Systematic review of the effects of isotemporal substitution of sedentary behavior with light physical activity on body composition and cardiometabolic health in children and adolescents

doi:10.11852/zgetbjzz2024-1430

Abstract

Abstract: Objective To systematically evaluate the effects of isochronous substitution of light physical activity (LPA) for sedentary behavior (SB) on body composition and cardiometabolic health in children and adolescents based on compositional data analysis. Methods Relevant literature published up to April 8, 2024, was retrieved from CNKI, PubMed, Embase, EBSCO, and Web of Science.Literature screening and quality assessment were conducted, and data on study population, age, and substitution patterns were extracted. Results A total of 32 studies were included, with 22 focusing on body composition and 10 on cardiometabolic health.For cardiometabolic outcomes, 7 short-duration substitution studies demonstrated beneficial effects, and 2 long-duration substitution studies showed positive improvements in blood lipids.Regarding body composition, 8 short-duration and 1 long-duration substitution studies reported significant improvements; 8 short-duration and 3 long-duration substitutions showed non-significant results; and 2 short-duration substitutions indicated adverse effects. Conclusion Substituting SB with LPA may partially mitigate some health risks associated with sedentary behavior in children and adolescents, although the evidence remains inconsistent and warrants further investigation.

Key words: light physical activity, sedentary behavior, children and adolescents, body composition, cardiac metabolism, isochronous substitution, systematic review

摘要： 目的系统评价基于成分数据分析的轻度身体活动(LPA)等时替代久坐行为(SB)对儿童青少年身体成分和心脏代谢的影响。方法检索在CNKI、PubMed、Embase、EBSCO、Web of Science数据库检索截至2024年4月8日发表的相关文献。对纳入文献进行筛选和质量评价,提取研究对象、年龄、替代形式等数据。结果共纳入文献32篇,其中身体成分相关22篇,心脏代谢相关10篇。在心脏代谢方面,7项短时替代研究显示有显著效应,2项长时替代研究显示对血脂改善有积极作用。在身体成分方面,8项短时替代和1项长时替代研究显示对身体成分改善效应显著,8项短时替代和3项长时替代研究显示效应不显著,2项短时替代产生负面效益。结论通过利用LPA替代SB在一定程度上能够减轻SB给儿童青少年健康带来的某些负面影响,但替代效应尚有争议,需进一步研究验证。

关键词: 轻度身体活动, 久坐行为, 儿童青少年, 身体成分, 心脏代谢, 等时替代, 系统综述

CLC Number:

R179
B804

WANG Siji, CHEN Jiu, XIE Jun. Systematic review of the effects of isotemporal substitution of sedentary behavior with light physical activity on body composition and cardiometabolic health in children and adolescents[J]. Chinese Journal of Child Health Care, 2026, 34(1): 46-52.

王思积, 陈九, 谢军. 轻度身体活动等时替代久坐行为对儿童青少年身体成分和心脏代谢影响的系统综述[J]. 中国儿童保健杂志, 2026, 34(1): 46-52.

