Gába Aleš, Hartwig Timothy B, Jašková Paulína, Sanders Taren, Dygrýn Jan, Vencálek Ondřej, Antczak Devan, Conigrave James, Parker Phillip, Del Pozo Cruz Borja, Fairclough Stuart J, Halson Shona, Hron Karel, Noetel Michael, Ávila-García Manuel, Cabanas-Sánchez Veronica, Cavero-Redondo Iván, Curtis Rachel G, da Costa Bruno G G, Del Pozo-Cruz Jesus, García-Hermoso Antonio, Leahy Angus A, Lubans David R, Maher Carol A, Martínez-Gómez David, Meredith-Jones Kim, Redondo-Tébar Andrés, Sabia Séverine, Silva Kelly S, Skidmore Paula, Villa-González Emilio, Yerramalla Manasa S, Lonsdale Chris
Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11, Olomouc, Czech Republic.
Australian Catholic University, Strathfield, NSW, Australia.
Sports Med. 2025 Mar;55(3):641-654. doi: 10.1007/s40279-024-02148-4. Epub 2024 Dec 21.
The distribution of time across physical activity, sedentary behaviors, and sleep appears to be essential for the management of obesity. However, the impact of reallocating time among these behaviors, collectively known as 24-h movement behaviors, remains underexplored.
This study examines the theoretical effects of reallocating time between 24-h movement behaviors on obesity indicators across different age groups.
We performed a pooled data meta-analysis of 9818 participants from 11 observational and experimental studies. To estimate the time spent in movement behaviors, we reprocessed and harmonized individual-level raw accelerometer-derived data. Isotemporal substitution models estimated theoretical changes in body mass index (BMI) and waist circumference (WC) associated with time reallocation between movement behaviors. We performed the analysis separately for children, adolescents, adults, and older adults.
Even minor reallocations of 10 min led to significant changes in obesity indicators, with pronounced effects observed when 30 min were reallocated. The most substantial adverse effects on BMI and WC occurred when moderate-to-vigorous physical activity (MVPA) was reallocated to other movement behaviors. For 30-min reallocations, the largest increase in BMI (or BMI z-score for children) occurred when MVPA was reallocated to light-intensity physical activity (LPA) in children (0.26 units, 95% confidence interval [CI] 0.15, 0.37) and to sedentary behavior (SB) in adults (0.72 kg/m, 95% CI 0.47, 0.96) and older adults (0.73 kg/m, 95% CI 0.59, 0.87). The largest increase in WC was observed when MVPA was substituted with LPA in adults (2.66 cm, 95% CI 1.42, 3.90) and with SB in older adults (2.43 cm, 95% CI 2.07, 2.79). Conversely, the highest magnitude of the decrease in obesity indicators was observed when SB was substituted with MVPA. Specifically, substituting 30 min of SB with MVPA was associated with a decrease in BMI z-score by - 0.15 units (95% CI - 0.21, - 0.10) in children and lower BMI by - 0.56 kg/m (95% CI - 0.74, - 0.39) in adults and by - 0.52 kg/m (95% CI - 0.61, - 0.43) in older adults. Reallocating time away from sleep and LPA showed several significant changes but lacked a consistent pattern. While the predicted changes in obesity indicators were generally consistent across age groups, inconsistent findings were observed in adolescents, particularly for reallocations between MVPA and other behaviors.
This investigation emphasizes the crucial role of MVPA in mitigating obesity risk across the lifespan, and the benefit of substituting SB with low-intensity movement behaviors. The distinct patterns observed in adolescents suggest a need for age-specific lifestyle interventions to effectively address obesity. Emphasizing manageable shifts, such as 10-min reallocations, could have significant public health implications, promoting sustainable lifestyle changes that accommodate individuals with diverse needs, including those with severe obesity.
身体活动、久坐行为和睡眠的时间分配似乎对肥胖管理至关重要。然而，在这些统称为24小时运动行为的活动之间重新分配时间的影响仍未得到充分研究。
本研究探讨在不同年龄组中，在24小时运动行为之间重新分配时间对肥胖指标的理论影响。
我们对来自11项观察性和实验性研究的9818名参与者进行了汇总数据的荟萃分析。为了估计运动行为所花费的时间，我们对个体层面原始的加速度计数据进行了重新处理和统一。等时替代模型估计了与运动行为之间时间重新分配相关的体重指数（BMI）和腰围（WC）的理论变化。我们分别对儿童、青少年、成年人和老年人进行了分析。
即使仅10分钟的轻微时间重新分配也会导致肥胖指标的显著变化，当重新分配30分钟时，效果更为明显。当中等至剧烈身体活动（MVPA）被重新分配到其他运动行为时，对BMI和WC产生的不利影响最为显著。对于30分钟的重新分配，当MVPA被重新分配到儿童的轻度身体活动（LPA）（0.26个单位，95%置信区间[CI]0.15，0.37）以及成年人（0.72kg/m，95%CI0.47，0.96）和老年人（0.73kg/m，95%CI0.59，0.87）的久坐行为（SB）时，BMI（或儿童的BMI z评分）出现最大增幅。当MVPA被LPA替代时，成年人的WC增幅最大（2.66cm，95%CI1.42，3.90），当MVPA被SB替代时，老年人的WC增幅最大（2.43cm，95%CI2.07，2.79）。相反，当用MVPA替代SB时，肥胖指标的下降幅度最大。具体而言，用30分钟的MVPA替代SB，儿童的BMI z评分下降-0.15个单位（95%CI -0.21，-0.10），成年人的BMI下降-0.56kg/m（95%CI -0.74，-0.39），老年人的BMI下降-0.52kg/m（95%CI -0.61，-0.43）。从睡眠和LPA中重新分配时间显示出一些显著变化，但缺乏一致的模式。虽然肥胖指标的预测变化在各年龄组中总体一致，但在青少年中观察到不一致的结果，特别是在MVPA和其他行为之间的重新分配方面。
本研究强调了MVPA在降低全生命周期肥胖风险中的关键作用，以及用低强度运动行为替代SB的益处。在青少年中观察到的不同模式表明，需要针对特定年龄的生活方式干预措施来有效解决肥胖问题。强调可管理的时间转移，如10分钟的重新分配，可能对公共卫生产生重大影响，促进可持续的生活方式改变，以适应包括重度肥胖者在内的不同需求的个体。
