Physical Activity and Sedentary Time Associations with Metabolic Health Across Weight Statuses in Children and Adolescents

Objective: The aim of this study was to examine the prevalence of metabolic health across weight statuses and the associations of physical activity and sedentary time within and across metabolic health-weight status groups. Methods: Six studies (n = 4,581) from the International Children's Accelerometry Database were used. Sedentary time, light physical activity, and moderate to vigorous physical activity (MVPA) were accelerometer derived. Individuals were classified with normal weight (NW), overweight, or obesity. Strict and lenient composite definitions of metabolic health were created. Binomial and multinomial logistic regressions controlling for age, sex, study, and accelerometer wear time were conducted. Results: The metabolically unhealthy (MU) prevalence was 26.4% and 45.6% based on two definitions. Across definitions, more sedentary time was associated with higher odds of MU classification compared with metabolically healthy (MH) classification for the NW group. More MVPA was associated with lower odds of MU classification than MH classification for NW and overweight groups. For multinomial logistic regressions, more MVPA was associated with lower odds of MH-obesity classification, as well as MU-NW, -overweight, and -obesity classifications, compared with the MH-NW group. Furthermore, more sedentary time was associated with higher odds of MU-NW classification compared with the MH-NW group. Conclusions: More MVPA was beneficial for metabolic health and weight status, whereas lower sedentary time was beneficial for metabolic health alone, although associations were weak.