References

[1] 张云婷,马生霞,陈畅,等.中国儿童青少年身体活动指南[J].中国循证儿科杂志,2017,12(6):401-409.
Zhang YT, Ma SH, Chen C, et al.Physical activity guidelines for children and adolescents in China[J].Chin J Evid Based Pediatr,2017,12(6):401-409.(in Chinese)
[2] Landry BW, Driscoll SW.Physical activity in children and adolescents[J].PM&R,2012,4(11):826-832.
[3] Domingues SF, Diniz da Silva C, Faria FR,et al.Sleep, se-dentary behavior, and physical activity in Brazilian adole-scents: Achievement recommendations and BMI associations through compositional data analysis[J].PLoS One,2022,17(4):e0266926.
[4] Cao Z, Xu C, Zhang P,et al.Associations of sedentary time and physical activity with adverse health conditions: Outcome-wide analyses using isotemporal substitution model[J].EClinical Med,2022,48:101424-101424.
[5] Bull FC, Al-Ansari SS, Biddle S,et al.World Health Organization 2020 guidelines on physical activity and sedentary behaviour[J].Br J Sports Med,2020,54(24):1451-1462.
[6] Hui SSC, Zhang R, Suzuki K,et al.The associations between meeting 24-hour movement guidelines and adiposity in Asian adolescents: The Asia-fit study[J].Scand J Med Sci Sports,2021,31(3):763-771.
[7] Moola S, Munn Z, Tufanaru C, et al.Systematic reviews of etiology and risk[J].Joanna Briggs Institute reviewer's manual,2017,5:217.
[8] Myers J.Exercise and cardiovascular health[J].Circulation,2003,107(1):e2-e5.
[9] Carson V, Tremblay MS, Chaput JP,et al.Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses[J].Appl Physiol Nutr Metab,2016,41(Suppl 6):294-302.
[10] Moura BP, Rufino RL, Faria RC,et al.Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescents[J].PLoS One,2019,14(11):e0225856.
[11] Hansen BH, Anderssen SA, Andersen LB,et al.Cross-sectional associations of reallocating time between sedentary and active behaviours on cardiometabolic risk factors in young people: An international Children's Accelerometry database (ICAD) analysis[J].Sports Med,2018,48(10):2401-2412.
[12] Marshall ZA, Mackintosh KA, Gregory JW,et al.Using compositional analysis to explore the relationship between physical activity and cardiovascular health in children and adolescents with and without type 1 diabetes[J].Pediatr Diabetes,2022,23(1):115-125.
[13] Aljahdali AA, Baylin A, Ruiz-Narvaez EA,et al.Sedentary patterns and cardiometabolic risk factors in Mexican children and adolescents: Analysis of longitudinal data[J].Int J Behav Nutr Phys Act,2022,19(1):143.
[14] 陈伟业,卢可缘,邹高雍,等.广州市中学生身体行为对血压影响的等时替代研究[J].现代预防医学,2023,50(4):638-643.
Chen WY, Lu KY, Zou GY, et al.An isochronous substitution study on the effect of physical behavior on blood pressure among middle school students in Guangzhou[J].Mod Prev Med,2023,50(4):638-643.(in Chinese)
[15] Cao Y, Zhu L, Chen Z,et al.The effect of different intensity physical activity on cardiovascular metabolic health in obese children and adolescents: An isotemporal substitution model[J].Front Physiol,2023,14:1041622.
[16] Moura BP, Rufino RL, Faria RC,et al.Can replacing sitting time with standing time improve adolescents' cardiometabolic health?[J].Int J Environ Res Public Health,2019,16(17):3115.
[17] Reis LN, Reuter CP, Okely A,et al.Replacing screen time, with physical activity and sleep time: Influence on cardiovascular indicators and inflammatory markers in Brazilian children[J].J Pediatr,2024,100(2):149-155.
[18] Verswijveren SJ, Salmon J, Daly RM,et al.Reallocating sedentary time with total physical activity and physical activity bouts in children: Associations with cardiometabolic biomarkers[J].J Sports Sci,2021,39(3):332-340.
[19] Huang WY, Wong S, He G,et al.Isotemporal substitution analysis for sedentary behavior and body mass index[J].Med Sci Sports Exerc,2016,48(11):2135-2141.
[20] Aggio D, Smith L, Hamer M.Effects of reallocating time in different activity intensities on health and fitness: A cross sectional study[J].Int J Behav Nutr Phys Act,2015,12:1-7.
[21] Loprinzi PD, Cardinal BJ, Lee H,et al.Markers of adiposity among children and adolescents: implications of the isotemporal substitution paradigm with sedentary behavior and physical activity patterns[J].J Diabetes Metab Disord,2015,14:1-14.
[22] Sardinha LB, Marques A, Minderico C,et al.Cross-sectional and prospective impact of reallocating sedentary time to physical activity on children's body composition[J].Pediatr Obes,2017,12(5):373-379.
[23] Del Pozo-Cruz B, Gant N, Del Pozo-Cruz J,et al.Relationships between sleep duration, physical activity and body mass index in young New Zealanders: An isotemporal substitution analysis[J].PLoS One,2017,12(9):e0184472.
[24] Dumuid D, Wake M, Clifford S,et al.The association of the body composition of children with 24-hour activity composition[J].J Pediatr, 2019,208:43-49.
[25] Chen H, Wang LJ, Xin F,et al.Associations between 24-h movement behaviours and BMI in Chinese primary-and middle-school students[J].J Exerc Sci Fit,2023,21(2):186-192.
[26] 梁果,王丽娟,陈欢,等.24h活动时间分布及替代与儿童身体质量指数的关系研究:基于成分分析模型[J].体育科学,2022,42(3):77-84.
