Adil Shanaz, Gordon Morris, Hathagoda Wathsala, Kuruppu Chandrani, Benninga Marc A, Rajindrajith Shaman
Pediatrics, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.
University of Central Lancashire, Preston, UK
BMJ Paediatr Open. 2024 Dec 5;8(1):e003069. doi: 10.1136/bmjpo-2024-003069.
Lack of physical activity (PA) and sedentary behaviour (SB) have emerged as critical global health concerns in children and are believed to be associated with functional constipation (FC). The present study aims to explore this potential association.
A comprehensive search of PubMed, Scopus, Web of Science, Embase, Cochrane Library and PsycInfo databases was conducted through 2023 using terms related to constipation and PA and SB in ages 0-18 years. Titles and abstracts were screened against eligibility criteria. Constipation was diagnosed using Rome (II-IV) criteria. Full-text reviews were reviewed, and data were extracted. Risk of Bias in Non-randomized Follow-up Studies of Exposure quality assessment tool was used to evaluate the risk of bias of studies.
We assessed the association between lack of PA/SB and FC.
A total of 2170 titles were screened. Nine studies encompassing 3849 children from six countries were included. Of these, four were community/school-based studies, one was a birth cohort, three were case series and two were hospital-based case-controlled studies. All 10 studies assessed the association between PA and FC. Only three showed an association between lack of PA and FC. Five studies evaluated the effects of SB on FC, and only two reported a positive association. The methods used to assess PA/SB differed across the studies. All nine studies included in the systematic review were rated as having high risk of bias.
Despite numerous studies suggesting a link between insufficient PA/SB and FC, this systematic review did not uncover compelling evidence supporting such an association.
缺乏身体活动（PA）和久坐行为（SB）已成为全球儿童健康的关键问题，并且被认为与功能性便秘（FC）有关。本研究旨在探讨这种潜在关联。
通过在2023年对PubMed、Scopus、Web of Science、Embase、Cochrane图书馆和PsycInfo数据库进行全面检索，使用与0至18岁儿童便秘、PA和SB相关的术语。根据纳入标准筛选标题和摘要。使用罗马（II-IV）标准诊断便秘。进行全文综述并提取数据。采用非随机暴露随访研究中的偏倚风险质量评估工具来评估研究的偏倚风险。
我们评估了PA/SB缺乏与FC之间的关联。
共筛选了2170个标题。纳入了9项研究，涵盖来自6个国家的3849名儿童。其中，4项是基于社区/学校的研究，1项是出生队列研究，3项是病例系列研究，2项是基于医院的病例对照研究。所有10项研究均评估了PA与FC之间的关联。只有3项研究显示PA缺乏与FC之间存在关联。5项研究评估了SB对FC的影响，只有2项报告了正相关。各研究中评估PA/SB的方法不同。纳入系统评价的所有9项研究均被评为具有高偏倚风险。
尽管众多研究表明PA/SB不足与FC之间存在联系，但本系统评价未发现支持这种关联的令人信服的证据。
