Sedentary behavior and sleep for children and adolescents with obesity: A systematic review

Sedentary behavior and inadequate sleep are well-known lifestyle determinants of obesity that are linked to poor health outcomes, including into adulthood. This systematic review aims to synthesize evidence on how sedentary behavior (different durations, frequencies, patterns, or types) and improved sleep and/or sleep hygiene are related to improved health and functioning and reduced obesity-associated disability for the integrated management of obesity. We systematically searched electronic databases and trial registries for randomized trials and prospective cohort studies published between 2012 and 2023. The searches yielded 8990 records, 95 of which were read in full text by independent reviewers. No completed studies met the selection criteria. Only one ongoing study will likely meet the review's selection criteria, but data collection has not yet been completed. The lack of participants with obesity at baseline was the most common exclusion reason (51 studies, 53%), followed by ineligible exposures (12 studies, 12%) like dietary counseling or parenting interventions. As randomized trials and prospective cohort studies concerning sedentary behavior or sleep in children and adolescents have traditionally focused on the primary prevention of obesity, future research should include children and adolescents with obesity and present subgroup analyses for different degrees of obesity and comorbidities.