Abstract
Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.
Highlights
Physical activity (PA) is vital to the physical, psychological/ social, and cognitive health of school-aged children and youth (Janssen and LeBlanc 2010; Tremblay et al 2010b)
The current Canadian guidelines are based on a systematic review of the relationships between PA and health indicators in school-aged children and youth, which supported the importance of moderate- to vigorous-intensity physical activity (MVPA) (Janssen and LeBlanc 2010; Tremblay et al 2010b, 2011)
While the significance of MVPA cannot be overstated, this research and messaging approach has resulted in a narrow focus on 1 h of the 24-h period (
Summary
Physical activity (PA) is vital to the physical, psychological/ social, and cognitive health of school-aged children and youth (Janssen and LeBlanc 2010; Tremblay et al 2010b). This research gap may be due to the historical focus on MVPA (Tremblay et al 2010a; Marshall and Ramirez 2011) and the widespread use of subjective assessments of PA (Reilly et al 2008; Adamo et al 2009; Janssen and LeBlanc 2010; Trost et al 2011), which cannot accurately capture LPA (e.g., various incidental activities accumulated throughout the day) (Hamilton et al 2004; Tremblay et al 2007). This is unfortunate, as studies from Canada and the United States indicate that children and youth spend ϳ4–6 h/day in LPA (Matthews et al 2008; Troiano et al 2008; Colley et al 2011; Chaput et al 2014), and emerging research suggests that spending more waking hours in LPA compared with sedentary pursuits may provide some health benefits (Hamilton et al 2004; Tremblay et al 2007, 2010a; Spittaels et al 2012)
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