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

Abstract

Background Little is known on how context-specific sedentary behaviors (SB) affect adiposity. This study aimed to investigate compositional associations between context-specific SB and adiposity and estimate the differences in adiposity associated with replacing school and out-of-school SB with physical activity (PA). Methods This study included 336 children and adolescents. Time spent in SB and PA was estimated using multi-day 24-hour raw accelerometer data. SB and PA were specified for school and out-of-school times. Fat mass percentage (FM%) and fat mass index (FMI) were used as adiposity indicators. A compositional isotemporal substitution model was used to estimate differences in adiposity associated with one-to-one reallocations of time from context-specific SB to PA. Results Participants spent approximately two thirds of their school and out-of-school time being sedentary. Relative to the remaining 24-h movement behaviors, significant associations between out-of-school SB and adiposity were found in both boys (βilr1 = 0.63, 95% confidence interval [CI] = 0.03–1.22 for FM%; βilr1 = 0.76, 95% CI = 0.03–1.49 for FMI) and girls (βilr1 = 0.62, 95% CI = 0.25–0.98 for FM%; βilr1 = 0.80, 95% CI = 0.28–1.32 for FMI). Replacing 30 min/day of out-of-school SB with out-of-school light PA decreased FM% by 10.1% (95% CI = 3.3–17.9) and FMI by 14% (95% CI = 2.7–24) in girls. No significant associations were found for school SB. Conclusions A reduction of out-of-school SB in favor of light PA should be advocated as an appropriate target for interventions and strategies to prevent childhood obesity.

Changes in sedentary behavior patterns during the transition from childhood to adolescence and their association with adiposity: a prospective study based on compositional data analysis

“…One possible explanation for the decrease in sedentary fragmentation could be a change in movement behaviors associated with the transition to secondary school [ 39 ]. As most school time corresponds to SB [ 40 , 41 ] and considering the SB patterns during lessons (i.e., prolonged uninterrupted sitting), it can be assumed that the increase in prolonged SB is caused mainly by an increase in school-based SB. Another contributor to prolonged SB could be the increased time spent traveling to school in a car or bus.…”

Association between Metabolic Syndrome Diagnosis and the Physical Activity—Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study

“…The present results thus strengthen recent obesity treatment strategies consisting in breaking up extended periods of SED time, replacing it with MVPA (the preferred and more efficient scenario) or with LPA (beneficial but with lower effect estimates). These strategies would give the chance to be more flexible by acting on different combinations of time spent in MVPA, LPA and sedentary behaviors [ 49 , 50 , 51 , 52 ]. In clinical practice, this means that youths with obesity should benefit from an individual behavioral diagnostic, targeting different intensities of PA and SED behaviors, and that stakeholders need to be sensitized to support the shift from long periods of SED time to daily routines incorporating bouts of PA.…”

Changes in Sedentary Behavior Patterns During the Transition From Childhood to Adolescence and Their Association With Adiposity: a Prospective Study Based on Compositional Data Analysis

“…Another explanation could be a change in movement behaviors associated with the transition to secondary school. As most school time corresponds to SB [33,34] and considering the SB patterns during lessons (i.e., prolonged uninterrupted sitting), it can be assumed that the increase in prolonged SB is caused mainly by an increase in school-based SB. In addtion, the age-related decrease in non-organized leisure time activities may also be associated with unhealthy time use across childhood and adolescence [35].…”