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Reallocating time between 24-h movement behaviors for obesity management across the lifespan : A pooled data meta-analysis of more than 9800 participants from seven countries

Gába, Aleš
; 
Hartwig, Timothy B.
; 
Jašková, Paulína
; 
Sanders, Taren
; 
Dygrýn, Jan
; 
Vencálek, Ondřej
; 
Antczak, Devan
; 
Conigrave, James
; 
Parker, Philip
; 
del Pozo Cruz, Borja
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Author
Gába, Aleš
Hartwig, Timothy B.
Jašková, Paulína
Sanders, Taren
Dygrýn, Jan
Vencálek, Ondřej
Antczak, Devan
Conigrave, James
Parker, Philip
del Pozo Cruz, Borja
Fairclough, Stuart J.
Halson, Shona
Hron, Karel
Noetel, Michael
Ávila-García, Manuel
Cabanas-Sánchez, Verónica
Cavero-Redondo, Iván
Curtis, Rachel G.
da Costa, Bruno G. G.
del Pozo-Cruz, Jesus
García-Hermoso, A.
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
Abstract
Background 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. Objective This study examines the theoretical effects of reallocating time between 24-h movement behaviors on obesity indicators across different age groups. Methods 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. Results 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/m2, 95% CI 0.47, 0.96) and older adults (0.73 kg/m2, 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/m2 (95% CI − 0.74, − 0.39) in adults and by − 0.52 kg/m2 (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. Conclusions 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.
Keywords
Date
2025
Type
Journal article
Journal
Sports Medicine
Book
Volume
55
Issue
3
Page Range
641-654
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Institute for Positive Psychology and Education
Faculty of Education and Arts
Non-faculty
Collections
Institute for Positive Psychology and Education
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URI
https://hdl.handle.net/20.500.14802/13836
Relation URI
DOI
10.1007/s40279-024-02148-4
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Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open
Notes
© The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.