Guiding Questions

A1. What is the association between physical activity and health-related outcomes?

Is there a dose-response association (volume, duration, frequency, intensity)?

Does the association vary by type or domain of physical activity?

A2. What is the association between sedentary behaviour and health-related outcomes?

Is there a dose-response association (total volume and the frequency, duration and intensity of interruption)?

Does the association vary by type and domain of sedentary behaviour?

Inclusion Criteria

• Population: Children aged 5 to under 18 years of age
• Exposure: Greater volume, duration, frequency or intensity of physical activity; greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour.
• Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity; lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour.

The GRADE Evidence Profiles developed for the 2019 Australian 24-Hour Movement Guidelines for Children and Young People (5-17 years) by Okely et al. (1) were used as a basis for this update for children and adolescents, given the rigor in methods and recency in included evidence. The following modifications were made to the GRADE assessments from the Okely update: 1) evidence from observational studies evaluating associations was upgraded one level if the studies were well-conducted longitudinal studies with no serious risk of bias, to better reflect the certainty in findings regarding associations from such studies and 2) evidence from all studies was downgraded one level if there was only one study, due to inability to assess consistency. The development of the Australian guideline utilized the GRADE-ADOLOPMENT approach, leveraging the work done in Canada in the development of their 24-hour guidelines (2, 3). For each PICO, identified systematic reviews were incorporated into the existing Evidence Profiles according to the study designs included in the review. A summary of findings for each review is provided. In cases where the identified systematic reviews suggested differences in the quality assessment (risk of bias, inconsistency, indirectness, imprecision, or other risk of bias) or overall certainty, the evidence profiles were edited accordingly. Additional evidence reviewed for the US Physical Activity Guidelines Advisory Committee report were included in the draft Evidence Profiles to contextualize the overall body of evidence.

Evidence identified

Twenty-one reviews were identified (published from 2017 to 2019) that examined the association between physical activity and/or sedentary behaviour and health-related outcomes among children and adolescents (4–24).

Fourteen reviews examined the relationship between physical activity and health-related outcomes, five reviews examined the relationship between sedentary behaviour and health-related outcomes, and two reviews included both physical activity and sedentary behaviour (Table A.1). The most commonly reported outcomes in the reviews were measures of adiposity and cardiometabolic health. No reviews were identified that evaluated the association between physical activity and adverse effects, mental health outcomes, or sleep outcomes and no reviews were identified that evaluated the association between sedentary behaviour and physical fitness, adverse effects, cognitive outcomes, or prosocial behaviour.

Furthermore, none of the existing reviews robustly examined whether there was a dose-response association between physical activity or sedentary behaviour and health-related outcomes, whether the association varied by type or domain of physical activity or sedentary behaviour, and whether physical activity modified the effect of sedentary behaviour on mortality.

In most cases, each review was narrowly scoped to look at specific types of physical activity (e.g., high-intensity interval training, school-based physical activity programs) or sedentary behaviour (e.g., objectively-measured sedentary time) and limited inclusion to specific study designs (e.g., only randomized controlled trials).

Few reviews (three) included evidence published into 2019. About half of the reviews included evidence published from database inception through at least 2017; seven reviews searched through 2014, 2015, or 2016 and three reviews did not report search dates. Extracted data for each review is included in Appendix 1A.

None of the systematic reviews were rated as having high credibility based on the AMSTAR 2 instrument. Six were rated as having moderate credibility, 10 were rated as having low credibility, and 5 were rated as having critically low credibility. Given concerns regarding the comprehensiveness and the validity of the results presented in reviews rated as having very low credibility, they were not incorporated into the final Evidence Profiles. Table A.2 presents the ratings for each review according to all the AMSTAR 2 main domains.

A.1. Physical Activity

Table A.1.a. Physical fitness and physical activity, children and adolescents (PDF, 135K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Physical fitness (e.g., cardiorespiratory, motor development, muscular fitness)

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles developed to support the development of the Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.b. Cardiometabolic health and physical activity, children and adolescents (PDF, 144K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Cardiometabolic health (e.g., blood pressure, dyslipidaemia, glucose, insulin resistance)

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.c. Bone health and physical activity, children and adolescents (PDF, 113K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Bone health

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.d. Adiposity/body composition and physical activity, children and adolescents (PDF, 126K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Adiposity/Body composition

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.e. Adverse effects and physical activity, children and adolescents (PDF, 90K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Adverse effects

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.f. Mental health and physical activity, children and adolescents (PDF, 131K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Mental health (e.g., depressive symptoms, self-esteem, anxiety symptoms, ADHD)

*Importance: CRITCAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.g. Cognitive outcomes and physical activity, children and adolescents (PDF, 108K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Cognitive outcomes (e.g., academic performance, executive function)

*Importance: CRITCAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.h. Prosocial behaviour and physical activity, children and adolescents (PDF, 101K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Prosocial behaviour (e.g., conduct problems, peer relations, social inclusion)

*Importance: IMPORTANT

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.1.I. Sleep duration and quality and physical activity, children and adolescents (PDF, 51K)

Questions: What is the association between physical activity and health-related outcomes? Is there a dose response association (volume, duration, frequency, intensity)? Does the association vary by type or domain of PA?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, duration, frequency, or intensity of physical activity

Comparison: No physical activity or lesser volume, duration, frequency, or intensity of physical activity

Outcome: Sleep duration and quality

*Importance: IMPORTANT

No GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years)(26) and no systematic reviews identified by WHO.

A.2. Sedentary Behaviour

Table A.2.a. Physical fitness and sedentary behaviour, children and adolescents (PDF, 111K)

Questions: What is the association between sedentary behaviour and health-related outcomes? Is there a dose response association (total volume and the frequency, duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Physical fitness (e.g., cardiorespiratory, motor development, muscular fitness)

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.2.b. Cardiometabolic health and sedentary behaviour, children and adolescents (PDF, 101K)

Questions: What is the association between sedentary behaviour and health-related outcomes? Is there a dose response association (total volume and the frequency, duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Cardiometabolic health (e.g., blood pressure, dyslipidaemia, glucose, insulin resistance)

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.2.c. Bone health and sedentary behaviour, children and adolescents (PDF, 87K)

Questions: What is the association between sedentary behaviour and health-related outcomes? Is there a dose response association (total volume and the frequency, duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Bone health

*Importance: CRITICAL

Bone health outcomes not reviewed in Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years) (26). Red font denotes information from WHO update using review of existing systematic reviews.

Table A.2.d. Adiposity/body composition and sedentary behaviour, children and adolescents (PDF, 112K)

Questions: What is the association between sedentary behaviour and health-related outcomes? Is there a dose response association (total volume and the frequency, duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Adiposity/Body composition

*Importance: CRITICAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.2.e. Adverse effects and sedentary behaviour, children and adolescents (PDF, 50K)

Questions: What is the association between sedentary behaviour and health-related outcomes? Is there a dose response association (total volume and the frequency, duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Adverse effects

*Importance: CRITICAL

No GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years)(26) and no systematic reviews identified by WHO.

Table A.2.f. Mental health and sedentary behaviour, children and adolescents (PDF, 94K)

Questions: What is the association between sedentary behaviour duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Mental health (e.g., depressive symptoms, self-esteem, anxiety symptoms, ADHD)

*Importance: CRITCAL

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.2.g. Cognitive outcomes and sedentary behaviour, children and adolescents (PDF, 96K)

Questions: What is the association between sedentary behaviour duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Cognitive outcomes (e.g., academic performance, executive function)

*Importance: CRITCAL

Black font is from original GRADE Evidence Profiles for academic achievement from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.2.h. Prosocial behaviour and sedentary behaviour, children and adolescents (PDF, 103K)

Questions: What is the association between sedentary behaviour duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Prosocial behaviour (e.g., conduct problems, peer relations, social inclusion)

*Importance: IMPORTANT

Black font is from original GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years).(26) Red font denotes additions based on WHO update using review of existing systematic reviews.

Table A.2.i. Sleep duration and quality and sedentary behaviour, children and adolescents (PDF, 88K)

Questions: What is the association between sedentary behaviour duration and intensity of interruption)? Does the association vary by type and domain of sedentary behaviour?

Population: Children aged 5-under 18 years of age

Exposure: Greater volume, decreased frequency, duration or intensity of interruption of sedentary behaviour

Comparison: Lesser volume, increased frequency, duration or intensity of interruption of sedentary behaviour

Outcome: Sleep duration and quality

*Importance: IMPORTANT

No GRADE Evidence Profiles from Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (12-17 years)(26) and no systematic reviews identified by WHO.

Appendix 1A. Data Extractions

Download PDF (165K)

References

1.

Okely AD, Ghersi D, Loughran SP, Cliff DP, Shilton T, Jones RA, et al. Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (13-17 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep — Research Report. Australian Government, Department of Health.; 2019. Contract No.: Available from https://www1​.health.gov​.au/internet/main/publishing​.nsf/Content/ti-5-17years. (accessed 29 July 2020)..

2.

Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput JP, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2016/06/17 ed2016. p. S240–65. [PubMed: 27306432]

3.

Poitras VJ, Gray CE, Borghese MM, Carson V, Chaput JP, Janssen I, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2016/06/17 ed2016. p. S197–239. [PubMed: 27306431]

4.

Bea JW, Blew RM, Howe C, Hetherington-Rauth M, Going SB. Resistance Training Effects on Metabolic Function Among Youth: A Systematic Review. Pediatr Exerc Sci. 2017/01/05 ed2017. p. 297–315. [PMC free article: PMC6240908] [PubMed: 28050919]

5.

Belmon LS, van Stralen MM, Busch V, Harmsen IA, Chinapaw MJM. What are the determinants of children’s sleep behavior? A systematic review of longitudinal studies. Sleep Med Rev. 2018/12/12 ed2019. p. 60–70. [PubMed: 30529431]

6.

