Authors
Anders Husøy, Knut Eirik Dalene, Bjørge H Hansen, Lauren B Sherar, Esther van Sluijs, Sigmund A Anderssen, Jostein Steene-Johannessen, Anna Bugge, Camilla T Damsgaard, Niels Wedderkopp, Geir K Resaland, Eva Corpeleijn, Lu Yang, Antje Hebestreit, Christoph Buck, Fabio Lauria, Toomas Veidebaum, Charalambos Hadjigeorgiou, Stefaan De Henauw, Lauren Lissner, Dénes Molnár, Luis A Moreno, Mélanie Henderson, Marie-Eve Mathieu, Soren Harnois-Leblanc, Jo Salmon, Simone J J M Verswijveren, Jose Castro-Piñero, Oscar L Veiga, Kate Northstone, Niels C Møller, Peter Lund Kristensen, Luís B Sardinha, Susi Kriemler, Pedro C Hallal, Inácio Crochemore-Silva, Ulf Ekelund, Jakob Tarp, International Children’s Accelerometry Database (ICAD) Collaborators
Published in
JAMA pediatrics. Oct 06, 2026. Epub Oct 06, 2026.
Abstract
The evidence for benefits of higher physical activity and lower sedentary time on the cardiometabolic risk profile in youth is based on cross-sectional and small prospective studies.
To determine the prospective associations between device-measured physical activity and sedentary time with later cardiometabolic risk profiles in youth.
The International Children's Accelerometry Database and cohorts identified from a systematic literature search (final search performed December 2024).
Studies measured physical activity and sedentary time with an accelerometer at baseline and had prospective data on at least 1 cardiometabolic risk marker.
Individual participant data were transferred to a secure network, harmonized, and analyzed as a single dataset using mixed linear regression models with different statistical adjustment based on directed acyclic graphs. Effect sizes are β coefficients per SD exposure increment.
Body mass index (BMI); insulin, glucose, low-density lipoprotein (LDL) cholesterol, and triglyceride levels; and systolic blood pressure, analyzed individually and as composite scores.
Of 5432 records screened, 12 relevant studies were identified, of which 8 provided individual participant data. Fourteen cohorts (12 874 participants; mean [range] age, 10.4 [5.0-17.9] years; 6577 female [52%]) with a mean (SD) follow-up of 3.1 (2.0) years were included. Moderate to vigorous physical activity (per SD, 26 minutes/day) was inversely associated with insulin (-0.24 µIU/mL; 95% CI, -0.38 to -0.10 µIU/mL), LDL cholesterol level (-1.54 mg/dL; 95% CI, -1.93 to -0.77 mg/dL), triglyceride level (-1.77 mg/dL, 95% CI, -2.65 to -0.88 mg/dL), and the composite risk scores (-0.04; 95% CI, -0.06 to -0.02). However, moderate to vigorous physical activity was not associated with BMI (0.00; 95% CI, -0.005 to 0.005) and associated with a higher systolic blood pressure (0.25 mm Hg; 95% CI, 0.04-0.46 mm Hg). Associations for vigorous intensity activity were similar, except that there was no association with systolic blood pressure. Higher sedentary time was not associated with a worse cardiometabolic profile but was associated with lower blood glucose concentration (-0.36 mg/dL; 95% CI, -0.72 to 0 mg/dL) and lower systolic blood pressure (-0.90 mm Hg; 95% CI, -1.22 to -0.58 mm Hg). The magnitude and direction of associations were modified by modeling approach, sex, BMI, age, and follow-up time.
Results of this harmonized individual participant data meta-analysis suggest that physical activity of moderate and vigorous intensity was beneficially associated with some cardiometabolic risk markers during childhood and adolescence. However, associations were weak, sensitive to the modeling approach, and heterogeneous across subgroups. Sedentary time is unlikely an important determinant of cardiometabolic risk in youth.
PMID:
42837607
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.
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