No. of participants (No. of studies) | Design | Quality assessment | Absolute effect | Quality | ||||
---|---|---|---|---|---|---|---|---|
Risk of bias | Inconsistency | Indirectness | Imprecision | Other | ||||
The range of mean ages at time of exposure measurement was ~0.75 to 4.95 years; the oldest mean age at follow-up was 15.5 years. Data were collected by randomized trial, case-control, cross-sectionally, and up to 12 years of follow-up. Adiposity measures were: BMI (absolute, z-score, SD score, percentile); fat mass index, lean mass index, trunk fat mass index; % body fat (measured using DXA); skinfold ratio (triceps skinfold thickness to subscapular skinfold thickness); sum of skinfolds; waist-to-height ratio; waist-to-hip ratio; weight-for-height (z-score); weight-for-age (z-score); waist circumference (absolute, z-score for age); weight status (CDC, IOTF, or WHO cut-points; Flemish reference data; French reference standards; Rolland Cachera reference curves; United Kingdom reference standards in 1999); total fat mass (SD score); lean mass (SD score). | ||||||||
412 (1) | Randomized triala | Serious risk of biasb | No serious inconsistency | No serious indirectness | No serious imprecision | None | Screen time c was significantly lower in the intervention vs control group at 2, 6, and 9 months post-interventiond. BMI z-scores were not different between the intervention and control groups at baseline or 9-month follow-up, but BMI z-scores increased in both groups [34]. | Moderatee |
32,699 (13) | Longitudinalf | Serious risk of biasg | No serious inconsistency | No serious indirectness | No serious imprecision | None | Screen-based sedentary behaviours: Computer (duration): 1/1 studies reported null associations [85] Computer games (frequency): 1/1 studies reported null associations [82] Screen time (duration): 2/3 studies reported unfavourable associations [33, 84] 1/3 studies reported null associations [87] TV time (duration): 6/10 studies reported unfavourable associations [33, 54, 81, 83, 88, 90] 1/10 studies reported null associations [86] 3/10 studies reported mixed unfavourable and null associations [82, 85, 89] Watching DVDs (duration): 1/1 studies reported unfavourable associations [83] Other sedentary behaviours: Time in baby seats (duration): 1/1 studies reported mixed unfavourable, null, and favourable associations [45] Time in the car (duration): | Very lowh |
1242 (2) | Case-controli | Serious risk of biasj | No serious inconsistency | No serious indirectness | No serious imprecision | None | TV time [35, 36] and total sedentary time [36] were not different between children with overweight/obese (case group) or normal weight (control group) status, but watching TV for ≥ 1 h/day was unfavourably associated with having overweight status (OR = 1.71, 95% CI: 1.07, 2.75, p = 0.02) [35]. | Very lowk |
94,191 (47) | Cross-sectionall | Serious risk of biasm | No serious inconsistency | No serious indirectness | No serious imprecision | None | Objectively measured sedentary time: Sedentary time 30-min bouts (accelerometer derived): 1/1 studies reported null associations [40] Total sedentary time (accelerometer-derived): 10/11 studies reported null associations [37–40, 47, 53, 60, 75, 78, 80] 1/11 studies reported mixed unfavourable and null associations [77] Screen-based sedentary behaviours: Computer (duration): 3/4 studies reported null associations [63, 67, 79] 1/4 studies reported mixed unfavourable and null associations [71] Screen time (duration): 6/18 studies reported unfavourable associations [32, 33, 46, 50, 59, 73] 10/18 studies reported null associations [44, 52, 57, 58, 62, 64, 65, 71, 72, 79] 2/18 studies reported mixed unfavourable and null associations [41, 61] TV time (duration): 5/23 studies reported unfavourable associations [33, 55, 66, 67, 71] 11/23 studies reported null associations [31, 42, 43, 49, 50, 56, 60, 63, 69, 75, 76] 5/23 studies reported mixed unfavourable and null associations [48, 51, 54, 68, 79] 1/23 studies reported mixed null and favourable associations [74] 1/23 studies reported mixed unfavourable, null, and favourable associations [70] Using the internet (duration): 1/1 studies reported null associations [69] Video games (duration): 1/1 studies reported unfavourable associations [69] Watching DVDs/videos (duration): 1/1 studies reported null associations [69] Other sedentary behaviours: Sedentary quiet play (duration): 1/1 studies reported mixed unfavourable and null associations [79] Time in baby seats (duration): 1/1 studies reported null associations [45] Using books (duration): 1/1 studies reported null associations [69] | Very lown |