The aim of this systematic review was to summarize the literature on the associations between breaks in sitting time and cardiovascular health, in children and adolescents. The search was conducted using five databases (MEDLINE, SCOPUS, WEB OF SCIENCE, PSYCINFO and CINAHL) through to 01 October 2019. Due to heterogeneity of the data, meta-analyses were not possible. We screened 2577 studies, and 15 studies were included, representing 9116 participants, from six different countries. Five observational studies and four experimental studies showed associations between breaks in sitting time and cardiovascular health, i.e. an increased number of breaks in sitting time was negatively associated with a cardiovascular health outcome. No associations between number of breaks in sitting time and cardiovascular health outcomes were found in the six remaining studies. Studies examining associations between breaks in sitting time and cardiovascular health in children have shown some favorable associations. More epidemiological evidence is required, to inform lifestyle interventions and public health policies, which could translate into long-term implications on population health.
- M.S. Tremblay, S. Aubert, J.D. Barnes, T.J. Saunders, V. Carson, A.E. Latimer-Cheung et al. Sedentary Behavior Research Network (SBRN)–Terminology Consensus Project process and outcome, International Journal of Behavioral Nutrition and Physical Activity, 14 (2017) 75.
- WHO. Global Status Report on Noncommunicable Diseases 2014: World Health Organization2014.
- W. Bao, S.A. Threefoot, S.R. Srinivasan, G.S. Berenson, Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study, American Journal of Hypertension, 8 (1995) 657-65.
- X. Chen, Y. Wang, Tracking of blood pressure from childhood to adulthood: a systematic review and meta–regression analysis, Circulation,117 (2008) 3171-3180.
- V.J. Poitras, C.E. Gray, X. Janssen, S. Aubert, V. Carson, G. Faulkner, G.S. Goldfield, J.J. Reilly , M. Sampson , M.S. Tremblay, Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0–4 years), BMC Public Health, 17 (2017) 868.
- V. Carson, S. Hunter, N. Kuzik, C.E. Gray, V.J. Poitras, J.P Chaput, T.J. Saunders, P.T. Katzmarzyk, A.D. Okely, S. Connor Gorber, M.E. Kho, M. Sampson, H. Lee, M.S. Tremblay, Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update, Applied Physiology, Nutrition, and Metabolism, 41 (2016) S240- S65.
- A.D. Okely, D. Ghersi, K.D. Hesketh, R. Santos, S.P. Loughran, D.P. Cliff, T. Shilton, D. Grant, R.A. Jones, R.M. Stanley, J. Sherring, T. Hinkley, S.G. Trost, C. McHugh, S. Eckermann, K. Thorpe, K. Waters, T.S. Olds, T. Mackey, R. Livingstone, H. Christian, H. Carr, A. Verrender, J.R. Pereira, Z. Zhang, K.L. Downing, M.S. Tremblay, A collaborative approach to adopting/adapting guidelinesThe Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep, BMC Public Health, 17 (2017) 869.
- M.S. Tremblay, J-P. Chaput, K.B. Adamo, S. Aubert, J.D. Barnes, L. Choquette, M. Duggan, G. Faulkner, G.S. Goldfield, C.E. Gray, R. Gruber, K. Janson, I. Janssen, X. Janssen, A. Jaramillo Garcia, N. Kuzik, C. LeBlanc, J. MacLean, A.D. Okely, V.J. Poitras, M.E. Rayner, J.J. Reilly, M. Sampson, J.C. Spence, B.W. Timmons, V. Carson, Canadian 24-Hour Movement Guidelines for the Early Years (0– 4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep, BMC Public Health, 17 (2017) 874.
- D.W. Dunstan, B.A. Kingwell, R. Larsen, G.N. Healy, E. Cerin, M.T. Hamilton, J.E. Shaw, D.A. Bertovic, P.Z. Zimmet, J. Salmon, N. Owen, Breaking up prolonged sitting reduces postprandial glucose and insulin responses, Diabetes Care, 35 (2012) 976-83.
- N .Gupta, M. Heiden, M. Aadahl, M. Korshøj, M.B. Jørgensen, A. Holtermann, What is the effect on obesity indicators from replacing prolonged sedentary time with brief sedentary bouts, standing and different types of physical activity during working days? A cross-sectional accelerometer-based study among blue-collar workers, PLoS One, 11 (2016) e0154935.
