Biddle Stuart J H, García Bengoechea Enrique, Wiesner Glen
Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia.
Institute for Resilient Regions, University of Southern Queensland, Education City, 37 Sinnathamby Boulevard, Springfield Central, QLD, 4300, Australia.
Int J Behav Nutr Phys Act. 2017 Mar 28;14(1):43. doi: 10.1186/s12966-017-0497-8.
Sedentary behaviour (sitting time) has becoming a very popular topic for research and translation since early studies on TV viewing in children in the 1980s. The most studied area for sedentary behaviour health outcomes has been adiposity in young people. However, the literature is replete with inconsistencies.
We conducted a systematic review of systematic reviews and meta-analyses to provide a comprehensive analysis of evidence and state-of-the-art synthesis on whether sedentary behaviours are associated with adiposity in young people, and to what extent any association can be considered 'causal'. Searches yielded 29 systematic reviews of over 450 separate papers. We analysed results by observational (cross-sectional and longitudinal) and intervention designs.
Small associations were reported for screen time and adiposity from cross-sectional evidence, but associations were less consistent from longitudinal studies. Studies using objective accelerometer measures of sedentary behaviour yielded null associations. Most studies assessed BMI/BMI-z. Interventions to reduce sedentary behaviour produced modest effects for weight status and adiposity. Accounting for effects from sedentary behaviour reduction alone is difficult as many interventions included additional changes in behaviour, such as physical activity and dietary intake. Analysis of causality guided by the classic Bradford Hill criteria concluded that there is no evidence for a causal association between sedentary behaviour and adiposity in youth, although a small dose-response association exists.
Associations between sedentary behaviour and adiposity in children and adolescents are small to very small and there is little to no evidence that this association is causal. This remains a complex field with different exposure and outcome measures and research designs. But claims for 'clear' associations between sedentary behaviour and adiposity in youth, and certainly for causality, are premature or misguided.
自20世纪80年代对儿童看电视的早期研究以来，久坐行为（坐立时间）已成为一个非常热门的研究和转化话题。久坐行为对健康影响的研究中，最受关注的领域是年轻人的肥胖问题。然而，文献中存在诸多不一致之处。
我们对系统评价和荟萃分析进行了一项系统综述，以全面分析关于久坐行为是否与年轻人肥胖相关的证据及最新综合情况，以及这种关联在多大程度上可被视为“因果关系”。检索得到了对450多篇独立论文的29项系统综述。我们通过观察性（横断面和纵向）及干预性设计来分析结果。
横断面证据表明屏幕时间与肥胖之间存在微弱关联，但纵向研究的关联性不太一致。使用客观加速度计测量久坐行为的研究未发现关联。大多数研究评估了体重指数/体重指数z评分。减少久坐行为的干预措施对体重状况和肥胖产生了适度影响。由于许多干预措施包括行为上的其他改变，如体育活动和饮食摄入，仅考虑减少久坐行为的影响很困难。根据经典的布拉德福德·希尔标准进行的因果关系分析得出结论，尽管存在小剂量反应关联，但没有证据表明久坐行为与青少年肥胖之间存在因果关联。
儿童和青少年中久坐行为与肥胖之间的关联很小至非常小，几乎没有证据表明这种关联是因果关系。这仍然是一个复杂的领域，存在不同的暴露和结果测量方法以及研究设计。但声称久坐行为与青少年肥胖之间存在“明确”关联，尤其是因果关系，还为时过早或存在误导。
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