Liang G, Wang LJ, Chen H, et al.Study on the relationship between 24-h activity time distribution and substitution and children's BMI:Based on a component analysis model[J].Sports Sci,2022,42(03):77-84.(in Chinese)
[27] Gába A, Dygryn J, Štefelová N,et al.Replacing school and out-of-school sedentary behaviors with physical activity and its associations with adiposity in children and adolescents: A compositional isotemporal substitution analysis[J].Environ Health Prev Med,2021,26:1-9.
[28] 陈欢,王丽娟,梁果,等.上海市中小学生身体活动、久坐行为与BMI的等时替代关系[J].首都体育学院学报,2024,36(1):88-96.
Chen H, Wang LJ, Liang G, et al.Isochronous substitution relationship between physical activity, sedentary behavior and BMI among primary and secondary school students in Shanghai[J].J Capital Inst Phys Educ,2024,36(1):88-96.(in Chinese)
[29] 叶荣荣,黄宝莹,张东枚,等.青少年低强度身体活动久坐时间与体成分的关联[J].中国学校卫生,2023,44(10):1488-1492.
Ye RR, Huang BY, Zhang DM, et al.Association between sedentary time of low-intensity physical activity and body composition in adolescents[J].Chin Sch Health,2023,44(10):1488 - 1492.(in Chinese)
[30] 刘焱,卢冬磊,段金成,等.身体活动对儿童肥胖和体脂影响变化的等时替代效果分析[J].中国儿童保健杂志,2023,31(10):1065-1069,1075.
Liu Y, Lu DL, Duan JC, et al.Isochronous substitution effect analysis of changes in the effects of physical activity on childhood obesity and body fat[J].Chin J Child Health Care,2023,31(10):1065-1069,1075.(in Chinese)
[31] 汪容佳,武宝爱,郜艳晖,等.儿童青少年24 h活动行为与肥胖相关指标的关系[J].中国学校卫生,2023,44(1):28-31.
Wang RJ, Wu BA, Gao YH, et al.Relationship between 24 h activity behavior and obesity-related indicators in children and adolescents[J].Chin Sch Health,2023,44(1):28-31.(in Chinese)
[32] Fairclough SJ, Dumuid D, Mackintosh KA,et al.Adiposity, fitness, health-related quality of life and the reallocation of time between children's school day activity behaviours: A compositional data analysis[J].Prev Med Rep,2018,11:254-261.
[33] Fairclough SJ, Dumuid D, Taylor S,et al.Fitness, fatness and the reallocation of time between children's daily movement behaviours: An analysis of compositional data[J].Int J Behav Nutr Phys Act,2017,14:1-12.
[34] Collings PJ, Westgate K, Väistö J,et al.Cross-sectional associations of objectively-measured physical activity and sedentary time with body composition and cardiorespiratory fitness in mid-childhood: The PANIC study[J].Sports Med,2017,47:769-780.
[35] Dalene KE, Anderssen SA, Andersen LB,et al.Cross-sectional and prospective associations between physical activity, body mass index and waist circumference in children and adolescents[J].Obes Sci Pract,2017,3(3):249-257.
[36] Gába A, Pedišić, Štefelová N,et al.Sedentary behavior patterns and adiposity in children: A study based on compositional data analysis[J].BMC pediatrics,2020,20:1-11.
[37] Jones MA, Skidmore PM, Stoner L,et al.Associations of accelerometer-measured sedentary time, sedentary bouts, and physical activity with adiposity and fitness in children[J].J Sports Sci,2020,38(1):114-120.
[38] Mcalister KL, Zink J, Chu D,et al.Cross-sectional and longitudinal associations between non-school time physical activity, sedentary time, and adiposity among boys and girls: An isotemporal substitution approach[J].Int J Environ Res Public Health,2021,18(9):4671.
[39] Tan K, Cai L, Lai L,et al.Association of reallocating time in different intensities of physical activity with weight status changes among normal-weight chinese children: A national prospective study[J].Int J Environ Res Public Health,2020,17(16):5761.
[40] 冯展鹏,谭思洁,刘焱,等.基于成分等时替代法建立青少年肥胖干预模型[J].中国学校卫生,2023,44(11):1641-1644,1649.
Feng ZP, Tan SJ, Liu Y, et al.An intervention model for adolescent obesity based on component isochronous substitution method[J].Chin Sch Health,2023,44(11):1641-1644,1649.(in Chinese)
[41] Grasten A, Watt A.Perceptions of motivational climate, goal orientations, and light-to-vigorous-intensity physical activity engagement of a sample of Finnish grade 5 to 9 students[J].J Phys Act Health,2016,9(3):5.
[42] Hamilton MT, Hamilton DG, Zderic TW.Exercise physiology versus inactivity physiology: An essential concept for understanding lipoprotein lipase regulation[J].Exerc Sport Sci Rev,2004,32(4):161-166.
[43] Michael Marmot.食物、营养、身体活动和癌症预防[M].陈君石,译.北京:中国协和医科大学出版社,2008:218-221.
[44] Eanes L.CE: Too much sitting: A newly recognized health risk[J].Am J Nurs,2018,118(9):26-34.
[45] Katzmarzyk PT.Standing and mortality in a prospective cohort of Canadian adults[J].Med Sci Sports Exerc,2014,46(5):940-946.
[46] Calabró MA, Lee JM, Saint-Maurice PF,et al.Validity of physical activity monitors for assessing lower intensity activity in adults[J].Int J Behav Nutr Phys Act,2014,11:1-9.
[47] Basterfield L, Pearce MS, Adamson AJ,et al.Effect of choice of outcome measure on studies of the etiology of obesity in children[J].Ann Epidemiol,2012,22(12):888-891.
[48] Evenson KR, Catellier DJ, Gill K,et al.Calibration of two objective measures of physical activity for children[J].J Sports Sci,2008,26(14):1557-1565.
[49] Zhu Z, Chen P, Zhuang J.Intensity classification accuracy of accelerometer-measured physical activities in Chinese children and youth[J].Res Q Exerc Sport,2013,84(Suppl 2):4-11.