- G.N. Healy, D.W. Dunstan, J. Salmon, E. Cerin, J.E. Shaw, P.Z. Zimmet, N. Owen, Breaks in sedentary time: beneficial associations with metabolic risk, Diabetes Care, 31 (2008) 661- 666.
- G.N. Healy, C.E. Matthews, D.W. Dunstan, E.A. Winkler, N. Owen, Sedentary time and cardiometabolic biomarkers in US adults: NHANES 2003–06, European Heart Journal, 32 (2011) 590-597.
- P.T. Katzmarzyk, Standing and mortality in a prospective cohort of Canadian adults, Medicine & Science in Sports & Exercise, 46 (2014) 940-946.
- D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, Annals of Internal Medicine, 151 (2009) 264-269.
- C. Schardt, M.B. Adams, T. Owens, S. Keitz, P. Fontelo, Utilization of the PICO framework to improve searching PubMed for clinical questions, BMC Medical Informatics and Decision Making, 7 (2007) 1.
- G.H. Guyatt, A.D. Oxman, H.J. Schünemann, P. Tugwell, A. Knottnerus, GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology, Journal of Clinical Epidemiology, 64 (2011) 380-382.
- G.H. Guyatt, A.D. Oxman, G. Vist, R. Kunz, J. Brozek, P. Alonso-Coello, V. Montori , E.A. Akl , B. Djulbegovic , Y. Falck-Ytter , S.L. Norris , J.W. Jr Williams , D. Atkins , J. Meerpohl , H.J. Schünemann, GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias), Journal of Clinical Epidemiology, 64 (2011) 407-415.
- T.J. Saunders, J-P. Chaput, G.S. Goldfield, R.C. Colley, G.P. Kenny, E. Doucet, M.S. Tremblay, Prolonged sitting and markers of cardiometabolic disease risk in children and youth: a randomized crossover study, Metabolism, 62(2013) 1423-1428.
- Saunders TJ, Tremblay MS, Mathieu M-È, Henderson M, O’Loughlin J, Tremblay A et al. Associations of sedentary behavior, sedentary bouts and breaks in sedentary time with cardiometabolic risk in children with a family history of obesity, PLoS One, 8 (2013) e79143.
- R.C. Colley, D. Garriguet, I. Janssen, S.L. Wong, T.J. Saunders, V. Carson, M.S. Tremblay, The association between accelerometermeasured patterns of sedentary time and health risk in children and youth: results from the Canadian Health Measures Survey, BMC Public Health, 13 (2013) 200.
- V. Carson, M. Stone, G. Faulkner, Patterns of Sedentary Behavior and Weight Status Among Children, Pediatric Exercise Science, 26 (2014) 95-102.
- T.J. Saunders, J-P. Chaput, G.S. Goldfield, R.C. Colley, G.P. Kenny, E. Doucet, M.S. Tremblay, Children and youth do not compensate for an imposed bout of prolonged sitting by reducing subsequent food intake or increasing physical activity levels: a randomised cross-over study, The British Journal of Nutrition, 111 (2014) 747-754.
- L. Gabel, N.D. Ridgers, P.A. Della Gatta, L. Arundell, E. Cerin, S. Robinson, R.M. Daly, D.W. Dunstan, J. Salmon, Associations of sedentary time patterns and TV viewing time with inflammatory and endothelial function biomarkers in children, Pediatric Obesity, 11 (2016) 194-201.
- A.M. Contardo-Ayala, J. Salmon, A. Timperio, B. Sudholz, N.D. Ridgers, P. Sethi, D.W. Dunstan, Impact of an 8-Month Trial Using Height-Adjustable Desks on Children's Classroom Sitting Patterns and Markers of Cardio-Metabolic and Musculoskeletal Health, International Journal of Environmental Research and Public Health, 13 (2016).
- A.M. Contardo-Ayala, B. Sudholz, J. Salmon, D.W. Dunstan, N.D. Ridgers, L. Arundell, A. Timperio, The impact of height-adjustable desks and prompts to break-up classroom sitting on adolescents' energy expenditure, adiposity markers and perceived musculoskeletal discomfort, PLoS One, 13 (2018).