Cao M, Quan M, Zhuang J. Effect of High-Intensity Interval Training versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Children and Adolescents: A Meta-Analysis. Int J Environ Res Public Health. 2019/05/06 ed2019. [PMC free article: PMC6539300] [PubMed: 31052205]

7.

Collins H, Fawkner S, Booth JN, Duncan A. The effect of resistance training interventions on weight status in youth: a meta-analysis. Sports medicine - open. 2018/08/22 ed2018. p. 41. [PMC free article: PMC6102165] [PubMed: 30128805]

8.

Eddolls WTB, McNarry MA, Stratton G, Winn CON, Mackintosh KA. High-Intensity Interval Training Interventions in Children and Adolescents: A Systematic Review. Sports Med. 2017/06/24 ed2017. p. 2363–74. [PMC free article: PMC5633633] [PubMed: 28643209]

9.

Errisuriz VL, Golaszewski NM, Born K, Bartholomew JB. Systematic Review of Physical Education-Based Physical Activity Interventions Among Elementary School Children. J Prim Prev. 2018/05/01 ed2018. p. 303–27. [PubMed: 29705883]

10.

Fang K, Mu M, Liu K, He Y. Screen time and childhood overweight/obesity: A systematic review and meta-analysis. Child Care Health Dev. 2019/07/05 ed2019. p. 744–53. [PubMed: 31270831]

11.

Koedijk JB, van Rijswijk J, Oranje WA, van den Bergh JP, Bours SP, Savelberg HH, et al. Sedentary behaviour and bone health in children, adolescents and young adults: a systematic review. Osteoporos Int. 2017/05/27 ed2017. p. 2507–19. [PMC free article: PMC5550522] [PubMed: 28547135]

12.

Krahenbuhl T, Guimaraes RF, Barros Filho AA, Goncalves EM. Bone Geometry and Physical Activity in Children and Adolescents: Systematic Review. Rev Paul Pediatr2018. p. 230–7. [PMC free article: PMC6038793] [PubMed: 29412432]

13.

Lee JE, Pope Z, Gao Z. The Role of Youth Sports in Promoting Children’s Physical Activity and Preventing Pediatric Obesity: A Systematic Review. Behav Med. 2016/06/24 ed2018. p. 62–76. [PubMed: 27337530]

14.

Marker C, Gnambs T, Appel M. Exploring the myth of the chubby gamer: A meta-analysis on sedentary video gaming and body mass. Soc Sci Med. 2019/07/03 ed2019. p. 112325. [PubMed: 31262505]

15.

Marques A, Santos DA, Hillman CH, Sardinha LB. How does academic achievement relate to cardiorespiratory fitness, self-reported physical activity and objectively reported physical activity: a systematic review in children and adolescents aged 6-18 years. Br J Sports Med. 2017/10/17 ed2018. p. 1039. [PubMed: 29032365]

16.

Martin R, Murtagh EM. Effect of Active Lessons on Physical Activity, Academic, and Health Outcomes: A Systematic Review. Research quarterly for exercise and sport. 2017/03/23 ed2017. p. 149–68. [PubMed: 28328311]

17.

Miguel-Berges ML, Reilly JJ, Moreno Aznar LA, Jimenez-Pavon D. Associations Between Pedometer-Determined Physical Activity and Adiposity in Children and Adolescents: Systematic Review. Clin J Sport Med. 2017/07/14 ed2018. p. 64–75. [PubMed: 28704256]

18.

Mohammadi S, Jalaludin MY, Su TT, Dahlui M, Mohamed MNA, Majid HA. Dietary and physical activity patterns related to cardio-metabolic health among Malaysian adolescents: a systematic review. BMC Public Health. 2019/03/02 ed2019. p. 251. [PMC free article: PMC6396523] [PubMed: 30819123]

19.

Pozuelo-Carrascosa DP, Cavero-Redondo I, Herraiz-Adillo A, Diez-Fernandez A, Sanchez-Lopez M, Martinez-Vizcaino V. School-Based Exercise Programs and Cardiometabolic Risk Factors: A Meta-analysis. Pediatrics. 2018/10/20 ed2018.

20.

Singh AS, Saliasi E, van den Berg V, Uijtdewilligen L, de Groot RHM, Jolles J, et al. Effects of physical activity interventions on cognitive and academic performance in children and adolescents: a novel combination of a systematic review and recommendations from an expert panel. Br J Sports Med. 2018/08/01 ed2019. p. 640–7. [PubMed: 30061304]

21.

Skrede T, Steene-Johannessen J, Anderssen SA, Resaland GK, Ekelund U. The prospective association between objectively measured sedentary time, moderate-to-vigorous physical activity and cardiometabolic risk factors in youth: a systematic review and meta-analysis. Obes Rev. 2018/10/03 ed2019. p. 55–74. [PubMed: 30270500]

22.

Stanczykiewicz B, Banik A, Knoll N, Keller J, Hohl DH, Rosinczuk J, et al. Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis. BMC Public Health. 2019/05/02 ed2019. p. 459. [PMC free article: PMC6492316] [PubMed: 31039760]

23.

Verswijveren S, Lamb KE, Bell LA, Timperio A, Salmon J, Ridgers ND. Associations between activity patterns and cardio-metabolic risk factors in children and adolescents: A systematic review. PLoS One. 2018/08/17 ed2018. p. e0201947. [PMC free article: PMC6095515] [PubMed: 30114269]

24.

Xue Y, Yang Y, Huang T. Effects of chronic exercise interventions on executive function among children and adolescents: a systematic review with meta-analysis. Br J Sports Med. 2019/02/10 ed2019. [PubMed: 30737201]

25.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. [PMC free article: PMC5833365] [PubMed: 28935701]

26.

Australia Co. Australian 24-Hour Movement Guidelines for Children (5-12 years) and Young People (13-17 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. 2019. p. 148.

27.

2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC. 2018. p. 1–779.

28.

Carson V, Ridgers ND, Howard BJ, Winkler EA, Healy GN, Owen N, et al. Light-intensity physical activity and cardiometabolic biomarkers in US adolescents. PLoS One. 2013;8(8):e71417. [PMC free article: PMC3739773] [PubMed: 23951157]

29.

Aggio D, Ogunleye AA, Voss C, Sandercock GR. Temporal relationships between screen-time and physical activity with cardiorespiratory fitness in English schoolchildren: a 2-year longitudinal study. Prev Med. 2012;55(1):37–9. [PubMed: 22561029]

30.

Hjorth MF, Chaput JP, Michaelsen K, Astrup A, Tetens I, Sjodin A. Seasonal variation in objectively measured physical activity, sedentary time, cardio-respiratory fitness and sleep duration among 8-11 year-old Danish children: a repeated-measures study. BMC Public Health. 2013;13:808. [PMC free article: PMC3846279] [PubMed: 24010811]

31.

Mitchell JA, Pate RR, Blair SN. Screen-based sedentary behavior and cardiorespiratory fitness from age 11 to 13. Med Sci Sports Exerc. 2012;44(7):1302–9. [PMC free article: PMC3359423] [PubMed: 22217567]

32.

Aggio D, Smith L, Hamer M. Effects of reallocating time in different activity intensities on health and fitness: a cross sectional study. Int J Behav Nutr Phys Act. 2015;12:83. [PMC free article: PMC4482052] [PubMed: 26104041]

33.

Aires L, Pratt M, Lobelo F, Santos RM, Santos MP, Mota J. Associations of cardiorespiratory fitness in children and adolescents with physical activity, active commuting to school, and screen time. J Phys Act Health. 2011;8: Suppl 2:S198–S205. [PubMed: 21918233]

34.

Ciesla E, Mleczko E, Bergier J, Markowska M, Nowak-Starz G. Health-Related Physical Fitness, BMI, physical activity and time spent at a computer screen in 6 and 7-year-old children from rural areas in Poland. Ann Agric Environ Med. 2014;21(3):617–21. [PubMed: 25292140]

35.

Dencker M, Bugge A, Hermansen B, Andersen LB. Objectively measured daily physical activity related to aerobic fitness in young children. J Sports Sci. 2010;28(2):139–45. [PubMed: 20035491]

36.

Dowda M, Pfeiffer KA, Lobelo F, Porter DE, Pate RR. Cardiorespiratory fitness and proximity to commercial physical activity facilities among 12th grade girls. J Adolesc Health. 2012;50(5):497–502. [PMC free article: PMC3336089] [PubMed: 22525114]

37.

Drenowatz C, Kobel S, Kettner S, Kesztyus D, Steinacker JM. Interaction of sedentary behaviour, sports participation and fitness with weight status in elementary school children. Eur J Sport Sci. 2014;14(1):100–5. [PubMed: 24533500]

38.

Filho VCB, da Silva Lopes A, Bozza R, Rech CR, de Campos W. Correlates of cardiorespiratory and muscular fitness among Brazilian adolescents. Am J Health Behav. 2014;38(1):42–52. [PubMed: 24034679]

39.

Grontved A, Ried-Larsen M, Froberg K, Wedderkopp N, Brage S, Kristensen PL, et al. Screen time viewing behaviors and isometric trunk muscle strength in youth. Med Sci Sports Exerc. 2013;45(10):1975–80. [PubMed: 24048320]

40.

Hay J, Maximova K, Durksen A, Carson V, Rinaldi R, Torrance B, et al. Physical activity intensity and cardiometabolic risk in youth. Arch Pediatr Adolesc Med. 2012;166(11):1022–9. [PubMed: 22965682]

41.

Lämmle L, Woll A, Mensink GB, Bos K. Distal and proximal factors of health behaviors and their associations with health in children and adolescents. Int J Environ Res Public Health. 2013;10(7):2944–78. [PMC free article: PMC3734470] [PubMed: 23863614]

42.

