Association Between Sedentary Behavior and Obesity in School-age Children in China: A Systematic Review of Evidence

Abstract

<jats:sec> <jats:title>Background and Objective:</jats:title> <jats:p> China has experienced a rapid increase in the number of obese and overweight children, and sedentary behavior has been recognized as an important factor. The purpose of this review is to summarize studies on the relationship between sedentary behavior and obesity in school-age children in China.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>A systematic search was conducted to identify studies that investigate the relationship between sedentary behavior and obesity in children between the ages of 6 and 18 years in China. Two researchers independently screened studies, assessed their methodological quality, and extracted relevant data. Findings on the relationship between sedentary behavior and obesity in children were synthesized and analyzed.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> A total of 17 studies were included in the review. Fifteen out of 17 studies indicated that spending too much time engaged in sedentary behavior, especially screen-based sedentary behavior, was associated with obesity in children and adolescents in China. Possible reasons for this association are less energy expenditure, increased energy intake, and insufficient sleep owning to overtime sedentary behavior. Moreover, seven, six, and three studies justified children’s physical activity, dietary intake, or sleep, and most of the studies (five, three, and two) indicated that association between sedentary behavior and obesity is independent of these justified variables. Although differences in gender and area of residence in the association between sedentary behavior and obesity were examined in five studies, definite conclusions could not be drawn because of inconsistent findings or limited research.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>Future research is necessary to enhance understanding on demographic differences in the association between sedentary behavior and obesity in children as well as on the contributions of different types of sedentary behavior to child obesity in China.</jats:p> </jats:sec>

Can we estimate the causal effects of diet and sedentary behavior on schoolchildren’s overweight/obesity from observational studies?

“…In line with the present study, schoolchildren's sedentary time, especially their screen time, was associated with overweight/obesity in other studies [38,39]. Other studies also found an impact of consuming SSB on excess weight in children and adults [40][41][42][43]. In Brazil, the consumption of SSB increased over the weekend by more than a third compared to the weekday [36].…”

“…In Brazil, the consumption of SSB increased over the weekend by more than a third compared to the weekday [36]. The problem is compounded by the increasing tendency of both consuming SSB and sedentary activities worldwide [40][41][42][43][44][45][46][47][48][49][50].…”

Current Status and Potential Recommendations of Childhood Obesity in China

“…Increased sedentary behaviors has been identified as a special risk factor for obesity. Most of studies showed that spending too much time on sedentary lifestyle, especially sedentary behavior involves staring at screens, was strongly related to childhood obesity in China [24].…”

Relationship of 24-Hour Movement Behaviors with Weight Status and Body Composition in Chinese Primary School Children: A Cross-Sectional Study

“…For instance, engaging in a larger amount of PA (especially with high intensity) was found be significantly associated with a lower risk of overweight/obesity, lower levels of PBF and higher levels of FFM and SMM in children from different countries [ 11 , 12 ]. ST was also evident to be positively associated with the weight status and PBF and negatively correlated with the FFM and SMM in children [ 13 , 14 , 15 , 16 ]. For sleep duration, it showed an inverse association with risks of overweight/obesity and percentage of body fat [ 16 , 17 ], while limited studies have examined the relationship between sleep duration and FFM and SMM in children [ 18 ].…”