The prospective association between objectively measured sedentary time, moderate-to-vigorous physical activity and cardiometabolic risk factors in youth: a systematic review and meta-analysis

Sedentary time and moderate-to-vigorous physical activity (MVPA) may be uniquely related to cardiometabolic health. Excessive sedentary time is suggested as an independent cardiometabolic risk factor, while MVPA is favourably associated with cardiometabolic health. This systematic review and meta-analysis summarizes the evidence on a prospective relationship between objectively measured sedentary time, MVPA and cardiometabolic health indicators in youth. PubMed, Embase, CINAHL, PhyscINFO and SPORTDiscus were systematically searched from January 2000 until April 2018. Studies were included if sedentary time and physical activity were measured objectively and examined associations with body mass index, waist circumference, triglycerides, high-density lipoprotein, insulin, blood pressure or the clustering of these cardiometabolic risk factors. We identified 30 studies, of which 21 were of high quality. No evidence was found for an association between sedentary time and cardiometabolic outcomes. The association between MVPA and individual cardiometabolic risk factors was inconsistent. The meta-analysis for prospective studies found a small but significant effect size between MVPA at baseline and clustered cardiometabolic risk at follow-up (ES -0.014 [95% CI, -0.024 to -0.004]). We conclude that there is no prospective association between sedentary time and cardiometabolic health, while MVPA is beneficially associated with cardiometabolic health in youth.