Machado-Rodrigues AM, MJ C-e-S, Mota J, Padez C, Ronque E, Cumming SP, et al. Cardiorespiratory fitness, weight status and objectively measured sedentary behaviour and physical activity in rural and urban Portuguese adolescents. J Child Health Care. 2012;16(2):166–77. [PubMed: 22363047]

43.

Martinez-Gomez D, Ortega FB, Ruiz JR, Vicente-Rodriguez G, Veiga OL, Widhalm K, et al. Excessive sedentary time and low cardiorespiratory fitness in European adolescents: the HELENA study. Arch Dis Child. 2011;96(3):240–6. [PubMed: 21220264]

44.

Poethko-Muller C, Krug S. Social and health related risk factors for low cardio respiratory fitness in German adolescents: Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). J Public Health. 2014;22(2):187–96.

45.

Ruiz JR, Ortega FB, Castillo R, Martin-Matillas M, Kwak L, Vicente-Rodriguez G, et al. Physical activity, fitness, weight status, and cognitive performance in adolescents.. J Pediatr. 2010;157(6):917–22. [PubMed: 20673915]

46.

Sandercock GR, Ogunleye AA. Independence of physical activity and screen time as predictors of cardiorespiratory fitness in youth. Pediatr Res. 2013;73(5):692–7. [PubMed: 23417036]

47.

Santos R, Mota J, Okely AD, Pratt M, Moreira C, MJ C-e-S, et al. The independent associations of sedentary behaviour and physical activity on cardiorespiratory fitness. Br J Sports Med. 2014;48(20):1508–12. [PubMed: 23410883]

48.

Simhaee D, Corriveau N, Gurm R, Geiger Z, Kline-Rogers E, Goldberg C, et al. Recovery heart rate: an indicator of cardiovascular risk among middle school children. Pediatr Cardiol. 2013;34(6):1431–7. [PubMed: 23483242]

49.

Tucker JS, Martin S, Jackson AW, Morrow JR, Jr., Greenleaf CA, Petrie TA. Relations between sedentary behavior and FITNESSGRAM healthy fitness zone achievement and physical activity. Journal of physical activity & health. 2014;11(5):1006–11. [PubMed: 23799274]

50.

Berentzen NE, Smit HA, van RL, Gehring U, Kerkhof M, Postma DS, et al. Screen time, adiposity and cardiometabolic markers: mediation by physical activity, not snacking, among 11-year-old children. Int J Obes. 2014;38(10):1317–23. [PubMed: 24946910]

51.

Dumith SC, Garcia LM, da Silva KS, Menezes AM, Hallal PC. Predictors and health consequences of screen-time change during adolescence-1993 Pelotas (Brazil) birth cohort study. J Adolesc Health. 2012;51:(6 Suppl):S16–S21. [PMC free article: PMC3508419] [PubMed: 23283154]

52.

Gopinath B, Hardy LL, Kifley A, Baur LA, Mitchell P. Activity behaviors in schoolchildren and subsequent 5-yr change in blood pressure. Med Sci Sports Exerc. 2014;46(4):724–9. [PubMed: 24056270]

53.

Grontved A, Ried-Larsen M, Moller NC, Kristensen PL, Wedderkopp N, Froberg K, et al. Youth screen-time behaviour is associated with cardiovascular risk in young adulthood: the European Youth Heart Study. Eur J Prev Cardiol. 2014;21(1):49–56. [PubMed: 22767966]

54.

Hjorth MF, Chaput JP, Damsgaard CT, Dalskov SM, Andersen R, Astrup A, et al. Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: a longitudinal study in 8-11 year old Danish children. PLoS One. 2014;9(8):e104677. [PMC free article: PMC4125285] [PubMed: 25102157]

55.

Wennberg P, Gustafsson PE, Dunstan DW, Wennberg M, Hammarstrom A. Television viewing and low leisure-time physical activity in adolescence independently predict the metabolic syndrome in mid-adulthood. Diabetes Care. 2013;36(7):2090–7. [PMC free article: PMC3687313] [PubMed: 23340896]

56.

Atkin AJ, Ekelund U, Moller NC, Froberg K, Sardinha LB, Andersen LB, et al. Sedentary time in children: influence of accelerometer processing on health relations. Med Sci Sports Exerc. 2013;45(6):1097–104. [PubMed: 23274612]

57.

Berendes A, Meyer T, Hulpke-Wette M, Herrmann-Lingen C. Association of elevated blood pressure with low distress and good quality of life: results from the nationwide representative German Health Interview and Examination Survey for Children and Adolescents. Psychosom Med. 2013;75(4):422–8. [PubMed: 23645707]

58.

Chaput JP, Saunders TJ, Mathieu ME, Henderson M, Tremblay MS, O’Loughlin J, et al. Combined associations between moderate to vigorous physical activity and sedentary behaviour with cardiometabolic risk factors in children. Appl Physiol Nutr Metab. 2013;38(5):477–83. [PubMed: 23668753]

59.

Chinapaw MJ, Altenburg TM, van EM, Gemke RJ, Vrijkotte TG. Screen time and cardiometabolic function in Dutch 5-6 year olds: cross-sectional analysis of the ABCD-study. BMC Public Health. 2014;14:933. [PMC free article: PMC4169832] [PubMed: 25200635]

60.

Colley RC, Garriguet D, Janssen I, Wong SL, Saunders TJ, Carson V, et al. The association between accelerometer-measured patterns of sedentary time and health risk in children and youth: results from the Canadian Health Measures Survey. BMC Public Health. 2013;13:200. [PMC free article: PMC3599834] [PubMed: 23497190]

61.

Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A, et al. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents.[Erratum appears in JAMA. 2012 May 9;307(18):1915 Note: Sardinha L [corrected to Sardinha, L B]; Anderssen, S A [corrected to Anderson, L B]]. JAMA. 2012;307(7):704–12. [PMC free article: PMC3793121] [PubMed: 22337681]

62.

Fang YL, Liang L, Fu JF, Gong CX, Xiong F, Liu GL, et al. Level of non-high-density-lipoprotein cholesterol and its related factors in Chinese Han students. Hong Kong J Paediatr. 2013;18(4):210–6.

63.

Giussani M, Antolini L, Brambilla P, Pagani M, Zuccotti G, Valsecchi MG, et al. Cardiovascular risk assessment in children: role of physical activity, family history and parental smoking on BMI and blood pressure. J Hypertens. 2013;31(5):983–92. [PubMed: 23425707]

64.

Gopinath B, Baur LA, Hardy LL, Kifley A, Rose KA, Wong TY, et al. Relationship between a range of sedentary behaviours and blood pressure during early adolescence. J Hum Hypertens. 2012;26(6):350–6. [PubMed: 21614023]

65.

Hardy L, E D-W, Thrift A, Okely A, Baur L. Screen time and metabolic risk factors among adolescents. Pediatr Adolesc Med. 2010;164(7):643–9. [PubMed: 20603465]

66.

Henderson M, Gray-Donald K, Mathieu ME, Barnett TA, Hanley JA, O’Loughlin J, et al. How are physical activity, fitness, and sedentary behavior associated with insulin sensitivity in children? Diabetes Care. 2012;35(6):1272–8. [PMC free article: PMC3357250] [PubMed: 22492585]

67.

Henderson M, Gray-Donald K, Rabasa-Lhoret R, Bastard JP, Barnett TA, Benedetti A, et al. Insulin secretion and its association with physical activity, fitness and screen time in children. Obesity. 2014;22(2):504–11. [PubMed: 24030901]

68.

Martinez-Gomez D, Rey-Lopez JP, Chillon P, Gomez-Martinez S, Vicente-Rodriguez G, Martin-Matillas M, et al. Excessive TV viewing and cardiovascular disease risk factors in adolescents. The AVENA cross-sectional study. BMC Public Health. 2010;10:274. [PMC free article: PMC2892447] [PubMed: 20500845]

69.

Pahkala K, Heinonen OJ, Lagstrom H, Hakala P, Hakanen M, Hernelahti M, et al. Clustered metabolic risk and leisure-time physical activity in adolescents: effect of dose? Br J Sports Med. 2012;46(2):131–7. [PubMed: 20961920]

70.

Rey-Lopez JP, Bel-Serrat S, Santaliestra-Pasias A, de Moraes AC, Vicente-Rodriguez G, Ruiz JR, et al. Sedentary behaviour and clustered metabolic risk in adolescents: the HELENA study. Nutr Metab Cardiovasc Dis. 2013;23(10):1017–24. [PubMed: 22906564]

71.

Saunders TJ, Tremblay MS, Mathieu ME, Henderson M, O’Loughlin J, Tremblay A, et al. Associations of sedentary behavior, sedentary bouts and breaks in sedentary time with cardiometabolic risk in children with a family history of obesity. PLoS One. 2013;8(11):e79143. [PMC free article: PMC3835898] [PubMed: 24278117]

72.

Sisson SB, Shay CM, Camhi SM, Short KR, Whited T. Sitting and cardiometabolic risk factors in U.S. adolescents. J Allied Health. 2013;42(4):236–42. [PubMed: 24326921]

73.

Staiano AE, Harrington DM, Broyles ST, Gupta AK, Katzmarzyk PT. Television, adiposity, and cardiometabolic risk in children and adolescents. Am J Prev Med. 2013;44(1):40–7. [PMC free article: PMC3527837] [PubMed: 23253648]

74.

Stamatakis E, Coombs N, Jago R, Gama A, Mourao I, Nogueira H, et al. Type-specific screen time associations with cardiovascular risk markers in children. Am J Prev Med. 2013;44(5):481–8. [PubMed: 23597812]

75.

