The purpose of this review is to describe the amount of time children spend in sedentary behaviour and to determine if there are specific factors that associate with sedentary behaviour in children. The following search terms were used to identify relevant articles: sedentary behaviour, inactivity, television, computer, video games, small screen, sitting, prevalence, patterns, correlates, factors and determinants. The databases used to conduct the search included PubMed, PsycINFO, ERIC (Education Resources Information Center) and Academic Search Premier. The studies reviewed were limited to those that sampled children (2-18 years), were written in English and used a measure of sedentary behaviour as the dependent variable. Several studies reported the time spent watching television or the proportion of children at or above a threshold for television viewing (eg, ≥3 h/day). Among the accelerometer studies included, the National Health and Nutrition Examination Survey is the largest and reported ∼6.1, 7.5 and 8.0 h/day mean sedentary time in children 6-11, 12-15 and 16-19 years old, respectively. Taken together, the existing literature across the world indicates a slightly higher level of sedentary behaviour in older children. Higher levels of sedentary behaviour were also reported in non-white children, children from lower socioeconomic status background and children from households with more access to televisions/computers. Lower levels of sedentary behaviour were reported in children whose parents have rules/limitations on screen time.

Sedentary behavior was associated with greater increases in BMI at the 90th, 75th and 50th BMI percentiles between ages 9 and 15 years, independent of MVPA. Preventing an increase in sedentary behavior from childhood to adolescence may contribute to reducing the number of children classified as obese.

Direct observation systems and accelerometry have become well-established measurements of physical activity in young children as well as older groups. Pedometry and HR monitoring have been shown to be applicable, but these methods have been studied less extensively than direct observation and accelerometry. Proxy reports of physical activity are attractive because of low burden, but they have limited validity.

The purpose of this study was to examine the association between sedentary behavior and obesity among 12‐year‐old children, while adjusting for moderate‐to‐vigorous physical activity (MVPA) and other potential confounding variables. Cross‐sectional analyses were carried out with data from 5,434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual‐energy X‐ray emission absorptiometry, and height and weight measurements were used to calculate BMI (kg/m2). The children wore an accelerometer for 7 days. The cut points for sedentary behavior and MVPA were ≤199 and ≥3,600 counts per minute (cpm), respectively. Logistic regression analyses were performed to estimate odds ratios (ORs), adjusting for potential confounders of physical activity that included gender, social factors, early life factors, and maturation. The minimally adjusted association between sedentary behavior and obesity was positive, OR = 1.18 (1.08, 1.28). After adjusting for the series of potential confounders of physical activity the positive association remained, OR = 1.32 (1.14, 1.53). The crude association between 15 min of MVPA per day and obesity was negative, OR = 0.54 (0.48, 0.62). When 15 min of MVPA per day was additionally controlled for in the models, the positive associations between sedentary behavior and obesity were negated. Sedentary behavior was positively associated with obesity in the 12‐year‐old children, but this association was not independent of MVPA; low levels of MVPA among the sedentary children increased the odds of obesity. These findings support the importance of specifically engaging in MVPA during childhood to reduce the prevalence of obesity.

BACKGROUND Weight-for-length (WFL) is currently used to assess adiposity under 2 years. We assessed WFL- versus BMI-based estimates of adiposity in healthy infants in determining risk for early obesity. METHODS Anthropometrics were extracted from electronic medical records for well-child visits for 733949 full-term infants from a large pediatric network. World Health Organization WFL and BMI z scores (WFL-z and BMI-z, respectively) were calculated up to age 24 months. Correlation analyses assessed the agreement between WFL-z and BMI-z and within-subject tracking over time. Logistic regression determined odds of obesity at 2 years on the basis of adiposity classification at 2 months. RESULTS Agreement between WFL-z and BMI-z increased from birth to 6 months and remained high thereafter. BMI-z at 2 months was more consistent with measurements at older ages than WFL-z at 2 months. Infants with high BMI (≥85th percentile) and reference WFL (5th–85th percentiles) at 2 months had greater odds of obesity at 2 years than those with high WFL (≥85th percentile) and reference BMI (5th–85th percentiles; odds ratio, 5.49 vs 1.40; P < .001). At 2 months, BMI had a higher positive predictive value than WFL for obesity at 2 years using cut-points of either the 85th percentile (31% vs 23%) or 97.7th percentile (47% vs 29%). CONCLUSIONS High BMI in early infancy is more strongly associated with early childhood obesity than high WFL. Forty-seven percent of infants with BMI ≥97.7th percentile at 2 months (versus 29% of infants with WFL ≥97.7th percentile at 2 months) were obese at 2 years. Epidemiologic studies focused on assessing childhood obesity risk should consider using BMI in early infancy.