Relationship between young peoples' sedentary behaviour and biomedical health indicators: a systematic review of prospective studies

Abstract
The aim of this systematic review was to describe the prospective relationship between childhood sedentary behaviour and health indicators. We identified prospective studies from searches in PubMed, EMBASE, PsycInfo and Cochrane, from January 1989 through April 2010. Two reviewers independently screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data. We identified 31 papers, examining 27 different cohorts. The quality score of the studies ranged from 38 to 88%. Nine studies were scored as high quality. According to the best evidence synthesis we found insufficient evidence for a longitudinal positive relationship between 'sedentary time'- mainly TV viewing - and body mass index (BMI) and more specific indicators of fat mass. One high quality and two low quality studies found a significant inverse relationship between sedentary time - mainly TV viewing - and aerobic fitness, leading to moderate evidence for this inverse relationship. There was insufficient evidence for a longitudinal relationship between sedentary time and blood pressure, blood lipids or bone mass. Our systematic review suggests that there is moderate evidence for a longitudinal inverse relationship between screen time and aerobic fitness during childhood. Thus there is evidence to limit screen time in young people in order to prevent low levels of fitness. The possible detrimental health effects of prolonged or excessive sitting on other health indicators needs further study.