Vaisto J, Eloranta AM, Viitasalo A, Tompuri T, Lintu N, Karjalainen P, et al. Physical activity and sedentary behaviour in relation to cardiometabolic risk in children: cross-sectional findings from the Physical Activity and Nutrition in Children (PANIC) Study. Int J Behav Nutr Phys Act. 2014;11:55. [PMC free article: PMC4008488] [PubMed: 24766669]

76.

Yoshinaga M, Hatake S, Tachikawa T, Shinomiya M, Miyazaki A, Takahashi H. Impact of lifestyles of adolescents and their parents on cardiovascular risk factors in adolescents. J Atheroscler Thromb. 2011;18(11):981–90. [PubMed: 21836372]

77.

You MA, Son YJ. Prevalence of metabolic syndrome and associated risk factors among Korean adolescents: analysis from the Korean national survey. Asia Pac J Public Health. 2012;24(3):464–71. [PubMed: 21527432]

78.

Carson V, Janssen I. Volume, patterns, and types of sedentary behavior and cardio-metabolic health in children and adolescents: a cross-sectional study. BMC Public Health. 2011;11:274. [PMC free article: PMC3112118] [PubMed: 21542910]

79.

Barlett ND, Gentile DA, Barlett CP, Eisenmann JC, Walsh DA. Sleep as a mediator of screen time effects on US children’s health outcomes: A prospective study. J Child Media. 2012;6(1):37–50.

80.

Basterfield L, Pearce MS, Adamson AJ, Frary JK, Parkinson KN, Wright CM, et al. Physical activity, sedentary behavior, and adiposity in English children. Am J Prev Med. 2012;42(5):445–51. [PubMed: 22516483]

81.

Basterfield L, Pearce MS, Adamson AJ, Reilly JK, Parkinson KN, Reilly JJ, et al. Effect of choice of outcome measure on studies of the etiology of obesity in children. Ann Epidemiol. 2012;22(12):888–91. [PubMed: 23084839]

82.

Creighton MJ, Goldman N, Teruel G, Rubalcava L. Migrant networks and pathways to child obesity in Mexico.. Soc Sci Med. 2011;72(5):685–93. [PMC free article: PMC3057383] [PubMed: 21277058]

83.

Drenowatz C, Kobel S, Kettner S, Kesztyus D, Wirt T, Dreyhaupt J, et al. Correlates of weight gain in German children attending elementary school. Prev Med. 2013;57(4):310–4. [PubMed: 23769901]

84.

Fuller-Tyszkiewicz M, Skouteris H, Hardy LL, Halse C. The associations between TV viewing, food intake, and BMI. A prospective analysis of data from the Longitudinal Study of Australian Children. Appetite. 2012;59(3):945–8. [PubMed: 23000277]

85.

Hands BP, Chivers PT, Parker HE, Beilin L, Kendall G, Larkin D. The associations between physical activity, screen time and weight from 6 to 14 yrs: The Raine Study. J Sci Med Sport. 2011;14(5):397–403. [PubMed: 21531620]

86.

Hjorth MF. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: Support from a longitudinal study in 8- to 11-year-old children. Int J Obes. 2014;38(7):959–65. [PubMed: 24304596]

87.

Kwon S, Burns TL, Levy SM, Janz KF. Which contributes more to childhood adiposity-high levels of sedentarism or low levels of moderate-through-vigorous physical activity? The Iowa Bone Development Study. J Pediatr. 2013;162(6):1169–74. [PMC free article: PMC3664130] [PubMed: 23305957]

88.

Lin LJ, Chang HY, Luh DL, Hurng BS, Yen LL. The trajectory and the related physical and social determinants of body mass index in elementary school children: results from the child and adolescent behaviors in long-term evolution study. J Obes. 2014;2014:728762. [PMC free article: PMC4119650] [PubMed: 25114800]

89.

Magee CA, Caputi P, Iverson DC. Patterns of health behaviours predict obesity in Australian children. J Paediatr Child Health. 2013;49(4):291–6. [PubMed: 23574555]

90.

Miller DP. Associations between the home and school environments and child body mass index. Soc Sci Med. 2011;72(5):677–84. [PubMed: 21227558]

91.

Olafsdottir S, Berg C, Eiben G, Lanfer A, Reisch L, Ahrens W, et al. Young children’s screen activities, sweet drink consumption and anthropometry: results from a prospective European study. Eur J Clin Nutr. 2014;68(2):223–8. [PubMed: 24253759]

92.

Wijga AH, Scholtens S, Bemelmans WJ, Kerkhof M, Koppelman GH, Brunekreef B, et al. Diet, Screen Time, Physical Activity, and Childhood Overweight in the General Population and in High Risk Subgroups: Prospective Analyses in the PIAMA Birth Cohort. J Obes. 2010;2010. [PMC free article: PMC2915806] [PubMed: 20721356]

93.

Williams SM, Taylor RW, Taylor BJ. Secular changes in BMI and the associations between risk factors and BMI in children born 29 years apart. Pediatr Obes. 2013;8(1):21–30. [PubMed: 23001951]

94.

Chen YC, Tu YK, Huang KC, Chen PC, Chu DC, Lee YL. Pathway from central obesity to childhood asthma. Physical fitness and sedentary time are leading factors. Am J Respir Crit Care Med. 2014;189(10):1194–203. [PubMed: 24669757]

95.

Mitchell JA, Pate RR, Beets MW, Nader PR. Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years. Int J Obes. 2013;37(1):54–60. [PubMed: 22430304]

96.

Mitchell JA, Rodriguez D, Schmitz KH, udrain-McGovern J. Greater screen time is associated with adolescent obesity: a longitudinal study of the BMI distribution from Ages 14 to 18. Obesity. 2013;21(3):572–5. [PMC free article: PMC3630469] [PubMed: 23592665]

97.

Altenburg TM, Singh AS, van MW, Brug J, Chinapaw MJ. Direction of the association between body fatness and self-reported screen time in Dutch adolescents. Int J Behav Nutr Phys Act. 2012;9:4. [PMC free article: PMC3398280] [PubMed: 22273542]

98.

Augustin NH, Mattocks C, Cooper AR, Ness AR, Faraway JJ. Modelling fat mass as a function of weekly physical activity profiles measured by actigraph accelerometers. Physiol Meas. 2012;33(11):1831–9. [PubMed: 23110964]

99.

Barnett TA, O’Loughlin J, Sabiston CM, Karp I, Belanger M, Van HA, et al. Teens and screens: the influence of screen time on adiposity in adolescents. Am J Epidemiol. 2010;172(3):255–62. [PubMed: 20616201]

100.

Falbe J, Rosner B, Willett WC, Sonneville KR, Hu FB, Field AE. Adiposity and different types of screen time. Pediatrics. 2013;132(6):e1497–e505. [PMC free article: PMC3838528] [PubMed: 24276840]

101.

Gilbert-Diamond D, Li Z, chi-Mejia AM, McClure AC, Sargent JD. Association of a television in the bedroom with increased adiposity gain in a nationally representative sample of children and adolescents. Jama Pediatr. 2014;168(5):427–34. [PMC free article: PMC4141563] [PubMed: 24589630]

102.

Veitch J, van Stralen MM, Chinapaw MJ, Te Velde SJ, Crawford D, Salmon J, et al. The neighborhood social environment and body mass index among youth: a mediation analysis. Int J Behav Nutr Phys Act. 2012;9:31. [PMC free article: PMC3331800] [PubMed: 22429957]

103.

Calamaro CJ, Park S, Mason TB. Shortened sleep duration does not predict obesity in adolescents.. J Sleep Res. 2010;19(4):559–66. [PMC free article: PMC2965312] [PubMed: 20545836]

104.

Van den Bulck J, Hofman A. The television-to-exercise ratio is a predictor of overweight in adolescents: results from a prospective cohort study with a two year follow up. Prev Med. 2009;48(4):368–71. [PubMed: 19463482]

105.

Mamun AA, O’Callaghan MJ, Williams G, Najman JM. Television watching from adolescence to adulthood and its association with BMI, waist circumference, waist-to-hip ratio and obesity: a longitudinal study. Public Health Nutr. 2013;16(1):54–64. [PMC free article: PMC10271642] [PubMed: 22687709]

106.

Al-Ghamdi SH. The association between watching television and obesity in children of school-age in Saudi Arabia. J Family Community Med. 2013;20(2):83–9. [PMC free article: PMC3748652] [PubMed: 23983559]

107.

Huang HM, Chien LY, Yeh TC, Lee PH, Chang PC. Relationship between media viewing and obesity in school-aged children in Taipei, Taiwan. J Nurs Res. 2013;21(3):195–203. [PubMed: 23958609]

108.

Xi B, Wang C, Wu L, Zhang M, Shen Y, Zhao X, et al. Influence of physical inactivity on associations between single nucleotide polymorphisms and genetic predisposition to childhood obesity. Am J Epidemiol. 2011;173(11):1256–62. [PubMed: 21527513]

109.

Yi X, Yin C, Chang M, Xiao Y. Prevalence and risk factors of obesity among school-aged children in Xi’an, China. Eur J Pediatr. 2012;171(2):389–94. [PubMed: 21912892]

110.

Zurriaga O, Perez-Panades J, Quiles IJ, Gil CM, Anes Y, Quinones C, et al. Factors associated with childhood obesity in Spain. The OBICE study: a case-control study based on sentinel networks. Public Health Nutr. 2011;14(6):1105–13. [PubMed: 21299916]

111.

Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO. Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region. Int J Behav Nutr Phys Act. 2011;8:140. [PMC free article: PMC3339333] [PubMed: 22188825]

112.

Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO. Lifestyle factors associated with overweight and obesity among Saudi adolescents. BMC Public Health. 2012;12:354. [PMC free article: PMC3433359] [PubMed: 22591544]

113.