- E. Sousa-Sá, J.R. Pereira, Z. Zhang, S.L.C. Veldman, A.D. Okely, R. Santos, Association between breaks in sitting time and adiposity in Australian toddlers: Results from the GETUP! Study, Scandinavian Journal of Medicine & Science in Sports, 29 (2019) 259-265.
- V. Carson, I. Janssen, Volume, patterns, and types of sedentary behavior and cardiometabolic health in children and adolescents: a cross-sectional study, BMC Public Health, 11 (2011) 274.
- B.R. Belcher, D. Berrigan, A. Papachristopoulou, S.M. Brady, S.B. Bernstein, R.J. Brychta, J.D. Hattenbach, Tigner IL Jr, A.B. Courville, B.E. Drinkard, K.P. Smith, D.R. Rosing, P.L. Wolters, Chen KY, J.A. Yanovski, Effects of Interrupting Children's Sedentary Behaviors With Activity on Metabolic Function: A Randomized Trial, The Journal Of Clinical Endocrinology And Metabolism, 100 (2015) 3735-3743.
- M.M. Broadney, B.R. Belcher, D.A. Berrigan, R.J. Brychta, I.L. Tigner, F. Shareef, A. Papachristopoulou, J.D. Hattenbach, E.K. Davis, S.M. Brady, S.B. Bernstein, A.B. Courville, B.E. Drinkard, K.P. Smith, D.R. Rosing, P.L. Wolters, K.Y. Chen, J.A. Yanovski, Effects of interrupting sedentary behavior with short bouts of moderate physical activity on glucose tolerance in children with overweight and obesity: A randomized crossover trial, Diabetes Care, 41 (2018) 2220-2228.
- D.P. Bailey, S.J. Charman, T. Ploetz, L.A. Savory, C.J. Kerr, Associations between prolonged sedentary time and breaks in sedentary time with cardiometabolic risk in 10–14-year-old children: The HAPPY study, Journal of Sports Sciences, 35 (2017) 2164- 2171.
- K.P. Dowd, D.M. Harrington, A. Hannigan, A.E. Donnelly, Light-Intensity Physical Activity Is Associated with Adiposity in Adolescent Females, Medicine & Science in Sports & Exercise, 46 (2014) 2295-300.
- P.B. Júdice, A.M. Silva, J. Berria, E.L. Petroski, U. Ekelund, L.B. Sardinha, Sedentary patterns, physical activity and health-related physical fitness in youth: a cross-sectional study, International Journal of Behavioral Nutrition & Physical Activity, 14 (2017) 1-10.
- S.G. Trost, B.S. Fees, S.J. Haar, A.D. Murray, L.K. Crowe, Identification and validity of accelerometer cut ? points for toddlers, Obesity, 20 (11) 2317-2319.
- E. Johansson, L-M. Larisch, C. Marcus, M. Hagströmer, Calibration and validation of a wrist-and hip-worn ActiGraph accelerometer in 4-year-old children, PLoS One,11 (2016) e0162436.
- X. Janssen, D.P. Cliff, J.J. Reilly, T. Hinkley, R.A. Jones, M. Batterham,U. Ekelund, S. Brage, A.D. Okely, Validation of activPAL defined sedentary time and breaks in sedentary time in 4-to 6-year-olds, Pediatric Exercise Science, 26 (2014) 110-117.
- T. Altenburg, M. De Niet, M. Verloigne, I. De Bourdeaudhuij, O. Androutsos, Y. Manios, E. Kovacs, B. Bringolf-Isler, J. Brug, M. Chinapaw, Occurrence and duration of various operational definitions of sedentary bouts and cross-sectional associations with cardiometabolic health indicators: the ENERGY-project, Preventive Medicine, 71 (2015) 101-106.
- N. Cavill, S. Biddle, J.F. Sallis, Health enhancing physical activity for young people: Statement of the United Kingdom Expert Consensus Conference, Pediatric Exercise Science, 13 (2001) 12-25.
- M.S. Tremblay, R.C. Colley, T.J. Saunders, G.N. Healy, N. Owen, Physiological and health implications of a sedentary lifestyle, Applied Physiology, Nutrition, and Metabolism, 35 (2010) 725-740.
- S.F. Chastin, J. Palarea-Albaladejo, M.L. Dontje, D.A. Skelton, Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach, PLoS One,10 (2015) e0139984.