Physical activity (PA), sedentary behavior (SB), and sleep independently influence cardiometabolic health in youth. Because these behaviors are interdependent within a 24-hour day, compositional data Show more
Physical activity (PA), sedentary behavior (SB), and sleep independently influence cardiometabolic health in youth. Because these behaviors are interdependent within a 24-hour day, compositional data analysis has emerged as a method to examine how the distribution of time across behaviors relates to health. While evidence exists for adults and preschool-aged children, findings for school-aged youth, who are at higher risk for inactivity, remain limited. This systematic review examined associations between light PA (LPA), moderate-to-vigorous PA (MVPA), SB, and sleep and cardiometabolic health among youth aged 6 to 17 years. In May 2024, two reviewers conducted systematic searches across five databases following Cochrane criteria. Eligible studies were peer reviewed, included youth aged 6 to 17 years, and used compositional data analysis to assess cardiometabolic outcomes. Of 1,021 records screened, 10 studies met inclusion criteria, and 9 were rated moderate or high quality. MVPA, particularly vigorous PA, showed the most consistent benefits, including lower adiposity, reduced cardiometabolic risk, and higher fitness. SB was generally associated with adverse outcomes, while findings for LPA and sleep were mixed or null. Overall, evidence suggests that daily movement behavior distributions are important predictors of cardiometabolic health in youth and support movement-based public health guidance. Show less