Allender S, Kremer P, de Silva-Sanigorski A, Lacy K, Millar L, Mathews L, et al. Associations between activity-related behaviours and standardized BMI among Australian adolescents. J Sci Med Sport. 2011;14(6):512–21. [PubMed: 21683651]

114.

Al-Nakeeb Y, Lyons M, Collins P, Al-Nuaim A, Al-Hazzaa H, Duncan MJ, et al. Obesity, physical activity and sedentary behavior amongst British and Saudi youth: a cross-cultural study. Int J Environ Res Public Health. 2012;9(4):1490–506. [PMC free article: PMC3366625] [PubMed: 22690207]

115.

Badawi NES, Barakat AA, El Sherbini SA, Fawzy HM. Prevalence of overweight and obesity in primary school children in Port Said city. Gaz Egypt Paediatr Assoc. 2013;61(1):31–6.

116.

Beets MW, Foley JT. Comparison of 3 different analytic approaches for determining risk-related active and sedentary behavioral patterns in adolescents. J Phys Act Health. 2010;7(3):381–92. [PubMed: 20551496]

117.

Bener A, Al-Mahdi HS, Ali AI, Al-Nufal M, Vachhani PJ, Tewfik I. Obesity and low vision as a result of excessive Internet use and television viewing. Int J Food Sci Nutr. 2011;62(1):60–2. [PubMed: 20645888]

118.

Bingham DD, Varela-Silva MI, Ferrao MM, Augusta G, Mourao MI, Nogueira H, et al. Socio-demographic and behavioral risk factors associated with the high prevalence of overweight and obesity in Portuguese children. Am J Hum Biol. 2013;25(6):733–42. [PubMed: 24000096]

119.

Bishwalata R, Singh AB, Singh AJ, Devi LU, Singh RK. Overweight and obesity among schoolchildren in Manipur, India. Natl Med J India. 2010;23(5):263–6. [PubMed: 21250579]

120.

Bozza R, de CW, raujo Bacil ED, Barbosa F, V, Hardt JM, da Silva PM. [Sociodemographic and behavioral factors associated with body adiposity in adolescents]. [Portuguese]. Rev Paul Pediatr. 2014;32(3):241–6. [PMC free article: PMC4227347] [PubMed: 25479856]

121.

Bracale R, Milani L, Ferrara E, Balzaretti C, Valerio A, Russo V, et al. Childhood obesity, overweight and underweight: a study in primary schools in Milan. Eat Weight Disord. 2013;18(2):183–91. [PMC free article: PMC3664740] [PubMed: 23760847]

122.

Braithwaite I, Stewart AW, Hancox RJ, Beasley R, Murphy R, Mitchell EA, et al. The worldwide association between television viewing and obesity in children and adolescents: cross sectional study. PLoS One. 2013;8(9):e74263. [PMC free article: PMC3783429] [PubMed: 24086327]

123.

Brown JE, Broom DH, Nicholson JM, Bittman M. Do working mothers raise couch potato kids? Maternal employment and children’s lifestyle behaviours and weight in early childhood. Social Science & Medicine. 2010;70(11):1816–24. [PubMed: 20299142]

124.

Brown JE, Nicholson JM, Broom DH, Bittman M. Television viewing by school-age children: Associations with physical activity, snack food consumption and unhealthy weight. Soc Indic Res. 2011;101(2):221–5.

125.

Busch V, Manders LA, De L, Jr. Screen time associated with health behaviors and outcomes in adolescents. Am J Health Behav. 2013;37(6):819–30. [PubMed: 24001631]

126.

Cameron AJ, van Stralen MM, Brug J, Salmon J, Bere E, Chinapaw MJ, et al. Television in the bedroom and increased body weight: potential explanations for their relationship among European schoolchildren. Pediatr Obes. 2013;8(2):130–41. [PubMed: 23239631]

127.

Carriere C, Langevin C, Lamireau T, Maurice S, Thibault H. Dietary behaviors as associated factors for overweight and obesity in a sample of adolescents from Aquitaine, France. J Physiol Biochem. 2013;69(1):111–8. [PubMed: 22773296]

128.

Carson V, Janssen I. The mediating effects of dietary habits on the relationship between television viewing and body mass index among youth. Pediatr Obes. 2012;7(5):391–8. [PubMed: 22461393]

129.

Carson V, Stone M, Faulkner G. Patterns of sedentary behavior and weight status among children. Pediatr Exerc Sci. 2014;26(1):95–102. [PubMed: 24092774]

130.

Casiano H, Kinley D. Media use and health outcomes in adolescents: Findings form a nationally representative survey. J Can Acad Child Adolesc Psychiatry. 2012;21(4):296–301. [PMC free article: PMC3490531] [PubMed: 23133464]

131.

Chahal H, Fung C, Kuhle S, Veugelers PJ. Availability and night-time use of electronic entertainment and communication devices are associated with short sleep duration and obesity among Canadian children. Pediatr Obes. 2013;8(1):42–51. [PubMed: 22962067]

132.

Chaput JP, Lambert M, Mathieu ME, Tremblay MS, O’ LJ, Tremblay A. Physical activity vs. sedentary time: independent associations with adiposity in children. Pediatr Obes. 2012;7(3):251–8. [PubMed: 22461356]

133.

Chaput JP, Leduc G, Boyer C, Belanger P, LeBlanc AG, Borghese MM, et al. Objectively measured physical activity, sedentary time and sleep duration: independent and combined associations with adiposity in canadian children. Nutr Diabetes. 2014;4:e117. [PMC free article: PMC4079924] [PubMed: 24911633]

134.

Chen LP, Ziegenfuss JY, Jenkins SM, Beebe TJ, Ytterberg KL. Pediatric obesity and self-reported health behavior information. Clin Pediatr. 2011;50(9):872–5. [PubMed: 21357199]

135.

Colley RC, Wong SL, Garriguet D, Janssen I, Connor GS, Tremblay MS. Physical activity, sedentary behaviour and sleep in Canadian children: parent-report versus direct measures and relative associations with health risk. Health Rep. 2012;23(2):45–52. [PubMed: 22866540]

136.

de JE, Visscher TL, Hirasing RA, Heymans MW, Seidell JC, Renders CM. Association between TV viewing, computer use and overweight, determinants and competing activities of screen time in 4- to 13-year-old children. Int J Obes. 2013;37(1):47–53. [PubMed: 22158265]

137.

Decelis A, Jago R, Fox KR. Physical activity, screen time and obesity status in a nationally representative sample of Maltese youth with international comparisons. BMC Public Health. 2014;14:664. [PMC free article: PMC4091762] [PubMed: 24973912]

138.

Drake KM, Beach ML, Longacre MR, Mackenzie T, Titus LJ, Rundle AG, et al. Influence of sports, physical education, and active commuting to school on adolescent weight status. Pediatrics. 2012;130(2):e296–e304. [PMC free article: PMC3408684] [PubMed: 22802608]

139.

Dundar C, Oz H. Obesity-related factors in Turkish school children. ScientificWorldJournal. 2012;2012:353485. [PMC free article: PMC3322393] [PubMed: 22547980]

140.

Dupuy M, Godeau E, Vignes C, Ahluwalia N. Socio-demographic and lifestyle factors associated with overweight in a representative sample of 11-15 year olds in France: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) cross-sectional study. BMC Public Health. 2011;11:442. [PMC free article: PMC3123212] [PubMed: 21649892]

141.

Ekstedt M, Nyberg G, Ingre M, Ekblom O, Marcus C. Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study. Int J Behav Nutr Phys Act. 2013;10:82. [PMC free article: PMC3691618] [PubMed: 23800204]

142.

Ercan S, Dallar YB, Onen S, Engiz O. Prevalence of obesity and associated risk factors among adolescents in Ankara, Turkey. J Clin Res Pediatr Endocrinol. 2012;4(4):204–7. [PMC free article: PMC3537287] [PubMed: 23149433]

143.

Farajian P, Panagiotakos DB, Risvas G, Malisova O, Zampelas A. Hierarchical analysis of dietary, lifestyle and family environment risk factors for childhood obesity: the GRECO study. Eur J Clin Nutr. 2014;68(10):1107–12. [PubMed: 24824010]

144.

Fernandes RA, Christofaro DG, Cardoso JR, Ronque ER, Freitas J, I, Kawaguti SS, et al. Socioeconomic status as determinant of risk factors for overweight in adolescents. Cien Saude Colet. 2011;16(10):4051–7. [PubMed: 22031134]

145.

Fernandez-Alvira JM, Te Velde SJ, De B, I, Bere E, Manios Y, Kovacs E, et al. Parental education associations with children’s body composition: mediation effects of energy balance-related behaviors within the ENERGY-project. Int J Behav Nutr Phys Act. 2013;10:80. [PMC free article: PMC3695820] [PubMed: 23800170]

146.

Ferrar K, Olds T. Thin adolescents: Who are they? What do they do? Socio-demographic and use-of-time characteristics. Prev Med. 2010;51(3–4):253–8. [PubMed: 20630482]

147.

Garmy P, Clausson EK, Nyberg P, Jakobsson U. Overweight and television and computer habits in Swedish school-age children and adolescents: a cross-sectional study. Nurs Health Sci. 2014;16(2):143–8. [PMC free article: PMC4237184] [PubMed: 23796145]

148.

Ghavamzadeh S, Khalkhali HR, Alizadeh M. TV viewing, independent of physical activity and obesogenic foods, increases overweight and obesity in adolescents. J Health Popul Nutr. 2013;31(3):334–42. [PMC free article: PMC3805883] [PubMed: 24288947]

149.

Gonzalez Montero de EM, Herraez A, Marrodan S, M.D. [Determining factors in body mass index of Spanish schoolchildren based on the National Health Surveys]. [Spanish]. Endocrinologia y Nutricion. 2013;60(7):371–8. [PubMed: 23665404]

150.

