Association between 24‐hour movement behaviors and adiposity in children and adolescents: A compositional data meta‐analysis

PURPOSE: To quantitatively synthesize published evidence on the association between 24-hour movement behavior composition with adiposity in children and adolescents aged 3-18 years. METHODS: Systematic literature searches were conducted in five electronic databases to identify papers published between January 2015 and January 2024. A machine learning-assisted systematic review was conducted to identify studies applying compositional data analysis to examine the association between 24-hour movement behaviors and adiposity in children and youth. Random effect meta-analyses were estimated to examine the relative association between each component of the 24-hour movement behavior composition and body mass index z-score (zBMI), waist circumference, fat mass percentage, and fat mass index (FMI). RESULTS: A total of 16 studies reporting on 15,230 children and youth were included in the review. Most studies reported on zBMI (k = 14), followed by waist circumference (k = 5), body fat percentage (k = 3), and FMI (k = 2). Spending more time sleeping and engaged in moderate-to-vigorous intensity physical activity (MVPA) relative to other behaviors was associated with lower adiposity, while spending more time sedentary and engaged in light-intensity physical activity was associated with higher adiposity. CONCLUSION: These results provide support for most recommendations of the 24-hour movement behavior guidelines, including getting an adequate amount of sleep, limiting sedentary time, and engaging in MVPA, to improve adiposity outcomes.