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Table 1 The relationship between movement behaviours and adiposity

From: Systematic review of the relationships between combinations of movement behaviours and health indicators in the early years (0-4 years)

No. of studies Design Quality assessment No. of participants Absolute effect Quality
Risk of bias Inconsistency Indirectness Imprecision Other
Mean baseline ages ranged from 3.29-4.97 years. One study had exposure measurements as early as 6 months (no average provided) but averaged several exposure measurements over 2 years. Data were collected by clustered RCT (n = 2), non-randomized intervention (n = 1), longitudinal (n = 2), and cross-sectional (n = 3) study designs. All height-for-weight indices of adiposity were objectively measured except in one study, which did not clearly indicate how measurement occurred. Other indicators of adiposity were assessed via bioelectrical impedance, and skinfold thickness (subscapular and tricep surae).
2 Cluster RCTa Serious risk of biasb No serious inconsistency Serious indirectnessc No serious imprecision None 1245 SB + PA: The movement behaviour interventions were not associated with changes in weight-for-height indices in 2 studies [27, 28]. The movement behaviour intervention was favourably associated with body fat in 1 study [28]. LOWd
1 Non-randomized interventione Serious risk of biasf No serious inconsistency No serious indirectness No serious imprecision None 86 SB + PA: The movement behaviour intervention was favourably associated with BMI reduction in toddlers, but not in the preschool-aged sample [29]. VERY LOWg
2 Longitudinalh Serious risk of biasi No serious inconsistency Serious indirectnessj No serious imprecision Dose-response & large magnitude of an effect k 1827 SB + PA: Classification based on SB + PA variables was not associated with BMI percentile over 2 years in 1 study [30]. SLEEP + SB: High levels of sleep and low levels of TV time were favourably associated with BMI-z scores, sum of skinfold thickness, and overweight status, and not associated with skinfold thickness ratio when compared to low levels of sleep and high levels of TV time in 1 study [36]. High levels of sleep and low levels of TV time were favourably associated with BMI-z score, and not associated with sum of skinfold thickness, overweight status, and skinfold thickness ratio when compared to low levels of sleep, and low levels of TV time in 1 study [36]. High levels of sleep and low levels of TV time were not associated with BMI-z score, sum of skinfold thickness, overweight status, and skinfold thickness ratio when compared to high levels of sleep and high levels of TV time in 1 study [36]. VERY LOWl
3 Cross-sectionalm Serious risk of biasn No serious inconsistency No serious indirectness No serious imprecision None 3888 SB + PA: Children with high amounts of SB and low amounts of PA were favourably associated with obesity classification in 1 study [33] and not associated with obesity classification in 2 studies [34, 35]. VERY LOWo
  1. BMI body mass index, CI confidence interval, LPA light-intensity physical activity, MET metabolic equivalent, MVPA moderate- to vigorous-intensity activity, OR odds ratio, PA physical activity, RCT randomized controlled trial, SB sedentary behaviour, TPA total physical activity, TV television
  2. a Includes 2 cluster RCTs [27, 28]
  3. b Serious risk of bias. In 1 study, age was not adjusted for in the analysis [28]
  4. c Serious indirectness. The sedentary behaviour component of the intervention was minimal in both studies, which could have caused a risk for indirectness. However, in 1 study the intervention significantly decreased sedentary behaviour [28]. Additionally, the intervention effects on movement behaviour changes may have caused a risk for indirectness. In 1 study the intervention significantly decreased sedentary behaviour and increased LPA, but had no effect on MVPA [28]. In the other study [27], the intervention had no effect on sedentary time and TPA, while the control group showed improvements in MVPA
  5. d Quality of evidence was downgraded from “high” to “low” due to serious risk of bias and serious indirectness
  6. e Includes 1 non-randomized intervention [29]
  7. f Serious risk of bias. No control group
  8. gQuality of evidence was downgraded from “low” to “very low” due to serious risk of bias
  9. hIncludes 2 longitudinal studies [30, 36]
  10. i Serious risk of bias. Both studies used convenience sampling for recruitment. One study measured movement behaviours via questionnaire and showed no evidence of psychometric testing; additionally, the analyzed sample (n = 915) and the full recruitment cohort (n = 2128) differed on parental ethnicity, education, and household income [36]
  11. j Serious indirectness. In 1 study, the method of classifying “less active” and “more active” groups resulted in groupings that did not significantly differ on sedentary time, but did differ on various components of LPA and MVPA (i.e., bouts per day, average minutes per bout, average MET score per bout, and total minutes per day) [30]
  12. k Dose-response & large magnitude of an effect. One study [36] showed evidence of dose-response where the group with high levels of sleep and low levels of TV time saw the most benefits for adiposity; as well, this study had a large magnitude of effect (i.e., compared to high sleep and low TV group, low sleep and high TV group had increased odds of overweight status (OR = 5.93; 95% CI = 2.03, 17.30))
  13. l Quality of evidence was downgraded from “low” to “very low” due to serious risk of bias and serious risk of indirectness; because of this limitation, was not upgraded for dose-response and large magnitude of an effect
  14. m Includes 3 cross-sectional studies [33,34,35]
  15. n Serious risk of bias. All studies used subjective measurements (questionnaires) with inadequate consideration of psychometric testing. One study used convenience sampling [33]
  16. o Quality of evidence was downgraded from “low” to “very low” due to serious risk of bias