Govindan M, Gurm R, Mohan S, Kline-Rogers E, Corriveau N, Goldberg C, et al. Gender differences in physiologic markers and health behaviors associated with childhood obesity. Pediatrics. 2013;132(3):468–74. [PubMed: 23940242]

151.

Goyal JP, Kumar N, Parmar I, Shah VB, Patel B. Determinants of Overweight and Obesity in Affluent Adolescent in Surat City, South Gujarat region, India. Indian J Community Health. 2011;36(4):296–300. [PMC free article: PMC3263151] [PubMed: 22279261]

152.

Graff M, North K. Screen time behaviours may interact with obesity genes, independent of physical activity, to influence adolescent BMI in an ethnically diverse cohort. Pediatr Obes. 2013;8(6):e74–e9. [PMC free article: PMC3838440] [PubMed: 24039247]

153.

Gregori D, Foltran F, Ghidina M, Zobec F, Berchialla P. Familial environment in high- and middle-low-income municipalities: a survey in Italy to understand the distribution of potentially obesogenic factors. Public Health. 2012;126(9):731–9. [PubMed: 22789548]

154.

Grydeland M, Bergh IH, Bjelland M, Lien N, Andersen LF, Ommundsen Y, et al. Correlates of weight status among Norwegian 11-year-olds: The HEIA study. BMC Public Health. 2012;12:1053. [PMC free article: PMC3538064] [PubMed: 23216675]

155.

Hardy LL, King L, Hector D, Lloyd B. Weight status and weight-related behaviors of children commencing school. Prev Med. 2012;55(5):433–7. [PubMed: 22995371]

156.

Hatami M, Taib MN, Jamaluddin R, Saad HA, Djazayery A, Chamari M, et al. Dietary factors as the major determinants of overweight and obesity among Iranian adolescents. A cross-sectional study. Appetite. 2014;82:194–201. [PubMed: 25068789]

157.

Herman KM, Sabiston CM, Mathieu ME, Tremblay A, Paradis G. Sedentary behavior in a cohort of 8- to 10-year-old children at elevated risk of obesity. Prev Med. 2014;60:115–20. [PubMed: 24398174]

158.

Rajmil L, Lopez-Aguila S, Mompart-Penina A. [Health-related quality of life and factors associated with overweight and obesity in the pediatric population of Catalonia, Spain]. [Spanish]. Med Clin. 2011;137: Suppl 2:37–41. [PubMed: 22310362]

159.

Hong TK, Nguyen HH, Dibley MJ, Sibbritt DW, Phan NT, Tran TM. Factors associated with adolescent overweight/obesity in Ho Chi Minh city. Int J Pediatr Obes. 2010;5(5):396–403. [PubMed: 20233155]

160.

Hsu YW, Johnson C. Correlates of overweight status in Chinese youth: An East-West paradox. Am J Health Behav. 2011;35(4):496–506. [PubMed: 22040595]

161.

Inanc BB, Sahin DS, Oguzoncul AF, Bindak R, Mungan F. Prevalence of obesity in elementary schools in mardin, South-eastern of Turkey: a preliminary study. Balkan Med J. 2012;29(4):424–30. [PMC free article: PMC4115880] [PubMed: 25207047]

162.

Ismailov RM, Leatherdale ST. Rural-urban differences in overweight and obesity among a large sample of adolescents in Ontario. Int J Pediatr Obes. 2010;5(4):351–60. [PubMed: 20053147]

163.

Jahns L, Adair L, Mroz T, Popkin BM. The declining prevalence of overweight among Russian children: income, diet, and physical activity behavior changes. Econ Hum Biol. 2012;10(2):139–46. [PMC free article: PMC3268832] [PubMed: 21840274]

164.

Januszek-Trzciakowska A, Malecka-Tendera E, Klimek K, Matusik P. Obesity risk factors in a representative group of Polish prepubertal children. Arch Med Sci. 2014;10(5):880–5. [PMC free article: PMC4223122] [PubMed: 25395938]

165.

Jayawardene W, Lohrmann D, YoussefAgha A. Discrepant body mass index: behaviors associated with height and weight misreporting among US adolescents from the National Youth Physical Activity and Nutrition Study. Childhood obesity. 2014;10(3):225–33. [PubMed: 24828965]

166.

Jones RA, Okely AD, Caputi P, Cliff DP. Relationships between child, parent and community characteristics and weight status among young children. Int J Pediatr Obes. 2010;5(3):256–64. [PubMed: 19900149]

167.

Kantanista A, Osinski W. Underweight in 14 to 16 year-old girls and boys: prevalence and associations with physical activity and sedentary activities. Ann Agric Environ Med. 2014;21(1):114–9. [PubMed: 24738508]

168.

Katzmarzyk PT, Barreira TV, Broyles ST, Champagne CM, Chaput JP, Fogelholm M, et al. Relationship between lifestyle behaviors and obesity in 9-11 year old children: Results from a 12-country study (in press). Obesity. 2015.

169.

Katzmarzyk PT, Barreira TV, Broyles ST, Champagne CM, Chaput JP, Fogelholm M, et al. Physical Activity, Sedentary Time, and Obesity in an International Sample of Children (in press). Med Sci Sports Exerc. 2015. [PubMed: 25751770]

170.

Kettner S, Kobel S, Fischbach N, Drenowatz C, Dreyhaupt J, Wirt T, et al. Objectively determined physical activity levels of primary school children in south-west Germany. BMC Public Health. 2013;13:895. [PMC free article: PMC3852634] [PubMed: 24073638]

171.

Kimbro RT, Brooks-Gunn J, McLanahan S. Young children in urban areas: links among neighborhood characteristics, weight status, outdoor play, and television watching. Soc Sci Med. 2011;72(5):668–76. [PMC free article: PMC3058513] [PubMed: 21324574]

172.

Kristiansen H, Juliusson PB, Eide GE, Roelants M, Bjerknes R. TV viewing and obesity among Norwegian children: the importance of parental education. Acta Paediatr. 2013;102(2):199–205. [PubMed: 23121043]

173.

Kuhle S, Allen AC, Veugelers PJ. Perinatal and childhood risk factors for overweight in a provincial sample of Canadian grade 5 students. Int J Pediatr Obes. 2010;5(1):88–96. [PubMed: 19565401]

174.

Kuriyan R, Thomas T, Sumithra S, Lokesh DP, Sheth NR, Joy R, et al. Potential factors related to waist circumference in urban South Indian children. Indian Pediatr. 2012;49(2):124–8. [PubMed: 21719930]

175.

Lane A, Harrison M, Murphy N. Screen time increases risk of overweight and obesity in active and inactive 9-year-old Irish children: a cross sectional analysis. Journal of physical activity & health. 2014;11(5):985–91. [PubMed: 23799255]

176.

Leatherdale ST, Papadakis S. A multi-level examination of the association between older social models in the school environment and overweight and obesity among younger students. J Youth Adolesc. 2011;40(3):361–72. [PubMed: 20013351]

177.

Lee B, Kim H, Lee SK, Yoon J, Chung SJ. Effects of exposure to television advertising for energy-dense/nutrient-poor food on children’s food intake and obesity in South Korea. Appetite. 2014;81:305–11. [PubMed: 24996594]

178.

Legnani E, Legnani RF, Filho VC, Krinski K, Elsangedy HM, de CW, et al. [Factors associated with overweight in students from tri-border region: Argentina, Brazil and Paraguay]. [Spanish]. Arch Latinoam Nutr. 2010;60(4):340–7. [PubMed: 21866683]

179.

Liou YM, Liou TH, Chang LC. Obesity among adolescents: sedentary leisure time and sleeping as determinants. J Adv Nurs. 2010;66(6):1246–56. [PubMed: 20546358]

180.

Lissner L, Lanfer A, Gwozdz W, Olafsdottir S, Eiben G, Moreno LA, et al. Television habits in relation to overweight, diet and taste preferences in European children: the IDEFICS study. Eur J Epidemiol. 2012;27(9):705–15. [PMC free article: PMC3486991] [PubMed: 22911022]

181.

Marques A, Gaspar De MM. Trends and correlates of overweight and Obesity among adolescents from 2002 to 2010: A three-cohort study based on a representative sample of Portuguese adolescents. Am J Hum Biol. 2014;26(6):844–9. [PubMed: 25176416]

182.

Martinez-Gomez D, Moreno LA, Romeo J, Rey-Lopez P, Castillo R, Cabero MJ, et al. Combined influence of lifestyle risk factors on body fat in Spanish adolescents-the Avena study. Obes Facts. 2011;4(2):105–11. [PMC free article: PMC6444635] [PubMed: 21577017]

183.

Masse LC, Blanck HM, Valente M, Atienza AA, gurs-Collins T, Weber D, et al. Association between self-reported household practices and body mass index of US children and adolescents. Prev Chronic Dis. 2012;9:E174. [PMC free article: PMC3523893] [PubMed: 23237244]

184.

McConley RL, Mrug S, Gilliland M. Mediators of maternal depression and family structure on child BMI: Parenting quality and risk factors for child overweight. Obesity. 2011;19(2):345–52. [PubMed: 20798670]

185.

Mejia D, Berchtold A, Belanger RE, Kuntsche EN, Michaud PA, Suris JC. Frequency and effects of meeting health behaviour guidelines among adolescents. Eur J Public Health. 2013;23(1):8–13. [PubMed: 22544912]

186.

Melkevik O, Torsheim T, Rasmussen M. Patterns of screen-based sedentary behavior and physical activity and associations with overweight among Norwegian adolescents: A latent profile approach. Nor Epidemiol. 2010;20(1):109–17.

187.

