positively with numbers of technical app features (rho = 0.42, p < 0.05) and BCTs included (rho = 0.54, p < 0.01).ConclusionsPopular commercial apps to improve diet, physical activity and sedentary behaviour in children and adolescents had moderate quality overall, scored higher in terms of functionality. Most apps incorporated some BCTs and higher quality apps included more app features and BCTs. Future app development should identify factors that promote users' app engagement, be tailored to specific population groups, and be informed by health behaviour theories.

Project description:BackgroundThe association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents.MethodsWe conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3-18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time.ResultsIn total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life.ConclusionsThe findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.

Project description:BackgroundAlthough self-rated health (SRH) and performance-based physical function (PPF) are both strong predictors of mortality, little research has investigated the relationships between them. The objective of this study was to evaluate longitudinal, bi-directional associations between SRH and PPF.MethodsWe evaluated longitudinal associations between SRH and PPF in 3,610 adults aged 65-89 followed for an average of 4.8 (standard deviation [SD]: 4.4) years between 1994 and July 2011 in the Adult Changes in Thought study, a population-based cohort in the Seattle area. SRH was assessed with a single-item question in the ACT study. Participants were asked at each evaluation to rate their health as "excellent", "very good", "good", "fair", or "poor" in response to the question "In general, how would you rate your health at this time". PPF scores (ranging from 0-16, with higher indicating better performance) included walking speed, chair rises, grip strength, and balance.ResultsAt the baseline visit, participants averaged 74.5 (SD: 5.8) years of age and 2,115 (58.6%) were female. In multivariable linear mixed models, PPF declined with age, with more rapid decreases associated with very good, good, and fair (vs. excellent) baseline SRH. Adjusted annual change in PPF was -0.17 points (95% confidence interval [CI]: -0.19, -0.15) for individuals with excellent baseline SRH and -0.21 points (95% CI: -0.22, -0.19) for participants with fair SRH. In multivariable generalized linear mixed models, lower baseline PPF quartiles were associated with lower odds of excellent/very good/good SRH at age 75, however, differences between baseline PPF quartiles diminished with age.ConclusionsThese results suggest that less than excellent SRH predicts decline in physical functioning, however, poor physical functioning may not predict change in SRH in a reciprocal fashion. SRH provides a simple assessment tool for identifying individuals at increased risk for decline in physical function.

Dataset Information

Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis.

Publications

Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis.

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