Morley BC, Scully ML, Niven PH, Okely AD, Baur LA, Pratt IS, et al. What factors are associated with excess body weight in Australian secondary school students? Med J Aust. 2012;196(3):189–92. [PubMed: 22339525]

188.

Mungrue K, Fyzul A, Ramroop S, Persad T, Asgarali A. Are teenagers at risk for developing cardiovascular disease in later life? Int J Adolesc Med Health. 2013;25(1):75–80. [PubMed: 23314517]

189.

Mushtaq MU, Gull S, Mushtaq K, Shahid U, Shad MA, Akram J. Dietary behaviors, physical activity and sedentary lifestyle associated with overweight and obesity, and their socio-demographic correlates, among Pakistani primary school children. Int J Behav Nutr Phys Act. 2011;8. [PMC free article: PMC3250930] [PubMed: 22117626]

190.

Nigg C, Shor B, Tanaka CY, Hayes DK. Adolescent at-risk weight (overweight and obesity) prevalence in Hawai’i. Hawaii Med J. 2011;70(7 Suppl 1):4–10. [PMC free article: PMC3158456] [PubMed: 21886286]

191.

Olds TS, Maher CA, Ridley K, Kittel DM. Descriptive epidemiology of screen and nonscreen sedentary time in adolescents: A cross sectional study. Int J Behav Nutr Phys Act. 2010;7. [PMC free article: PMC3024298] [PubMed: 21194427]

192.

Peart T, Velasco Mondragon HE, Rohm-Young D, Bronner Y, Hossain MB. Weight status in US youth: the role of activity, diet, and sedentary behaviors. Am J Health Behav. 2011;35(6):756–64. [PubMed: 22251766]

193.

Peltzer K, Pengpid S. Overweight and obesity and associated factors among school-aged adolescents in Ghana and Uganda. Int J Environ Res Public Health. 2011;8(10):3859–70. [PMC free article: PMC3210586] [PubMed: 22073017]

194.

Perez VS, Novalbos-Ruiz JP, Rodriguez-Martin A, Martinez-Nieto JM, Lechuga-Sancho AM. Implications of family socioeconomic level on risk behaviors in child-youth obesity. Nutr Hosp. 2013;28(6):1951–60. [PubMed: 24506374]

195.

Pitrou I, Shojaei T, Wazana A, Gilbert F, Kovess-Masfety V. Child overweight, associated psychopathology, and social functioning: a French school-based survey in 6- to 11-year-old children. Obesity. 2010;18(4):809–17. [PubMed: 19713951]

196.

Rani MA, Sathiyasekaran BW. Behavioural determinants for obesity: a cross-sectional study among urban adolescents in India. J Prev Med Public Health / Yebang Uihakhoe Chi. 2013;46(4):192–200. [PMC free article: PMC3740224] [PubMed: 23946877]

197.

Rey-Lopez JP, Ruiz JR, Vicente-Rodriguez G, Gracia-Marco L, Manios Y, Sjostrom M, et al. Physical activity does not attenuate the obesity risk of TV viewing in youth. Pediatr Obes. 2012;7(3):240–50. [PubMed: 22434777]

198.

Rivera IR, Silva MA, Silva RD, Oliveira BA, Carvalho AC. Physical inactivity, TV-watching hours and body composition in children and adolescents. Arq Bras Cardiol. 2010;95(2):159–65. [PubMed: 20563518]

199.

Saab PG, Fitzpatrick S, Lai B, McCalla JR. Elevated body mass index and obesity among ethnically diverse adolescents. Ethn Dis. 2011;21(2):176–82. [PMC free article: PMC7485167] [PubMed: 21749021]

200.

Seo DC, Niu J. Trends in underweight and overweight/obesity prevalence in Chinese youth, 2004-2009. Int J Behav Med. 2014;21(4):682–90. [PubMed: 23744048]

201.

Shan XY, Xi B, Cheng H, Hou DQ, Wang Y, Mi J. Prevalence and behavioral risk factors of overweight and obesity among children aged 2-18 in Beijing, China. Int J Pediatr Obes. 2010;5(5):383–9. [PubMed: 20233154]

202.

Sigmundova D, Sigmund E, Hamrik Z, Kalman M. Trends of overweight and obesity, physical activity and sedentary behaviour in Czech schoolchildren: HBSC study. Eur J Public Health. 2014;24(2):210–5. [PMC free article: PMC3966283] [PubMed: 23813709]

203.

Sisson SB, Broyles ST, Baker BL, Katzmarzyk PT. Television, reading, and computer time: correlates of school-day leisure-time sedentary behavior and relationship with overweight in children in the U.S. Journal of physical activity & health. 2011;8: Suppl 2:S188–S97. [PubMed: 21918232]

204.

Sluyter JD, Scragg RK, Plank LD, Waqa GD, Fotu KF, Swinburn BA. Sizing the association between lifestyle behaviours and fatness in a large, heterogeneous sample of youth of multiple ethnicities from 4 countries. Int J Behav Nutr Phys Act. 2013;10:115. [PMC free article: PMC3853713] [PubMed: 24119635]

205.

Stamatakis E, Coombs N, Jago R, Gama A, Mour+úo I, Nogueira H, et al. Associations between indicators of screen time and adiposity indices in Portuguese children. Prev Med. 2013;56(5):299–303. [PubMed: 23435406]

206.

Stroebele N, McNally J, Plog A, Siegfried S, Hill JO. The association of self-reported sleep, weight status, and academic performance in fifth-grade students. J Sch Health. 2013;83(2):77–84. [PMC free article: PMC3552381] [PubMed: 23331266]

207.

Suglia SF, Duarte CS, Chambers EC, Boynton-Jarrett R. Social and behavioral risk factors for obesity in early childhood. J Dev Behav Pediatr. 2013;34(8):549–56. [PMC free article: PMC3960979] [PubMed: 24131877]

208.

Taber DR, Stevens J, Poole C, Maciejewski ML, Evenson KR, Ward DS. State disparities in time trends of adolescent body mass index percentile and weight-related behaviors in the United States. J Community Health. 2012;37(1):242–52. [PMC free article: PMC3363325] [PubMed: 21773818]

209.

Tambalis KD, Panagiotakos DB, Kavouras SA, Papoutsakis S, Sidossis LS. Higher prevalence of obesity in Greek children living in rural areas despite increased levels of physical activity. J Paediatr Child Health. 2013;49(9):769–74. [PMC free article: PMC3773292] [PubMed: 23724863]

210.

Thibault H, Carriere C, Langevin C, Kossi DE, Barberger-Gateau P, Maurice S. Prevalence and factors associated with overweight and obesity in French primary-school children. Public Health Nutr. 2013;16(2):193–201. [PMC free article: PMC10271746] [PubMed: 22953729]

211.

Thibault H, Contrand B, Saubusse E, Baine M, Maurice-Tison S. Risk factors for overweight and obesity in French adolescents: physical activity, sedentary behavior and parental characteristics. Nutrition. 2010;26(2):192–200. [PubMed: 19577429]

212.

Tin SP, Ho DS, Mak KH, Wan KL, Lam TH. Association between television viewing and self-esteem in children. J Dev Behav Pediatr. 2012;33(6):479–85. [PubMed: 22772822]

213.

Vaezghasemi M, Lindkvist M, Ivarsson A, Eurenius E. Overweight and lifestyle among 13-15 year olds: a cross-sectional study in northern Sweden. Scand J Public Health. 2012;40(3):221–8. [PubMed: 22637360]

214.

Wang C, Chen P, Zhuang J. A national survey of physical activity and sedentary behavior of Chinese city children and youth using accelerometers. Res Q Exerc Sport. 2013;84: Suppl 2:S12–S28. [PubMed: 24527563]

215.

Wang N, Xu F, Zheng LQ, Zhang XG, Li Y, Sun GZ, et al. Effects of television viewing on body fatness among Chinese children and adolescents. Chin Med J. 2012;125(8):1500–3. [PubMed: 22613659]

216.

Wijtzes AI, Bouthoorn SH, Jansen W, Franco OH, Hofman A, Jaddoe VW, et al. Sedentary behaviors, physical activity behaviors, and body fat in 6-year-old children: the generation R study. Int J Behav Nutr Phys Act. 2014;11:96. [PMC free article: PMC4145220] [PubMed: 25124336]

217.

Wilkosz ME, Chen JL, Kennedy C, Rankin S. Gender and ethnic disparities contributing to overweight in California adolescents.. J Public Health. 2010;18(2):131–44. [PMC free article: PMC2967257] [PubMed: 21088691]

218.

Yako YY, Hassan MS, Erasmus RT, van der ML, Janse van RS, Matsha TE. Associations of MC3R polymorphisms with physical activity in South African adolescents. Journal of physical activity & health. 2013;10(6):813–25. [PubMed: 23072813]

219.

Yen CF, Hsiao RC, Ko CH, Yen JY, Huang CF, Liu SC, et al. The relationships between body mass index and television viewing, internet use and cellular phone use: the moderating effects of socio-demographic characteristics and exercise. Int J Eat Disord. 2010;43(6):565–71. [PubMed: 19718665]

220.

Zhang J, Seo DC, Kolbe L, Middlestadt S, Zhao W. Trends in overweight among school children and adolescents in seven Chinese provinces, from 1991-2004. Int J Pediatr Obes. 2010;5(5):375–82. [PubMed: 20233156]

221.

Zhang J, Seo DC, Kolbe L, Middlestadt S, Zhao W. Associated trends in sedentary behavior and BMI among Chinese school children and adolescents in seven diverse Chinese provinces. Int J Behav Med. 2012;19(3):342–50. [PubMed: 21748473]

222.

Hajian-Tilaki K, Heidari B. Prevalences of overweight and obesity and their association with physical activity pattern among Iranian adolescents aged 12-17 years. Public Health Nutr. 2012;15(12):2246–52. [PMC free article: PMC10271770] [PubMed: 22578771]

223.

Faulkner G, Carson V, Stone M. Objectively measured sedentary behaviour and self-esteem among children. Ment Health Phys Act. 2014;7(1):25–9.

224.

Jackson LA, von Eye A, Fitzgerald HE, Witt EA, Zhao Y. Internet use, videogame playing and cell phone use as predictors of children’s body mass index (BMI), body weight, academic performance, and social and overall self-esteem. Comput Human Behav. 2011;27(1):599–604.

225.

Jackson LA, von Eye A, Fitzgerald HE, Zhao Y, Witt EA. Self-concept, self-esteem, gender, race and information technology use. Comput Human Behav. 2010;26(3):323–8.

226.

Jeong EJ, Kim DH. Social activities, self-efficacy, game attitudes, and game addiction. Cyberpsychol Behav Soc Netw. 2011;14(4):213–21. [PubMed: 21067285]

227.

Kiraly O, Griffiths MD, Urban R, Farkas J, Kokonyei G, Elekes Z, et al. Problematic internet use and problematic online gaming are not the same: findings from a large nationally representative adolescent sample. Cyberpsychol Behav Soc Netw. 2014;17(12):749–54. [PMC free article: PMC4267705] [PubMed: 25415659]

228.

McClure AC, Tanski SE, Kingsbury J, Gerrard M, Sargent JD. Characteristics associated with low self-esteem among US adolescents. Acad Pediatr. 2010;10(4):238–44. [PMC free article: PMC2914631] [PubMed: 20605547]

229.

Nihill GFJ, Lubans DR, Plotnikoff RC. Associations between sedentary behavior and self-esteem in adolescent girls from schools in low-income communities. Ment Health Phys Act. 2013;6(1):30–5.

230.

Racine EF, DeBate RD, Gabriel KP, High RR. The relationship between media use and psychological and physical assets among third- to fifth-grade girls. J Sch Health. 2011;81(12):749–55. [PubMed: 22070506]

231.

Bowers AJ, Berland M. Does recreational computer use affect high school achievement?. Educ Technol Res Dev. 2013;61(1):51–69.

232.

Brunborg GS, Mentzoni RA, Froyland LR. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems? J Behav Addict. 2014;3(1):27–32. [PMC free article: PMC4117274] [PubMed: 25215212]

233.

Romer D, Bagdasarov Z, More E. Older versus newer media and the well-being of United States youth: results from a national longitudinal panel. J Adolesc Health. 2013;52(5):613–9. [PubMed: 23375827]

234.

Sharif I, Wills TA, Sargent JD. Effect of visual media use on school performance: a prospective study. J Adolesc Health. 2010;46(1):52–61. [PMC free article: PMC2818002] [PubMed: 20123258]

235.

Esmaeilzadeh S, Kalantari H-A. Physical fitness, physical activity, sedentary behavior and academic performance among adolescent boys in different weight statuses. Med J Nutrition Metab. 2013;6(3):207–16.

236.

Ferguson CJ. The influence of television and video game use on attention and school problems: a multivariate analysis with other risk factors controlled. J Psychiatr Res. 2011;45(6):808–13. [PubMed: 21144536]

237.

Kiatrungrit K, Hongsanguansri S. Cross-sectional study of use of electronic media by secondary school students in Bangkok, Thailand. Shanghai Jingshen Yixue. 2014;26(4):216–26. [PMC free article: PMC4194004] [PubMed: 25317008]

238.

Martinez-Gomez D, Veiga OL, Gomez-Martinez S, Zapatera B, Martinez-Hernandez D, Calle ME, et al. Gender-specific influence of health behaviors on academic performance in Spanish adolescents: the AFINOS study. Nutr Hosp. 2012;27(3):724–30. [PubMed: 23114936]

239.

Munoz-Miralles R, Ortega-Gonzalez R, Batalla-Martinez C, Lopez-Moron MR, Manresa JM, Toran-Monserrat P. [Access and use of new information and telecommunication technologies among teenagers at high school, health implications. JOITIC Study]. [Spanish]. Aten Primaria. 2014;46(2):77–88. [PMC free article: PMC6983583] [PubMed: 24035765]

240.

Ozmert EN, Ince T, Pektas A, Ozdemir R, Uckardes Y. Behavioral correlates of television viewing in young adolescents in Turkey. Indian Pediatr. 2011;48(3):229–31. [PubMed: 21169649]

241.

Sanchez-Martinez M, Otero PA. Internet and associated factors in adolescents in the Community of Madrid. Aten Primaria. 2010;42(2):79–85. [PMC free article: PMC7022101] [PubMed: 19596495]

242.

Shashi Kumar R, Das RC, Prabhu HR, Bhat PS, Prakash J, Seema P, et al. Interaction of media, sexual activity and academic achievement in adolescents. Armed Forces Med J India. 2013;69(2):138–43. [PMC free article: PMC3862597] [PubMed: 24600087]

243.

Vassiloudis I, Yiannakouris N, Panagiotakos DB, Apostolopoulos K, Costarelli V. Academic performance in relation to adherence to the Mediterranean diet and energy balance behaviors in Greek primary schoolchildren. Journal of nutrition education and behavior. 2014;46(3):164–70. [PubMed: 24433816]

244.

O’Dea JA, Mugridge AC. Nutritional quality of breakfast and physical activity independently predict the literacy and numeracy scores of children after adjusting for socioeconomic status. Health Educ Res. 2012;27(6):975–85. [PubMed: 22798563]

245.

Hoza B, Smith AL, Shoulberg EK, Linnea KS, Dorsch TE, Blazo JA, et al. A randomized trial examining the effects of aerobic physical activity on attention-deficit/hyperactivity disorder symptoms in young children. J Abnorm Child Psychol. 2014. [PMC free article: PMC4826563] [PubMed: 25201345]

246.

Howie EK, Beets MW, Pate RR. Acute classroom exercise breaks improve on-task behavior in 4th and 5th grade students: A dose-response. Ment Health Phys Act. 2014;7(2):65–71.

247.

Gentile DA, Swing EL, Lim CG, Khoo A. Video game playing, attention problems, and impulsiveness: Evidence of bidirectional causality. Psychol Pop Media Cult. 2012;1(1):62–70.

248.

Hofferth SL. Home media and children’s achievement and behavior. Child Dev. 2010;81(5):1598–619. [PMC free article: PMC2941215] [PubMed: 20840243]

249.

Janssen I, Boyce WF, Pickett W. Screen time and physical violence in 10 to 16-year-old Canadian youth. Int J Public Health. 2012;57(2):325–31. [PubMed: 21110059]

250.

Lemmens JS, Valkenburg PM, Peter J. The effects of pathological gaming on aggressive behavior. J Youth Adolesc. 2011;40(1):38–47. [PMC free article: PMC3003785] [PubMed: 20549320]

251.

Parkes A, Sweeting H, Wight D, Henderson M. Do television and electronic games predict children’s psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Arch Dis Child. 2013;98(5):341–8. [PMC free article: PMC3625829] [PubMed: 23529828]

252.

Robertson LA, McAnally HM, Hancox RJ. Childhood and adolescent television viewing and antisocial behavior in early adulthood. Pediatrics. 2013;131(3):439–46. [PMC free article: PMC3581845] [PubMed: 23420910]

253.

Swing EL, Gentile DA, Anderson CA, Walsh DA. Television and video game exposure and the development of attention problems. Pediatrics. 2010;126(2):214–21. [PubMed: 20603258]

254.

Willoughby T, Adachi PJ, Good M. A longitudinal study of the association between violent video game play and aggression among adolescents. Dev Psychol. 2012;48(4):1044–57. [PubMed: 22040315]

255.

Demirok M, Ozdamli F, Hursen C, Ozcinar Z, Kutguner M, Uzunboylu H. The relationship of computer games and reported anger in young people. Australian Journal of Guidance and Counselling. 2012;22(1):33–43.

256.

Griffiths LJ, Dowda M, Dezateux C, Pate R. Associations between sport and screen-entertainment with mental health problems in 5-year-old children. Int J Behav Nutr Phys Act. 2010;7:30. [PMC free article: PMC2867988] [PubMed: 20409310]

257.

Przybylski AK. Electronic gaming and psychosocial adjustment. Pediatrics. 2014;134(3):e716–e22. [PubMed: 25092934]

258.

Rech RR, Halpern R, Tedesco A, Santos DF. Prevalence and characteristics of victims and perpetrators of bullying. J Pediatr. 2013;89(2):164–70. [PubMed: 23642427]

259.

Rosen L. Media and technology use predicts ill-being among children, preteens and teenagers independent of the negative health impacts of exercise and eating habits. Comput Human Behav. 2014;35:364–75. [PMC free article: PMC4338000] [PubMed: 25717216]

260.

Shokouhi-Moqhaddam S, Khezri-Moghadam N, Javanmard Z, Sarmadi-Ansar H, Aminaee M, Shokouhi-Moqhaddam M, et al. A Study of the Correlation between Computer Games and Adolescent Behavioral Problems. Addict Health. 2013;5(1–2):43–50. [PMC free article: PMC3905568] [PubMed: 24494157]

261.

Singh GK, Yu SM. The Impact of Ethnic-Immigrant Status and Obesity-Related Risk Factors on Behavioral Problems among US Children and Adolescents. Scientifica. 2012;2012:648152. [PMC free article: PMC3820528] [PubMed: 24278722]

262.

van Egmond-Frohlich AW, Weghuber D, de ZM. Association of symptoms of attention-deficit/hyperactivity disorder with physical activity, media time, and food intake in children and adolescents. PLoS One. 2012;7(11):e49781. [PMC free article: PMC3498177] [PubMed: 23166770]